Adolescents' Engagement with Crisis Hotline Risk-management Services: A Report from the Emergency Department Screen for Teen Suicide Risk (ED-STARS) Study.

Danielle R Busby,Theron Charles Casper,Cheryl A King,David Brent,Jaqueline Grupp‐Phelan,Madelyn Gould,Kent Page

doi:10.1111/sltb.12558

Abstract

This study examines the feasibility of a risk-management protocol for adolescent research participants at risk for suicide that relies on engagement with telephone crisis counselors. The study also examines whether engagement is moderated by adolescent demographics and clinical characteristics. Participants were 234 adolescents (83% female; 63% White) ages 12-18 (M=15.3years) drawn from the national study, Emergency Department Screen for Teens at Risk for Suicide (ED-STARS) Study One sample of adolescents randomized for 3-month telephone follow-up (n=2,850). This study's sample was comprised of adolescents who completed the follow-up (69% retention), met study risk criteria, and were transferred to a crisis hotline for risk management. Engagement with a counselor was assessed by successful call connection, call duration, and information sharing. Ninety-four percent of calls resulted in a successful call transfer, and the majority of youth (84%) shared information with counselor about one or more coping strategies. Average call length was 12.6min (SD=9.9). Engagement did not vary by gender, race, age, ethnicity, or clinical characteristics. Adolescents' engagement with telephone risk-management services was strong, suggesting that this strategy can address safety. Further, findings suggest telephone risk-management services effectively engage youth across demographic and clinical subgroups.

Highlights

Ninety-four percent of calls resulted in a successful call transfer of the adolescent from the telephone follow-up interviewer to a crisis hotline counselor
Nine youth participants (4%) disconnected the call after call transfer or immediately gave phone to parent and the crisis counselor (CC) reconnected with parent/or adult only
A total of 17 youth participants (7%) disconnected after call transfer and the CC reconnected with youth only

Summary

Methods

Engagement with a counselor was assessed by successful call connection, call duration, and information sharing This analysis sample includes 234 adolescents, ages 12- 18 years (M =15.3, SD = 1.5), from the ED-STARS subsample of 2,850 adolescents who were randomized to 3-month followup interviews (enriched for suicide risk) and participated in these interviews (n =1,957, 69% of adolescents designated for follow-up). The pre-identified risk triggers included a suicide attempt or suicidal ideation with a plan or suicidal intent in the past three months (Figure 1) This sample was comprised of predominately female (83%, n = 195) and Caucasian

Results

Discussion

Conclusion