Adolescents’ Engagement with Crisis Hotline Risk‐management Services: A Report from the Emergency Department Screen for Teen Suicide Risk (ED‐STARS) Study

Abstract

Objective This study examines the feasibility of a risk‐management protocol for adolescent research participants at risk for suicide that relies on engagement with telephone crisis counselors. The study also examines whether engagement is moderated by adolescent demographics and clinical characteristics. Method Participants were 234 adolescents (83% female; 63% White) ages 12–18 (M = 15.3 years) drawn from the national study, Emergency Department Screen for Teens at Risk for Suicide (ED‐STARS) Study One sample of adolescents randomized for 3‐month telephone follow‐up (n = 2,850). This study's sample was comprised of adolescents who completed the follow‐up (69% retention), met study risk criteria, and were transferred to a crisis hotline for risk management. Engagement with a counselor was assessed by successful call connection, call duration, and information sharing. Results Ninety‐four percent of calls resulted in a successful call transfer, and the majority of youth (84%) shared information with counselor about one or more coping strategies. Average call length was 12.6 min (SD = 9.9). Engagement did not vary by gender, race, age, ethnicity, or clinical characteristics. Conclusions Adolescents’ engagement with telephone risk‐management services was strong, suggesting that this strategy can address safety. Further, findings suggest telephone risk‐management services effectively engage youth across demographic and clinical subgroups.

Core components and strategies for suicide and risk management protocols in mental health research: a scoping review

“…Other examples of written materials included: a suicide referral card [32], an information card with mental health resources [36], and a list of referral information or a referral document [35,51]. 3.2: Immediate support services: Several documents (see Table 1) recommended including information on immediate support services for research participants who may be in acute distress or require urgent mental health interventions [1,2,14,34,40,43,44,46,47,49,50,52,53]. Immediate mental health support services endorsed by research staff included the use of a 24-h help-crisis line [52] and directing those in crisis to a URL link that consists of relevant resources [47].…”

“…4.2: Identification of risk level: Luxton et al [42] highlight that suicide risk levels are dynamic and change frequently. Thus, as highlighted in 12 documents [3,30,34,36,37,39,42,44,47,50,51,54] risk assessment needs to be an ongoing process during research assessments. Three of the documents focused on assessing and allocating established levels of risk to research participants [30,42].…”

“…Furthermore, Wilson and Christensen [54] recommended that assessing suicide risk should include evaluating the frequency and intensity of suicidal ideation, whether the participant has formulated a plan for harming themselves, and their perception of intention to self-harm. Research studies that incorporated telephone interviews, established a set of a pre-identified risk triggers and treatment session checklists to determine participants' level of risk [42,50]. 4.3: Utilization and scoring of validated risk assessment measures: In total, 11 documents utilized the administration and scoring of a validated risk assessment measure to assess for the presence of mental health conditions (e.g.…”

“…4.3: Utilization and scoring of validated risk assessment measures: In total, 11 documents utilized the administration and scoring of a validated risk assessment measure to assess for the presence of mental health conditions (e.g. depression), suicidal ideation or self-harm behaviours associated with increased risk of suicide attempts and death by suicide [14,30,32,33,35,37,43,46,50,52,55]. The results of these measures provide research staff with another level of information needed to respond.…”

Socio-affective program to reduce the risk of suicide in adolescents

“…En Colombia, Feria (2015) diseñó estrategias de desarrollo socio-afectivo en el manejo de emociones como factor protector en adolescentes de 12 a 19 años, concluyendo que los adolescentes presentan un alto índice de emociones negativas como la tristeza, culpa, miedo, reflejada estas en la mala relación con su entorno familiar y escolar, también identificó que la gran mayoría de estudiantes experimentan emociones negativas, donde su principal causa proviene de los hogares representados con falta de afectividad, familias disfuncionales y la falta de dialogo. Busby et al (2020) refieren que el adolescente participa activamente en las entrevistas telefónicas de seguimiento cuando fueron referidos para estos servicios. Estos hallazgos apoyan la recomendación que las líneas directas de crisis pueden desempeñar un papel integral en la gestión de riesgos de los jóvenes participantes en alto riesgo de suicidio.…”