Abstract
BackgroundThis paper describes a program of work designed to inform a service model to address a challenge for telephone helplines, namely frequent callers.MethodsWe conducted a systematic literature review and four empirical studies that drew on different data sources—(a) routinely collected calls data from Lifeline, Australia’s largest telephone helpline; (b) data from surveys/interviews with Lifeline frequent callers; (c) data from the Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) study; and (d) data from Australia’s National Survey of Mental Health and Wellbeing.ResultsFrequent callers represent 3 % of callers but make 60 % of calls. They are isolated and have few social supports but are not “time wasters”; they have major mental and physical health problems and are often in crisis. They make use of other services for their mental health problems. The circumstances under which they use telephone helplines vary, but current service models reinforce their calling behaviour.ConclusionsThe findings point to a service model that might better serve the needs of both frequent callers and other callers. The model involves offering frequent callers an integrated, tailored service in which they are allocated a dedicated and specially trained telephone crisis supporter (TCS), and given set calling times. It also involves promoting better linkages between telephone helplines and other services that provide mental health care, particularly general practitioners (GPs) and other primary care providers. The next step is to refine and test the model.
Highlights
This paper describes a program of work designed to inform a service model to address a challenge for telephone helplines, namely frequent callers
The studies suggested that frequent callers were more likely to be male and unmarried than other callers, but that, in the main, other key variables like age, mental health conditions or suicidality were unrelated to calling patterns
This led to suggestions about strategies that might meet the needs of frequent callers, including limiting the number and duration of calls permitted, assigning a specific telephone crisis supporter (TCS) to the caller, implementing face-to-face contact, initiating contact
Summary
Telephone helplines exist to provide support to callers who are going through a crisis (defined as a transient state of psychological disequilibrium during which their usual coping mechanisms are disrupted) [1, 2]. These helplines typically target people who may be experiencing mental health problems (e.g., depression or anxiety), have suffered abuse or trauma, be facing immediate stressors, or be feeling socially isolated.
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