Prospective study of association of characteristics of hotline psychological intervention in 778 high-risk callers with subsequent suicidal act

Abstract

Objectives: This study aimed to assess the association of the quality scores of hotline psychological intervention and the reduction of subsequent suicidal acts among high suicidal risk callers. Methods: High-risk callers at a national crisis hotline service in China were recruited and prospectively followed for up to 3 months after receiving a hotline psychological intervention. The quality of the intervention was evaluated by supervisors who listened to the tape-recorded calls using the Counseling Skills Rating Scale for Psychological Support Hotlines, which assessed three counseling domains: process, attitude and communication skill. The primary outcome was the occurrence of suicidal acts during the follow-up period. Secondary outcomes were before versus after changes during the intake intervention call in hopefulness, psychological stress and suicide intention reported by the callers. Results: Over the 3-month follow-up, 45 of 778 high-risk callers reported 61 suicide attempts, and 3 other callers died by suicide. Subsequent suicidal act was significantly more common in callers classified as being at higher risk during the intake call. Higher scores on the quality of suicidality assessing of the Counseling Skills Rating Scale for Psychological Support Hotlines were associated with reduced risk of suicidal acts during follow-up (hazard ratio = 0.38, 95% confidence interval = [0.18, 0.85]). Higher scores on the communication skill domain were associated with increases in hopefulness (β = 0.09) after the intervention, and higher scores on the counseling process domain (β = −0.12) and higher suicidal risk scores (β = −0.12) were associated with decreased suicide intention after intervention. Conclusion: Several characteristics of a hotline intervention for suicide prevention were associated with decreased risk of suicidal acts during follow-up. Intervention skill training for hotline operators should emphasize these specific counseling skills.

Suicide attempt risks among hotline callers with and without the coronavirus disease 2019 related psychological distress: a case-control study

“…The training covered basic knowledge, information, policy, and facts about COVID-19, response to caller’s concerns and development of rapport with callers, providing emotional relief, problem identification, collaborative discussion, problem-solving skills, and crisis intervention for high suicidal risk callers. The intervention and training for callers was described in a recent study [ 23 ].…”

“…Hopefulness and psychological distress were assessed by asking callers questions of “To what extent do you feel hopeful” and “To what extent do you feel psychological distress?” on scales from 0 to 100 (with higher scores indicating more hopeful and more distressed, respectively) using a validated procedure [ 23 ]. In the present study, the continuous scores of hopefulness and psychological distress were also converted into tertiles, i.e., hopeless (0), moderate hopeful (1–44) and high hopeful (45–100), and low stress (0–73), moderate stress (74–90) and severe stress (91–100).…”

Comparisons of Characteristics Between Psychological Support Hotline Callers With and Without COVID-19 Related Psychological Problems in China

“…To mitigate the psychological disturbance and possible psychological damage to the public, various forms of professional psychological crisis intervention services have been delivered in China ( 5 ). Our psychological support hotline, an online mental health service, provides real-time interactive psychological support, guidance, and crisis intervention remotely to different groups of people ( 6 , 7 ). During the pandemic, the Beijing Psychological Support Hotline (BPSH) provides 24/7 COVID-19 related psychological counseling services to Mandarin-speaking Chinese globally.…”

Mental health problems among hotline callers during the early stage of COVID-19 pandemic

“…Psychological distress was assessed by asking callers “To what extent do you feel psychological distressed?”. Callers were instructed that a score of 0 means completely no psychological distress and 100 means feeling completely distressed ( Tong et al, 2020 ). Hopefulness was assessed by asking callers “To what extent do you feel hopeful?”.…”

“…Hopefulness was assessed by asking callers “To what extent do you feel hopeful?”. Callers were instructed that a score of 0 means absolutely hopeless and 100 means completely hopeful ( Tong et al, 2020 ).…”