Crisis Calls Research Articles

Assessing a Suicide Prevention Helpline’s Impact on Caller Crisis Level and Suicidality

Objective Worldwide helplines are considered an important part of suicide prevention strategies. Nevertheless, evidence regarding the impact of suicide prevention helplines on the suicidality of its users remains limited and is frequently confronted with methodological issues. This study aimed to assess the impact of crisis calls on callers’ levels of crisis and suicidality both immediately after the call and at follow-up compared to before the call. After the call, the satisfaction of the callers with the intervention was also assessed. Methods A pre-post study, generated automatically by a telephone system, was conducted in order to compare the level of crisis and suicidality (operationalized by five indicators: hopelessness, entrapment, controllability, suicidal intent, and social support) experienced by callers before and immediately after the call and at follow-up (one to two weeks after the call). Results Callers (n = 487) showed significant improvement in their level of crisis (p < .001, d = −0.31), hopelessness (p < .001, d = −0.22), entrapment (p < .001, d = −0.25), suicide intent (p < .001, d = −0.37), and social support (p < .001, d = 0.33) after the call compared to before the call. Improvements were also found at follow-up compared to pretest. The satisfaction of callers with the helpline was high. Conclusions This study adds to the growing evidence on suicide prevention helplines and addresses some important methodological issues in helpline research. Furthermore, it shows promising results regarding the potential supportive impact of helplines on callers who feel suicidal.

Formal and informal hospital emergency management practices: managing for safety and performance amid crisis.

Although formal preparedness for unexpected crises has long been a concern of health care policy and delivery, many hospitals struggled to manage staff and equipment shortages, precarious finances, and supply chain disruptions among other difficulties during the Coronavirus disease pandemic. Our purpose was to analyze how hospitals used formal and informal emergency management practices to maintain safe and high-quality care while responding to crisis. We conducted a qualitative study based on 26 interviews with hospital leaders and emergency managers from 12 US hospitals, purposively sampled to vary along geographic location, urban/rural delineation, size, resource availability, system membership, teaching status, and performance levels among other characteristics. In order to manage staff, space, supplies, and system- related challenges, hospitals engaged formal and informal practices around planning, teaming, and exchanging resources and information. Relying solely only on formal or informal practices proved inadequate, especially when prespecified plans, the incident command structure, and existing contracts and communication platforms failed to support resilient response. We identified emergent capabilities-imaginative planning, recombinant teaming, and transformational exchange-through which hospitals achieved harmonious interplay between the formal and informal practices of emergency management that supported safe care and resilience amid crisis. Managing emergent challenges for and amid crisis calls for health care delivery organizations to engage creative planning processes, enable motivated workers with diverse skill sets to team up, and establish rich inter- and intra-organizational partnerships that support vital exchange.

Human development in China: cultural and value aspect

Anthropologism as a universal characteristic of modern philosophical knowledge puts man at the center of multilateral socio-cultural transformations as their goal, driving force and primary condition. The modern anthropological crisis calls for the search for new value foundations for human potential development and actualizes the study of cultural regional and country specifics of its implementation practices. The successes of the People's Republic of China largely determine a new vision of the place and role of man in socio-cultural transformations. Human potential forms a dynamic, rapidly changing image of the socio-cultural environment in China, determining the speed and direction of internal and external modernization processes. The development of human potential in China is becoming a priority. It is associated with the main goal – to achieve the level of "average prosperity" (&amp;#23567;&amp;#24247;), and it logically fits into the cultural and value paradigm of the "Chinese dream" (&amp;#20013;&amp;#22269;&amp;#26790;). Acting as a key component of the "scientific concept of development" (&amp;#31185;&amp;#23398;&amp;#35266;) in the form of a value setting "man is at the core" (&amp;#20197;&amp;#20154;&amp;#20026;&amp;#26412;), human potential is becoming one of the leading factors in the socio-cultural modernization of the People's Republic of China. A systematic approach in the research contributed to the analysis of the human potential development strategy of the People's Republic of China as an integral system of conceptual provisions and practices; an axiological approach helped to identify the value content of the strategy of the "power of human potential" of the People's Republic of China; the method of hermeneutic reconstruction contributed to the construction of a value model of a "comprehensive harmonious person" within the framework of the implementation of this strategy. The scientific novelty of this work consists in identifying the cultural and value components of the formation and development of human potential in China. The following results were developed by the author of the article : 1.The ideas of Chinese scientists about human development were made within the framework of cultural philosophy, social philosophy, economic theory, modernization and transnationalization theory. 2.The cultural and value component in the structure of human potential is revealed in the article , the characteristics of its individual elements are presented. 3.Based on the analysis of authentic sources, a hermeneutic reconstruction of the innovative axiological model of the "all-round harmonious person" in the context of building a "power of human potential" in the People's Republic of China was carried out. 4.The regional socio-cultural practices of the implementation of the concept of human development of the People's Republic of China, including comprehensive multi-level programs implemented at the national and supranational levels, are analyzed.

