Hotline Imminent Risk SS - B

Supporting Statement

the networking suicide prevention hotlines—Evaluation of imminent risk

2. Statistical Methods

B1. Respondent Universe and Sampling Methods

There are over 150 crisis centers in the Lifeline network. This evaluation is designed to identify and work with eight of those centers. Four of the eight centers in the Evaluation of the Lifeline Policies for Helping Callers at Imminent Risk will have received enhanced training in imminent risk procedures. They have been selected from a pool of crisis centers currently funded under the Crisis Center Follow-up Grant Program, a supplemental grant program of the Lifeline. Crisis centers involved in the grant program receive specific training in follow-up techniques to use with callers at imminent risk. This will enable the evaluation to examine whether centers’ familiarity with follow-up yields different types and rates of interventions with imminent risk callers. Four additional centers have been recruited from centers attending the SAMHSA-funded Crisis Centers Conference in July 2011 in Baltimore Maryland. The additional centers have been selected from those that have not been engaged in follow-up with callers. These centers may have already participated in previously approved evaluation activities in the past, but this was not a criterion for selection. Centers have been selected to represent a cross-section of the Lifeline network. Eligible calls will include those involving imminent risk, as identified by individual counselors using the Lifeline Policies and Guidelines for Helping Callers at Imminent Risk of Suicide.

B2. Information Collection Procedures

Data for the evaluation will be collected during imminent risk calls to the eight participating crisis centers. Counselors are trained in the guidelines for imminent risk callers and will complete imminent risk forms based on the discussion with the caller. The counselor will not ask questions from the form, but will complete the form based on the information discussed with the caller. For standard collection of these data across sites, the National Suicide Prevention Lifeline—Imminent Risk Form was developed.

Table 2 summarizes the information collection procedures for the imminent risk form.

Table 2. Procedures for the Collection of Information

National Suicide Prevention Lifeline—Imminent Risk Form

Indicators:

• Demographic information of the imminent risk caller

• Ratings on the suicidal desire and suicidal intent of callers

• Suicidal capability and history of risk behaviors (e.g., suicide attempt, violence, substance abuse, sleep problems)

• Protective factors/buffers (e.g., social supports, sense of purpose)

• Intervention type either agreed to by caller (e.g., take actions on his/her own behalf to immediately reduce imminent risk, get rid of lethal means) or taken by counselor (e.g., send public safety officials for safety check, send mobile crisis unit)

• Barriers to getting help for caller at imminent risk

• Steps taken to confirm emergency contact was made and when emergency contact was not made

Data Source(s): Imminent risk callers to NSPL

When Collected: At time of the call to the crisis hotline or after the call has been completed

B3. Methods to Maximize Response Rates

The National Suicide Prevention Lifeline—Imminent Risk Form will be implemented by all counselors in each of the eight centers as part of their job responsibilities. It is expected that counselors will complete imminent risk forms for 100% of callers who are at imminent risk for suicide.

B4. Tests of Procedures

The National Suicide Prevention Lifeline—Imminent Risk Form has been reviewed by experts in the fields of suicide prevention and mental health and piloted to determine burden levels.

B5. Statistical Consultants

The evaluator has full responsibility for the development of the overall statistical design and assumes oversight responsibility for data collection and analysis for the evaluation. Training and monitoring of data collection will be provided by the evaluator. The following individuals are primarily responsible for overseeing data collection and analysis:

Madelyn S. Gould, Ph.D., M.P.H.

Professor,

Psychiatry and Public Health (Epidemiology)

Columbia University/NYSPI

1051 Riverside Drive, Unit 72

New York, NY 10032

212-543-5329

Jimmie Lou Munfakh, B.A.

Psychiatry and Public Health (Epidemiology)

Columbia University/NYSPI

1051 Riverside Drive, Unit 72

New York, NY 10032

212-543-5482

Marjorie Kleinman, M.S.

Psychiatry and Public Health (Epidemiology)

Columbia University/NYSPI

1051 Riverside Drive, Unit 72

New York, NY 10032

212-543-5959

Alison Lake, M.A.

Psychiatry and Public Health (Epidemiology)

Columbia University/NYSPI

1051 Riverside Drive, Unit 72

New York, NY 10032

212-543-6714

The SAMHSA project officer responsible for receiving and approving deliverables is:

Richard McKeon, Ph.D., MPH

Chief, Suicide Prevention Branch

Center for Mental Health Services

SAMHSA

1 Choke Cherry Road, Room 6-1105

Rockville, MD 20857

240-276-1873

References

Gould, M.S., Kalafat, J., Harris–Munfakh, J.L., and Kleinman, M. (2007). An evaluation of crisis hotline outcomes part 2: Suicidal callers. Suicide and Life–Threatening Behavior, 37(3), 338–352.

Kalafat, J., Gould, M.S., Harris–Munfakh, J.L., and Kleinman, M. (2007). An evaluation of crisis hotline outcomes part 1: Nonsuicidal crisis callers. Suicide and Life–Threatening Behavior, 37(3), 322–337.

List of Attachments

1. Imminent Risk Form

2. Steering Committee Members

Page 4