Conference Agenda
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PS43: Crisis Helplines and Chat-Based Support Services
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Use of suicide prevention helpline services by first-time, frequent, and daily callers: follow-up on a national cohort study 1: Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; 2: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 3: Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen, Denmark; 4: Centre for Mental Health Research, National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia; 5: nstitute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark The object was to assess whether the proportion of answered calls to the national helpline for suicide prevention in Denmark improved following an expansion with a second venue and to examine whether this was reflected in the proportion of calls from first-time callers being answered relative to calls from frequent and daily callers. Furthermore, to assess national call rates to the helpline. A cohort design was applied to complete data on records of all calls placed to the Danish helpline for suicide prevention, from January 1st, 2020, to December 31st, 2025. Call records were provided with anonymised identification codes to mark individual phone numbers. To evaluate the impact of a second call centre, call data was compared between 2020-2022 and 2023-2025. A total of 1,236,620 calls were placed to the helpline between January 1st, 2020, and December 31st, 2025. A total of 265 individuals were categorized as frequent and 25 as daily callers. The overall response rate was 11.7% and the unique call response rate 47.9%. A total of 132,777 unique calls were placed and 64,311 calls answered in 2020-2022, increasing to 166,454 unique calls placed and 79,144 calls answered in 2023-2025. Compared to 2020-2022, odds of being answered were significantly higher for first-time callers (OR 1.04; 95% CI 1.00-1.07) and significantly lower for frequent and daily callers (ORs of 0.80; 95% CI 0.77-0.82 and 0.78; 95% CI 0.73-0.83, respectively) in 2023-2025. While an increase in answered calls was observed after the opening of a new call centre, an equivalent increase in number of incoming calls to the helpline was registered. In the years following the opening of a new call centre, we observed slight improvements in response around work shift hours in the primary call centre and better chances for first-time callers of having their call answered. Evaluation of the impact of a chat-based crisis service on caller crisis level and suicidality 1: Suicide Prevention Centre, Belgium; 2: Flemish Centre of Expertise in Suicide Prevention Introduction Suicide prevention helplines are widely recognized as essential components of comprehensive suicide prevention strategies. While a growing body of research has examined the effectiveness of telephone-based crisis interventions, empirical evidence regarding the immediate effects of online chat-based services remains comparatively limited. This gap is noteworthy given the increasing use of chat modalities, particularly among individuals who may be reluctant to seek help via telephone. The present study examines immediate changes in users’ self-reported crisis levels and suicidality before and after a chat interaction with the Flemish suicide-specific online chat service Zelfmoordlijn1813. In addition, users’ satisfaction with the chat intervention is assessed. Results of a previous, methodologically similar evaluation of telephone-based interventions conducted by the same crisis service will allow for an exploratory comparison between chat- and telephone-based modalities. Methods A pre–post evaluation design was embedded directly within the chat platform. Users were invited to complete brief self-report measures immediately before and after their chat conversation. Crisis and suicidality were operationalized using five indicators: hopelessness, feelings of entrapment, perceived controllability, suicidal intent, and perceived social support. Following the chat interaction, users were also asked to evaluate their satisfaction with the support received. Results The results of this evaluation will be presented, focusing on pre–post changes in crisis-related indicators and suicidal ideation among chat users and comparison to results from a previous telephone-based research. Conclusions This study aims to contribute to the growing evidence base on the effectiveness of online chat-based crisis services. From Crisis Call to Continued Care: Follow-Up Calls for Suicidal Callers at a National Hotline 1: Suicide Prevention Centre, Belgium; 2: Flemish Centre of Expertise in Suicide Prevention Introduction Many suicide-specific helplines excel at immediate crisis intervention, but offer no support beyond a single contact. The immediate crisis intervention may lower the acute suicidal distress and increase the feelings of safety but there is a lack of follow-up support or a clear pathway for long-term care. For some callers, this first contact is their only link to help. In response to this challenge, the Flemish suicide- specific helpline (Zelfmoordlijn 1813) developed a structured, fully anonymous follow-up model which reinforces its role as a low-threshold crisis service without providing therapy. This model focuses on short-term safety, the use of self-help tools, and reducing barriers to engaging with professional care. Methods A select