Clinical Triggers and Vital Signs Influencing Crisis Acknowledgment and Calls for Help by Anesthesiologists: A Simulation-Based Observational Study

(J Clin Anesth. 2023;90:111235 |https://doi.org/10.1016/j.jclinane.2023.111235) Swiftly mobilizing resources in perioperative emergencies is crucial for patient survival, with anesthesiologists typically bearing this responsibility. Recognizing the urgency, the call for help is emphasized through formalized “stat” calls. However, the timing of seeking assistance remains subjective, posing a challenge. While empirical evidence highlights blood pressure thresholds indicative of harm, ambiguity surrounds terms like “early” in crisis management. An assumption that anesthesiologists must possess all answers hinders timely collaboration, impacting patient care. Factors affecting crisis acknowledgment, especially in simulated settings, were explored among MOCA course participants. Acknowledgment, a pivotal step in emergency response, was scrutinized alongside potential differences between active participants and observers. This investigation seeks to expose vulnerabilities in ACRM implementation, guiding future studies on crisis management in perioperative settings.

Matching Mobile Crisis Models to Communities: An Example from Northwestern Ontario

Police are often the first to encounter individuals when they are experiencing a mental health crisis. Other professionals with different skill sets, however, may be needed to optimize crisis response. Increasingly, police and mental health agencies are creating co-responder teams (CRTs) in which police and mental health professionals co-respond to crisis calls. While past evaluations of CRTs have shown promising results (e.g. hospital diversions; cost-effectiveness), most studies occurred in larger urban contexts. How CRTs function in smaller jurisdictions, with fewer complementary resources and other unique contextual features, is unknown. This paper describes the evaluation of a CRT operating in a geographically isolated and northern mid-sized city in Ontario, Canada. Data from program documents, interviews with frontline and leadership staff, and ride-along site visits were analyzed according to an extended Donabedian framework. Through thematic analysis, 12 themes and 11 subthemes emerged. Overall, data showed that the program was generally operating and supporting the community as intended through crisis de-escalation and improved quality of care, but it illuminated potential areas for improvement, including complementary community-based services. Data suggested specific structures and processes of the embedded CRT model for optimal function in a northern context, and it demonstrated the transferability of the CRT model beyond large urban centres. This research has implications for how communities can make informed choices about what crisis models are best for them based on their resources and context, thus potentially improving crisis response and alleviating strain on emergency departments and systems.

Field encouraged about FCC proposal to improve routing of 988 crisis calls

The Federal Communications Commission (FCC), along with lawmakers and U.S. Health and Human Services Secretary Xavier Becerra, last month proposed that wireless calls to the 988 Suicide &amp; Crisis Lifeline be routed to ensure that callers in crisis have access to behavioral health resources in the state or territory from which they are calling to ensure privacy.

