Outcomes in Callers to the VA's 24/7 Veterans Crisis Line

拨打 VA 24/7 退伍军人危机热线的结果

• 批准号: 8443620
• 负责人: Kerry L Knox
• 金额: $ 38.58万
• 依托单位: VETERANS HEALTH RESEARCH INSTITUTE OF CENTRAL NEW YORK, INC.
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-19 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8443620
• 关键词: Address; Anger; Anxiety; Behavior; Behavior Therapy; Behavioral; Case Management; Cessation of life; Characteristics; Communities; Confusion; Critical Care; Data; Development; Distress; Effectiveness; Ensure; Goals; Health Services Research; Healthcare Systems; Hospitalization; Individual; Intervention; Life; Measures; Medical; Mental Depression; Mental Health; Mental Health Services; Methods; Modeling; Monitor; Moods; Nature; Outcome; Pattern; Pilot Projects; Population; Population Heterogeneity; Process; Protocols documentation; Provider; Research Personnel; Safety; Services; Suicide; Suicide attempt; Suicide prevention; Testing; United States; Variant; Veterans; War; care delivery; comparison group; design; follow-up; health care service organization; high risk; high standard; innovation; interest; social; study characteristics; suicidal; suicidal behavior; suicidal morbidity; suicide hotline; willingness

DESCRIPTION (provided by applicant): If we are ever to know with any certainty that crisis lines are effective in reducing deaths from suicide, or in managing distress levels in individuals before they are suicidal, three essential questions must be addressed: 1. Of the entire population of potential callers to a crisis line, what are the characteristics of individuals who cll a crisis line? 2. What are the key behavioral characteristics of responders that moderate individual characteristics of callers, resulting in acceptance of a referral given from a responder to the caller? 3. Is there an impact on important outcomes: death from suicide, suicide attempts and reattempts, hospitalization for suicidal behaviors, engagement in an ongoing safety planning process, and overall reductions in psycho-social distress? PUBLIC HEALTH RELEVANCE: We view a study of the Department of Veterans Affairs' (VA's) 24/7 Crisis Line (formerly called the VA Suicide Hotline) as significant since suicide prevention crisis lines continue to be an intervention of great interest, while still defying reaching a high standard of proven effectiveness. Due to the very nature of community crisis lines, by virtue of their anonymity, it is difficult to answer three questions that must be addressed if we are ever to know with any certainty that crisis lines are effective in reducing deaths from suicide, or in managing distress levels in individuals before they are suicidal. These questions underscore the significance of this application because of our distinct ability to address issues that cannot be done in any other crisis line setting: 1. Of the entire population of potential callers to a crisisline, what are the characteristics of individuals who call a crisis line? 2. What are the key behavioral characteristics of responders that moderate individual characteristics of callers, resulting in acceptance of a referral given from a responder to the caller? 3. Is there an impact on important outcomes: death from suicide, suicide attempts and reattempts, hospitalization for suicidal behaviors, engagement in an ongoing safety planning process, and overall reductions in psycho-social distress? We recognize that considerable advances have been made in addressing Questions 1 and 2; indeed, Dr. Madelyn Gould who is a Co-Investigator on this study has been a leader, with others, in the field of examining the utility of suicide crisis lines But a critical difference between the national network of suicide crisis lines across the United States (National Suicide Prevention Lifeline, or NSPL) and VA's Crisis Line is that the VA's Crisis Line has the enhanced ability to study characteristics of callers and responders, the capacity to provide nation-wide services through immediate referral and follow-up care, and the critical capacity to identify outcomes in callers to the Crisis Line. Through the use of some new, innovative methods, including causal modeling, we have developed a study that we strongly believe has the potential to have a high impact on delivery of care through suicide crisis lines. I summary: This may not be the perfect study of the effectiveness of a suicide crisis line, but it overcomes many of the limitations inherent to studies of community crisis lines.

描述(由申请人提供)：如果我们要确切地知道危机热线在减少自杀死亡或在个人自杀前管理痛苦程度方面是有效的，必须回答三个基本问题：1.在所有潜在的呼叫者中，设置危机热线的人的特征是什么？2.应答者的关键行为特征是什么，能够缓和呼叫者的个体特征，从而接受响应者的转介 对来电者？3.对重要结果是否有影响：自杀、自杀未遂和再次自杀死亡、因自杀行为住院、参与持续的安全规划过程，以及总体上减少心理-社会痛苦？ 公共卫生相关性：我们认为退伍军人事务部的24/7危机热线(以前称为退伍军人自杀热线)的一项研究具有重要意义，因为自杀预防危机热线仍然是一种备受关注的干预措施，同时仍不能达到证明有效性的高标准。由于社区危机热线的性质，由于它们的匿名性，如果我们要回答必须解决的三个问题，就很难回答 可以肯定地知道，危机处理在减少自杀死亡方面是有效的，或者在个人自杀之前控制他们的痛苦程度是有效的。这些问题突显了这款应用的重要性，因为我们有独特的能力来解决在任何其他危机线设置中都无法解决的问题：1.在整个潜在呼叫者中，拨打危机线的人的特征是什么？2.响应者的关键行为特征是什么，这些特征缓和了呼叫者的个人特征，导致了响应者对来电者的转介？3.是否会对重要结果产生影响：自杀死亡、自杀企图和再次尝试、因自杀行为住院、参与持续的安全规划过程，以及总体上减少心理-社会痛苦？我们认识到在解决问题1和2方面已经取得了很大进展；事实上，这项研究的联合调查员Madelyn Gould博士与其他人一起在审查自杀危机热线的效用领域一直是领导者，但美国全国自杀危机热线网络(国家自杀预防生命线，NSPL)与退伍军人事务部危机热线之间的一个关键区别是，退伍军人事务部的危机热线增强了研究来电者和响应者的特征的能力，有能力通过立即转介和后续护理提供全国范围的服务，以及确定拨打危机热线的来电者结果的关键能力。通过使用一些新的创新方法，包括因果模型，我们开发了一项研究，我们坚信这项研究有可能对通过自杀危机线提供护理产生很大影响。我的总结：这可能不是对自杀危机线有效性的完美研究，但它克服了社区危机线研究固有的许多局限性。