Therapeutic management of chronic callers to a suicide prevention center

Abstract

An attempt was made to discover an effective therapeutic technique for dealing with an individual who calls a suicide prevention center a large number of times (the chronic caller). There were two objectives to such a technique: (1) to reduce the frequency of calls made by chronic callers to the suicide prevention service and (2) to persuade these individuals to become more specific when discussing their problem. The method chosen to accomplish these objectives consisted of assigning a specific counselor to each chronic caller, setting a one‐hour time limit with respect to each call and, having the suicide prevention center call the chronic caller instead of waiting for the chronic caller to contact the service. Results of the seven‐week treatment program indicated that prior to having the service call the chronic callers, the mean number of calls made per week, for the treatment and control group, were roughly equal. Upon completion of the treatment condition, the mean number of calls per week for those chronic callers who had received weekly calls from the service, was significantly less in comparison with those chronic callers who had not received weekly calls. This trend in the data was maintained during a 9‐week follow‐up condition. Self‐report measures obtained from the counselors indicated that the chronic callers were becoming more concrete and specific when discussing their particular problem. Suggestions regarding the manner in which other community mental health centers might implement a similar program are also discussed.

Systematic review of research into frequent callers to crisis helplines

“…Of the 19 empirical studies, three were intervention studies [19][20][21] (summarised in Table 1), five were surveys of crisis helpline callers 16,17,[22][23][24][25] (summarised in Table 2), and 11 were call record audits 13,18,[26][27][28][29][30][31][32][33][34][35] (summarised in Table 3). Studies varied in their data collection methods and definition of frequent callers.…”

“…23,26,27,30,32 The intervention studies all took place in North America; two in Canada 20,21 and one in the USA. 19 All were restricted by a small sample size and only one study used a randomised controlled design. Brunet et al 20 was the only intervention study to provide a specific definition of frequent callers.…”

“…However, some studies commented on the frequency, nature and appropriateness of calls made by frequent callers as being problematic for crisis helplines. 13,18,19,27,28,30,32,34,35 Frequent callers were described as time-wasters who took up a significant amount of time for crisis helplines, limiting the amount of time available for other callers. 13,17,18,29,33,34 They were seen to contact crisis helplines continuously with recurring problems, without appearing to make discernable positive changes over time.…”

“…The mean number of calls for the intervention group reduced from 24 to 11 calls over a nine week period compared to 24 to 21 calls in the control group. 19 The study by Hall and Schlosar 21 limited frequent callers to a maximum of two calls per day for 15 minutes per call with no contact allowed between midnight and 08:00. Changes in suicide risk before and after the intervention were used to measure improvement, and a minor reduction in the suicidal behaviour of frequent callers was observed.…”

Caractéristiques des appelants réguliers utilisateurs de deux centres d'écoute ou d'intervention téléphonique du Saguenay-Lac-Saint-Jean :

“…Speer (1971) ajoute que, lorsque l'objectif est la fin de la chronicité des appels, il est indispensable (Brockopp, 1973 ;Kramer, 1994). Barmann (1980), Imboden (1981) (Haywood, 1981 ;Speer, 1971). Pour sa part, Imboden (1981) (Imboden, 1981 ;Kehoe & Grant, 1997 ;Kinsel & Nanson, 1981 ;Leuthe & O'Connor, 1981 (Gauthier & al, 2012, p. 71) Afin d'être efficaces, ces mécanismes de gestion doivent prendre en considération autant les besoins des appelants réguliers que ceux des écoutants tout en tenant compte des limites imposées à l'intérieur même des CEIT.…”