Exploring Exercise Intervention as a Therapeutic Catalyst within the Mental Health and Addiction Program in Nova Scotia: A Proof-of-Concept Study

IntroductionMany mental health conditions, including anxiety, mood disorders, and depression, can be effectively treated at a relatively low cost. Exercise interventions can be a therapeutic strategy, but even though exercise has consistently been shown to improve physical health, cognitive function, and psychological well-being, as well as reduce depression and anxiety symptoms, this intervention is often neglected in mental health care services.ObjectivesThe study aims to assess the feasibility of incorporating an Exercise Intervention Program (EIP) as a therapeutic pathway within the Mental Health and Addictions Program (MHAP) in Nova Scotia, as well as to evaluate the effectiveness of the program on mental health outcomes and incremental costs, and the patient acceptability and satisfaction with the program.Methods This proof-of-concept study has a pragmatic, prospective, controlled observational design with an embedded one-phase qualitative component. Patients with a primary diagnosis of depression or anxiety attending the Rapid Assessment and Stabilization Program (RASP, Halifax, Nova Scotia, Canada) will be offered to receive 60-minute exercise sessions three times per week, per 12 weeks. Patients with similar mental health conditions that have opted to wait for Cognitive Behavioral Therapy (CBT) with the community provider and declined from the EIP will be part of the control group. A certified recreational therapist will conduct the EIP. Participants of both groups (EIP and control condition) will be assessed at baseline and then weekly for four weeks, six weeks and then at 12 weeks post-enrollment. Primary outcomes include differences in the mean change in functional (well-being, resilience, and recovery) and symptom variables (depression, anxiety, and suicidal risk), which will be assessed through online validated scales/questionnaires. Service variables (patient acceptance and satisfaction) and health care utilization (crisis calls, emergency department visits, hospital admissions and readmissions, length of stay for each admission) will comprise the secondary outcomes.Results The results of the study will provide information about the effectiveness of EIP in the treatment of anxiety and depression compared to those only wait-listed to receive CBT or counselling from a CMHA provider. The study will also inform about the acceptability and satisfaction of the EIP, as well as the incremental cost-effectiveness of the intervention compared to the control condition.ConclusionsThis proof-of-concept study will demonstrate the effectiveness of EIP as an adjunctive or alternative therapeutic option for the treatment of anxiety and depression in patients seeking mental health support from the MHAP in Nova Scotia.Disclosure of InterestNone Declared

State Policies Associated with Availability of Mobile Crisis Teams.

Mobile crisis teams are comprised of multidisciplinary mental health professionals that respond to mental health crisis calls in community settings. This study identified counties with mobile crisis teams and examined state policies associated with mobile crisis teams. Descriptive statistics and geographic information system software were used to quantify and map counties with mobile crisis teams in the United States. Relationships between state policies and mobile crisis teams were examined using an adjusted logistic regression model, controlling for county characteristics and accounting for clustering by state. Approximately 40% (n = 1,245) of all counties in the US have at least one mobile crisis team. Counties in states with legislation in place to fund the 988 Suicide and Crisis Lifeline were more likely to have a mobile crisis team (Adjusted Odds Ratio (AOR): 2.0; Confidence Interval (CI): 1.23-3.26), whereas counties in states with 1115 waivers restricting Medicaid benefits were less likely to have a mobile crisis team (AOR: 0.43; CI: 0.21-0.86). Additionally, counties with the largest population were more likely to have a mobile crisis team (AOR: 2.20; CI:1.43-3.38) than counties with the smallest population. Having a mobile crisis teams was positively associated with legislation to fund 988. Legislation that encourages expansion of existing crisis care services, specifically funding aimed at mobile crisis teams, may help increase availability of services for people who are experiencing a mental health crisis in the community.

