The Effectiveness of Crisis Line Services: A Systematic Review

Abstract

Background: Crisis lines are a standard component of a public health approach to suicide prevention. Clinical aims include reducing individuals' crisis states, psychological distress, and risk of suicide. Efforts may also include enhancing access and facilitating connections to behavioral health care. This review examines models of crisis line services for demonstrated effectiveness.Methods: Literature searches of Medline, EMBASE, PsycINFO, Web of Science, CINAHL, Cochrane Library, and Google Scholar were conducted from January 1, 1990, to May 7, 2018. Experts were contacted, and references were mined for additional studies. Eligible studies provided health-or utilization-related effectiveness outcome(s). Results were graded according to the Oxford Centre for Evidence-Based Medicine and evaluated for risk of bias using the Effective Public Health Practice Project quality assessment tool for quantitative studies.Results: Thirty-three studies yielded effectiveness outcomes. In most cases findings regarding crisis calls vs. other modalities were presented. Evaluation approaches included user-and helper-reported data, silent monitoring, and analyses of administrative records. About half of studies reported immediate proximal outcomes (during the crisis service), and the remaining reported distal outcomes (up to four years post-contact). Most studies were rated at Oxford level four evidence and 80% were assessed at high risk of bias.Conclusions: High quality evidence demonstrating crisis line effectiveness is lacking. Moreover, most approaches to demonstrating impact only measured proximal outcomes. Research should focus on innovative strategies to assess proximal and distal outcomes, with a specific focus on behavioral health treatment engagement and future selfdirected violence.

Posttraumatic Stress Disorder, Suicidal Ideation, and Suicidal Self-Directed Violence Among U.S. Military Personnel and Veterans: A Systematic Review of the Literature From 2010 to 2018

“…References were then exported into Covidence review software. Review of studies for inclusion was based on previously-used systematic review frameworks, including those used by the study team (Hoffberg et al, 2020 ).…”

“…Study design was assessed independently (KSY, ASH), with conflicts resolved by a third author (RH). Each of these authors had prior experience conducting systematic reviews or meta-analyses (Bahraini et al, 2013 ; Hoffberg et al, 2018 , 2020 ; Holliday et al, 2018a ; Creech et al, 2019 ).…”

“…Risk of bias was evaluated independently by KSY and ASH, with discrepancies discussed among KSY, ASH, and RH until achieving consensus. Both KSY and ASH had prior experience evaluating risk of bias in prior systematic reviews (e.g., Hoffberg et al, 2018 , 2020 ).…”

Living Conditions of Adolescents Who Have Attempted Suicide in Mexico

“…Likewise, considering the low use of health services by adolescents, who have been reported to have attempted suicide by Borges [ 31 ], the need to strengthen the processes to identify adolescents at risk (due to risk factors or previous attempts) was revealed, this must be done by developing synergy not only with schools, but also with other meeting places, and using programs such as national or local emergency telephone lines (911). All these strategies require having an attention and follow up protocol that guarantees that the adolescent receives all the required attention, otherwise, the effectiveness of the strategy cannot be proven [ 32 ].…”

Les comorbidités somatiques et psychiatriques peuvent-elles expliquer l’excès de mortalité par suicide dans certaines catégories professionnelles en Suisse ?

“…On peut ainsi se demander si la mise en place de ces hotlines n'a pas ré pondu aux besoins des responsables politiques et des intervenants plus qu'à ceux de la population. À cet é gard, la litté rature sur les hotlines laisse voir la forte motivation des personnes engagé es [2] et les possibles effets bé né fiques d'un tel engagement [15], mais les donné es sur les appelants et les bé né fices pour eux sont plus rares [10]. L'intuition clinique de l'utilité du soutien psychologique par té lé phone existe dans de nombreux domaines, mais la litté rature empirique à ce propos est quasiment inexistante, et les bé né fices directs pour les usagers sont difficiles à dé montrer [10].…”