ABSTRACT
Our goal was to investigate the factor structure of a risk assessment tool utilized by suicide hotlines and to determine the predictive validity of the obtained factors in predicting subsequent suicidal behavior. We conducted an Exploratory Factor Analysis (EFA), an EFA in a Confirmatory Factor Analysis (EFA/CFA) framework, and a CFA on independent subsamples derived from a total sample of 1,085. Similar to previous studies, we found consistent evidence for a two-factor solution, with one factor representing a more pernicious form of suicide risk (i.e., Resolved Plans and Preparations; RPP) and one factor representing milder suicidal ideation (i.e., Suicidal Desire and Ideation; SDI). The RPP factor trended toward being more predictive of suicidal ideation at follow-up than the SDI factor.
Subject(s)
Hotlines , Risk Assessment , Suicide Prevention , Adolescent , Adult , Age Factors , Aged , Chi-Square Distribution , Factor Analysis, Statistical , Female , Follow-Up Studies , Humans , Male , Middle Aged , Risk Assessment/methods , Sex Factors , Suicidal Ideation , Suicide/psychology , Suicide/statistics & numerical data , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology , Surveys and Questionnaires , Young AdultABSTRACT
There is increasing recognition of the need for evaluations that identify program processes or mediators and assess degree of program implementation rather than focusing solely on outcome evaluation. This paper describes the application of complementary qualitative and quantitative evaluation procedures to assess the degree of implementation of multi-component family support programs for improving educational outcomes for at risk youth, and to assess the relationship between program implementation and outcomes. The qualitative evaluation involved prolonged engagement to identify common program domains or mediators. Using a method called Innovation Configuration Analysis, levels of implementation of program domains were explicated as well as an overall Implementation Fidelity Index. Strong positive relationships were found between overall program implementation and program-level outcomes achieved by student participants.
Subject(s)
Community Networks/organization & administration , Community-Institutional Relations , Family , Program Development , Program Evaluation/methods , School Health Services/organization & administration , Social Support , Students/psychology , Adolescent , Child , Child Development , Humans , Kentucky , Models, Organizational , Organizational Innovation , Parent-Child Relations , Psychology, Educational , Qualitative Research , Regression Analysis , Social ProblemsABSTRACT
The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed during their calls and 801 (49.5%) participated in the followup assessment. Significant decreases in callers' crisis states and hopelessness were found during the course of the telephone session, with continuing decreases in crisis states and hopelessness in the following weeks. A majority of callers were provided with referrals and/or plans of actions for their concerns and approximately one third of those provided with mental health referrals had followed up with the referral by the time of the follow-up assessment. While crisis service staff coded these callers as nonsuicidal, at follow-up nearly 12% of them reported having suicidal thoughts either during or since their call to the center. The need to conduct suicide risk assessments with crisis callers and to identify strategies to improve referral follow-up is highlighted.
Subject(s)
Crisis Intervention , Hotlines , Life Change Events , Cohort Studies , Female , Follow-Up Studies , Humans , MaleABSTRACT
In this study we evaluated the effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' suicide state from the beginning to the end of their calls to eight centers in the U.S. and again within 3 weeks of their calls. Between March 2003 and July 2004, 1,085 suicide callers were assessed during their calls and 380 (35.0%) participated in the follow-up assessment. Several key findings emerged. Seriously suicidal individuals reached out to telephone crisis services. Significant decreases in suicidality were found during the course of the telephone session, with continuing decreases in hopelessness and psychological pain in the following weeks. A caller's intent to die at the end of the call was the most potent predictor of subsequent suicidality. The need to heighten outreach strategies and improve referrals is highlighted.
Subject(s)
Crisis Intervention , Hotlines , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
The National Suicide Prevention Lifeline was launched in January 2005. Lifeline, supported by a federal grant from the Substance Abuse and Mental Health Services Administration, consists of a network of more than 120 crisis centers located in communities across the country that are committed to suicide prevention. Lifeline's Certification and Training Subcommittee conducted an extensive review of research and field practices that yielded the Lifeline's Suicide Risk Assessment Standards. The authors of the current paper provide the background on the need for these standards; describe the process that produced them; summarize the research and rationale supporting the standards; review how these standard assessment principles and their subcomponents can be weighted in relation to one another so as to effectively guide crisis hotline workers in their everyday assessments of callers to Lifeline; and discuss the implementation process that will be provided by Lifeline.