group of trained helpline responders invite adult callers in acute suicidal crisis to take part in a brief follow-up trajectory (maximum 3 conversations). Callers who consent are offered one to three scheduled telephone contacts. Focus of these conversations are immediate short-term safety, safety planning & coping tools and enhancing continuity of care. A qualitative pilot study with interviews and focus groups among callers (n=20-30), helpline responders (n=26) and staff (n=3) is used to examine acceptance, perceived feasibility and the perceived added value of the model for safety, coping with suicidal thoughts, and building bridges toward professional help. Results Preliminary results will be presented, focusing on the callers’ experiences and the perceptions of volunteers and staff on the structured, time-limited follow-up model. Conclusions The results will help to clarify whether an anonymous, structured follow-up model is acceptable and feasible within a suicide-specific helpline and whether it has the potential to strengthen safety, coping, and engagement with professional care. Further work will refine the protocol and prepare larger-scale evaluations of outcomes related to safety, help-seeking, and the integration of follow-up within broader suicide prevention strategies. An Evaluation of Samaritans’ Online Chat: Understanding Digital Emotional Support in Practice 1: Samaritans, United Kingdom; 2: Tavistock Institute of Human Relations; 3: Habitus Collective; 4: Lived Experience Consultant Purpose Engagement with crisis support services is changing. Samaritans' online chat is emerging as our fastest-growing service, with children 14 times more likely to use chat than our helpline, highlighting the need to understand and improve this service. The evaluation aimed to:
Methods We used a mixed-methods approach to triangulate findings, and capture breadth and depth of experiences. Data sources included:
Results Online Chat offers a distinct form of support, often chosen for privacy, accessibility, or when callers are too distressed to speak. Samaritans volunteers reported challenges with managing longer, more intense chats, and uncertainty around ending conversations supportively. Quantitative analysis showed a significant reduction in distress post-chat (average improvement of 3.07 points, 0-10 point scale). This is comparable to reductions in distress observed for the helpline (Samaritans, 2020). Impact was greatest for longer chats, female users and those experiencing bereavement or work-related stress. Age was not a significant factor. Overall, 87% of respondents reported reduced distress following the chat, and 94% would use the service again. Scaling is constrained by volunteer availability, with waiting times emerging as a critical issue for user experience and trust. Concerns regarding data handling and safeguarding were also highlighted. Conclusion Online Chat is effective in reducing distress, complementing Samaritans’ telephone service, contributing to the evidence base on digital emotional support (Mokkenstorm et al, 2017; Gould et al, 2021). Key priorities include enhancing volunteer training, accessibility and wait times. 9-8-8: Suicide Crisis Helpline’s Safety and Wellbeing Framework: A Systematic Approach to Supporting Responder Wellbeing in the Suicide Prevention Crisis Line Context 1: The Centre for Addiction and Mental Health, Canada; 2: The University of Toronto, Canada 9-8-8: Suicide Crisis Helpline (9-8-8) is available for anyone is Canada who is thinking about suicide or worried about someone they know. To support the staff and volunteers providing this crucial service, 9-8-8 is committed to providing training and supports that attend to responder wellbeing and prevent against cumulative stress and burnout. The 9-8-8 Safety and Wellbeing Framework was developed to ensure a comprehensive and systematic approach for education, training and organizational support for 9-8-8 personnel. The framework addresses three levels of support and highlights key areas of focus aligned with evidence and best practices: This presentation will provide an overview of several initiatives being rolled out across the 9-8-8 network of 38 partner organizations, at each level of the framework. Supportive foundations (Level 1) include organizational processes that support wellbeing (e.g., standard operating procedures); training and competency development; and networks of support (e.g., communities of practice). Responder-level initiatives (Level 2) include engagement in competency self-assessment and reflective practice, and support for responders to implement strategies to cope and mitigate stressors. Supervision, support and debriefing (Level 3) initiatives include training supervisors in a newly developed 9-8-8 responder debriefing model; a supervisor community of practice; and access to critical incident debriefing for all personnel. All education and training initiatives are systematically evaluated to inform continuous quality improvement. We will also describe our approach to the structured assessment of responder wellbeing. As part of a commitment to promoting a culture of wellbeing (Level 1), 9-8-8 held journey mapping, digital storytelling and listening sessions with responders to gain a comprehensive understanding of responders’ experiences in their 9-8-8 roles and the factors that support wellbeing. Some findings from 9-8-8 evaluations will be shared during the presentation. | ||