Recovery Funds Support Suicide Prevention Training

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The National Institute of Mental Health (NIMH) is using funds from the American Recovery and Reinvestment Act to provide grant support for the completion of a project under way to evaluate the effectiveness of a new training program for telephone crisis counselors at suicide hotline centers. The rollout of the new training program, which began in winter of 2008, offers an unrepeatable opportunity to assess the benefits of the training. The information could shape telephone-based suicide prevention services across the country.

The National Suicide Prevention Lifeline (NSPL), the nation’s leading source of immediate help for those dealing with suicide-related issues, is carrying out the training program across its network of crisis centers. The Substance Abuse and Mental Health Services Administration (SAMHSA), a part of the U.S. Department of Health and Human Services, funds NSPL. Madelyn S. Gould, Ph.D, at the New York State Psychiatric Institute, New York City, is the principal investigator for this study.

"By providing guidance on the effectiveness of training for telephone-based crisis counselors, the information obtained with Recovery Act funding of this project will have an important impact on public health efforts to assist people in crisis and prevent suicide," said NIMH Director Thomas R. Insel, M.D.

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One of the rationales for hotlines is research suggesting that suicides are often precipitated by stressful life events; in addition, those who attempt suicide and survive report ambivalence and a desire to be rescued and helped.

Evaluating the effectiveness of hotlines is difficult, however. Monitoring of the short-term benefits provided by telephone counseling — for example, with follow-up calls — suggests that the help provided does have positive effects on emotional well-being. However, such studies lack a control group against which results can be compared.

To overcome some of the inherent difficulties in testing these services, the investigators will use an approach in which hotline centers are assigned to receive training at various times on a random basis. The design provides a way to conduct a controlled study of whether trained telephone crisis counselors more effectively assess and refer callers. Silent monitoring of calls and follow-up telephone interviews with callers to the hotline will be used to provide information on the effectiveness of training and the impact of hotline services.

Results of the evaluation study will provide rigorously collected information on approaches used to provide crisis services and will have a direct impact on the ability of hotlines to provide effective help. Funding for the first year of this two-year grant is $809,819. (Funding for year 2 is subject to change.)

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