ARRIVE Together: A Qualitative Process Evaluation of the New Jersey State Police Co-responding Pilot Program

Law enforcement personnel are often first to respond to calls involving behavioral health emergencies. However, encounters with law enforcement are more dangerous and lethal for people with behavioral health conditions. Co-responding models, wherein law enforcement and behavioral health professionals respond to calls together, are among the top programs developed to improve responding to behavioral health crises. The current study describes a qualitative process evaluation of a co-responding pilot program in New Jersey: “Alternative Responses to Reduce Instances of Violence & Escalation” (ARRIVE Together). The evaluation centered on the experience of the co-responding team as to their perceptions of specific deployments and of the program implementation overall. Semi-structured interviews were conducted following 10 consecutive encounters (three interviews per encounter; February-March 2022). Transcripts were transcribed and thematically analyzed by two trained researchers independently. Once thematically analyzed, researchers determined a consensus and developed a SWOT analysis report. Thematic analysis produced six major themes: communication, staffing, training, resources, community outreach, and deployments with minors. Overall, participants were enthusiastic about the program, but they shared numerous observations about ways in which the program could be improved. Sample size, the brief follow-up window, and lack of generalizability to other contexts were among the most limiting factors. Further research should include an effectiveness evaluation and extend to urban and suburban communities and communities of color. Future research should also explore after-response affects including accessibility to follow-up care. The current study gives insight into piloting a co-responding model for approaching behavioral health crisis calls.

POLICE SOCIAL WORK CHALLENGES AND OPPORTUNITIES

Police social work is back to revitalization as there has been a growing demand for collaboration between police departments and social workers to intervene in mental and behavioral health crisis calls. Police departments usually deal with social control strategies and social workers primarily work on the social rehabilitation of individuals. This article describes the challenges and opportunities of police social work and offers models for strategic partnerships and collaborations. The paper also describes the significance of teaching police social work courses in programs accredited by the Council on Social Work Education (CSWE) and encouraging social work students to do their practical education in police departments or work with police officers in crisis response teams.

The sectoral trade losses from financial crises

Abstract The “Great Trade Collapse” triggered by the 2008-2009 crisis calls for a careful assessment of the trade losses from financial crises. We adopt a more detailed perspective by looking at the response of different types of trade (i.e. consumption, intermediate, capital goods, and business services) following various types of financial crises (i.e. debt, banking, and currency crises) in 41 emerging markets. Estimations performed in the 1980-2019 period using a combination of impact assessment and local projections to capture a causal dynamic effect running from financial crises to the trade activity show that the collapse of total trade is long-lasting and mainly driven by the fall of intermediate goods and to some extent capital goods, while trade in consumption goods and business services is more resilient to crises. Therefore, financial crises could lead to considerable disruption of global value chains, as observed during the Global Financial Crisis (GFC), and easily spill over from one country to another through trade linkages. The examination of heterogeneity reveals that total and sectoral trade is more severely impacted in countries with a lower share of manufacturing exports, less diversified exported products, and trading partners, with lower demand from trading partners and when associated with a deterioration of the domestic and external financial conditions and sudden stops. By contributing to the understanding of the trade effects of financial crises, our analysis provides insightful support for the design and implementation of policies aimed at coping with these effects.

Attractiveness of Photovoltaic Prosumerism in the European Electricity Market

The current energy crisis calls for a rapid transition to renewables. Solar photovoltaics (PV) is the key component of the future energy system and a majority of PV systems are installed on rooftops in Europe. This article studies the business case of prosumers, i.e., consumers who produce part or all of their electricity with PV. The levelized cost of PV electricity is compared with the average value of PV electricity for the prosumers in residential, commercial, and industrial installations in Finland, Germany, France, Italy, and Spain with different self‐consumption (SC) and weighted average cost of capital rates. Prosumer business cases are positive in every studied market segment and country, especially for industrial PV systems with 100% SC where a payback time of less than 4 years can be achieved. The sensitivity of payback time on key input parameters is also studied. Reasonable cost of capital and adequate SC of PV generation remain the key elements for attractive prosumerism.

Contextual Factors of Mental Health Crisis Calls to Law Enforcement: A Brief Report.

Law enforcement officers are frequent first responders to people experiencing mental health or suicide crises. Yet, as communities consider expanding crisis response options, we know very little about the nature of these calls that could inform decision making about which crisis response is best suited for the situation. This study is an exploratory, descriptive assessment of contextual factors, both individual and situational, of mental health and suicide crisis calls. Our dataset includes 166 calls to 9-1-1 related to a mental health emergency or suicide crisis. The majority were calls related to suicide (125 calls, 75%), which included more contextual factors than mental health crisis calls. Most calls resulted in the subject being transferred to the local emergency department (60%) or were resolved on scene (12%). Police use of force was rare, and no arrests were reported. The implications of these findings for communities developing alternatives to law enforcement crisis response are discussed.

Bioenergy crops, biodiversity and ecosystem services in temperate agricultural landscapes—A review of synergies and trade‐offs

AbstractThe Paris agreement on climate change requires rapid reductions in greenhouse gas emissions. One important mitigation strategy, at least in the intermediate future, is the substitution of fossil fuels with bioenergy. However, using agriculture‐ and forest‐derived biomass for energy has sparked controversy regarding both the climate mitigation potential and conflicts with biodiversity conservation. The urgency of the climate crisis calls for using forests for carbon sequestration and storage rather than for bioenergy, making agricultural biomass an attractive alternative for fossil energy substitution. However, this calls for comprehensive assessments of its sustainability in terms of consequences for biodiversity and ecosystem services. In this review, we provide a first holistic overview of the impacts on ecosystems of land‐use changes from bioenergy crop production in temperate climates, by synthesizing results on both biodiversity and ecosystem service impacts. We found that bioenergy‐related land‐use changes can have both positive and negative effects on ecosystems, with original land use, bioenergy crop type and scale of bioenergy production being important moderators of impacts. Despite the risk of opportunity cost for food production, perennial crop cultivation on arable land had the lowest occurrence of negative impacts on biodiversity and ecosystem services. Growing biomass for bioenergy on surplus land has been suggested as a way to alleviate competition with food production and biodiversity conservation, but our results demonstrate that utilizing marginal or abandoned land for bioenergy crop production cannot fully resolve these trade‐offs. Furthermore, there is a lack of empirical studies of the biodiversity value of marginal and abandoned land, limiting our understanding of the sustainability implications of biomass cultivation on surplus land. We argue that future research and policies for bioenergy production must explicitly consider biodiversity and ecosystem services in combination to avoid potential trade‐offs between the two and to ensure sustainable bioenergy production.

Clinical triggers and vital signs influencing crisis acknowledgment and calls for help by anesthesiologists: A simulation-based observational study

Study objectiveIn a perioperative emergency, anesthesiologists must acknowledge the unfolding crisis promptly, call for timely assistance, and avert patient harm. We aimed to identify vital signs and qualitative factors prompting crisis acknowledgment and to compare responses between observers and participants in simulation. DesignProspective, simulation-based, observational study. SettingAn anesthesia crisis resource management course at a freestanding simulation center. SubjectsSixty attending anesthesiologists from a variety of practice settings. InterventionsIn each case, a primary anesthesiologist in charge (PAIC) managed a simulated patient undergoing a uniformly scripted sequence of perioperative anaphylaxis and called for help from another anesthesiologist when a crisis began. Anesthesiologist observers (AOs) viewed the case separately and recorded times of crisis onset. MeasurementsSimulation footage was reviewed by investigators for patient vital signs and participant behaviors at times of crisis acknowledgment, with the call for help as an explicit proxy for PAIC crisis acknowledgment. These factors were categorized, and group-level data were compared. ResultsNineteen PAICs and 41 AOs were included. Clinicians acknowledged crises around a mean arterial pressure (MAP) of 65 mmHg and oxygen saturation of 94% as anaphylactic shock progressed. PAICs acknowledged crises at a higher respiratory rate than AOs (20 vs. 18 breaths/min, p = 0.038). Other vitals and timing of crisis acknowledgment did not differ between PAICs and AOs. Nearly half of all participants (45%) identified crises at MAP <65 mmHg. Timing of crisis acknowledgment varied widely (range: 421 s). ConclusionsDespite overall heterogeneity in clinical performance, anesthesiologists acknowledged crises per standard definitions of hypotension. Thresholds for crisis acknowledgment did not significantly differ between PAICs and AOs, suggesting minimal effect from active care responsibility. Many indicated crises at MAP <65 mmHg or after significant deterioration, risking failure-to-rescue events. We suggest that crisis management instruction should address triggers for requesting help.

Attributional and consequential life cycle perspectives of second-generation polylactic acid: The benefits of integrating a recycling strategy

The climate crisis calls for a shift from petrochemicals to bio-based products to reduce environmental consequences. Polylactic acid (PLA) is one of the most widely used biopolymers, due to its mechanical properties and renewable origin, to produce bio-based compostable plastic for food packaging. The objective of this study is to determine the environmental feasibility of a second-generation PLA production based on wheat straw; and the role of a chemical recycling plant on the environmental performance of a bioproduct at an early design stage. A holistic assessment was performed through the Life Cycle Assessment (LCA) methodology considering both attributional and consequential perspectives, through a cradle-to-grave approach. The attributional LCA results show that lactic acid production was the main contributor due to the wheat straw pre-treatment and downstream separation and purification (DSP) processes. The integration of a recycling plant leads to a significant reduction of burdens, ranging from 1.38 to 0.44 kg CO2eq in the Global Warming category. Furthermore, consequential LCA results shows that the increased demand for substitute products for activities such as feeding, fertilisation and energy generation and the indirect emissions from land use change related to the conversion of land for the cultivation of raw materials are relevant factors in the environmental effects associated with the possible implementation of straw-based bioPLA production system.

Exploring Yoruba Fire Cultures through Proverbs

This article argues that Yoruba proverbs are an essential source of popular wisdom on socio-environmental practices accessible through creative reconstruction and interpretation of their historical contexts. Learning from the everyday knowledge and accumulated wisdom of ordinary people holds significant promise at a time of unprecedented socio-environmental crisis and widespread calls for transformative change across scales. Drawing on the collection of Yoruba proverbs by Oyekan Owomoyela, broader Yoruba oral literature, Yoruba popular culture and a cross-disciplinary selection of academic literature, this article curates and reimagines nine Yoruba proverbs on the theme of fire, using these as an entry point to interrogate aspects of ecology and local understanding and practices of living with fires among the Yoruba people.

Digital Revolution

Digital revolution in present times has affected industry and revolutionized the way consumers are served and business operations are handled. The digital revolution has altogether improved the competitiveness of business enterprises including media houses to push their boundaries of communication into the global arena. In an emerging economy like India, commerce and business has seen a paradigm shift due to globalization and now coupled with artificial intelligence after the crisis pandemic scenario. The critical aspect during such a crisis calls for a strong channels of communication across all platforms.

First responders, mental health, dispatch coding, COVID-19: Crisis within a crisis

Community members experiencing mental health challenges often call 911. On one hand, mental health challenges among community members have grown exponentially during the coronavirus disease 2019 (COVID-19) pandemic. On the other hand, pressure on first responders has increased the complexity of emergency response due to the following reasons: responders not being trained in mental health, difficulties in properly identifying mental health calls, and discrepancies within police coding systems themselves. Consequently, mental health calls may not be addressed appropriately in a community. Understanding how first responders address 911 mental health crisis calls provides a foundation for improvement. A review of the literature illustrates the nature of responses from 911 to end disposition. The analysis highlights the challenges related to identifying mental health calls, matching appropriate responses, and targeting changes that could increase identification accuracy and speed. Based on the literature review, we are proposing a framework for training and research.

Conclusion: Mental health and legal responses to the adolescent mental health crisis: Raising the bar on best interests and promoting family connectedness in divorcing families

AbstractWe are currently facing an unprecedented increase in adolescent mental health problems resulting in alarmingly high levels of depression, anxiety, and suicidality. Significant mental health problems among youth pose unique challenges to families in the process of separation and divorce, as well as to family law professionals across all disciplines. The current adolescent mental health crisis calls for new ways of approaching our work with high conflict families to promote family connectedness and shift away from adversarial approaches that may exacerbate conflict and further destabilize families. As a conclusion to the special issue on adolescent mental health needs, the authors make multidisciplinary best practices recommendations and advocate for systems level changes in recognition of the needs of youth in crisis at this pivotal developmental stage.