The Challenges of Detecting Suicidal Callers in Text-Based Youth Helplines
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This document discusses the challenges of detecting suicidal callers in text-based youth helplines. Youth helplines have a general mission and helpers receive limited suicide risk assessment training. Text-based communication also lacks non-verbal cues. A study analyzed over 2,800 youths contacting a Quebec youth helpline, finding 42% reported past-year suicidal ideation and 21% reported suicide attempts. The study aims to estimate the proportion of suicidal youths, those mentioning suicidality, and interventions with risk assessments. Preliminary findings suggest suicidal ideation is often revealed by callers but risk is superficially explored in most interactions. The conclusion calls for better identifying suicidal youths and training helpers in text-based risk assessment.
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The Challenges of Detecting Suicidal Callers in Text-Based Youth Helplines
- 1. The challenges of detecting suicidal callers in text-based youth helplines LOUIS-PHILIPPE CÔTÉ; BRIAN L. MISHARA CENTER FOR RESEARCH AND INTERVENTION ON SUICIDE, ETHICAL ISSUES AND END-OF-LIFE PRACTICES UNIVERSITÉ DU QUÉBEC À MONTRÉAL, CANADA
- 2. The challenges of detecting suicidal callers in text-based youth helplines Challenges related to …. Mission and objectives of youth helplines Staff and training issues in youth helplines Nature of text-based communication We will illustrate these challenges by presenting the results of a study in progress
- 3. Youth helplines are general helplines They are used by youth … To get information on a wide variety of topics To discuss sensitive topics with a trusted adult anonymously To express distress (sometimes suicidal ideations) and get help
- 4. Youth helplines are general helplines No systematic suicide risk assessment policies Handling suicidal callers is a minor aspect of their overall training Suicide risk assessment skills are not practiced often
- 5. Youth helplines helpers are not (usually)… Psychologists or psychiatrists No comprehensive clinical interviews Scientists or suicidologists No complex validated scales Psychics or magicians No thoughts reading…
- 6. Text-based communication Lack of social, emotional and non verbal cues… Interpretation, inference, transference….
- 7. In summary, the main challenges … Suicide risk assessment is an uncommon practice in youth general helpline Suicide risk assessment in text-based youth helplines is more about helpers perceptions than objective description or prediction Gathering data on suicidality in text-based youth helplines is a complex operation
- 8. Research questions How effective are text-based youth helpline in detecting suicidal children? Generally speaking, Is there an underestimation of the number of suicidal callers in text-based youth helplines statistics?
- 9. Current study Evaluation of text-based youth helpline in Quebec (Canada) Good public image Often given as a reference in newspaper articles or in tv show
- 10. This study has three main objectives: 1) to estimate the proportion of suicidal individuals among the youths contacting a text-based youth helpline 2) to determine the proportion of the suicidal youths who mention their suicidal ideations in their conversation with the service 3) to assess the proportion of interventions with suicidal youths where the counselor performs a suicidal risk assessment
- 11. Method Post-intervention questionnaire Satisfaction (3 items) During the past 12 months, did you ever seriously consider attempting suicide? Have you ever tried to commit suicide? BDI-13 Suicide item postintervention suicidal ideations Content analysis Callers Age, gender Reason (s) of the call Apparent suicidality No (no indications) Maybe (indirect verbalizations) Yes (explicit verbalizations) Helpers Suicide risk investigation & action plan
- 12. Sample Postintervention questionnaire •n.2820 •Response rate ≈15% Suicidal ideations – 12 months •n.1314 (42%) Suicide attempt(s) •n. 671 (21%) Content analysis (in progress) •n.283 2820 youths who contacted the service answered the postintervention questionnaire 42% reported having experienced serious suicidal ideation in the past 12 months 35% reported having attempted suicide in their lifetime
- 13. Sample Postintervention questionnaire •n.2820 •Response rate ≈15% Suicidal ideations – 12 months •n.1314 (42%) Suicide attempt(s) •n. 671 (21%) Content analysis (in progress) •n.283 2820 answered the postintervention questionnaire 42% reported serious suicidal ideation in the past 12 months 35% reported having attempted suicide in their lifetime Content analysis (n.283) Recent suicidal ideation + suicide attempt(s) Age: 16.52 / Female: 88 %
- 14. First reason for contact 45% of kids who talked about their suicidal ideations called to talk about suicide 55% of kids who talked about their suicidal ideations called for another reason than suicide Mental illness symptoms is the most common reason
- 15. Exploration & revelation of suicidal ideations (SI) All interventions involving suicidality 78% SI revealed by the caller Primary reason for contact 90 % SI revealed by the caller Secondary reason for contact 66 % SI revealed by the caller
- 16. Suicide risk exploration No exploration 11% Superficial exploration 63% Adequate or elaborate exploration 28%
- 17. Safety plan No safety plan 60% Superficial 24% Adequate 17%
- 18. Correlations Directivity ↑ Suicide risk exploration ↑ Respect ↑ Safety plan ↑ Length of session ↑ Suicide risk ↑ exploration Safety plan ↑
- 19. Post-intervention suicidal ideation kids who did talked about suicide 10 % reported no post- intervention ideations 45 % reported they think that death would free them 45 % reported explicit suicide ideations
- 20. Post-intervention suicidal ideation kids who did not talked about suicide: 35 % reported no post- intervention ideations 39 % reported they think death would free them 26 % reported explicit suicide ideations
- 21. Conclusion We need to find creative ways to identify suicidal youth Pre-intervention questionnaire? Machine learning and NLP ? Post-intervention questionnaire with follow up? Better training in handling suicidal callers in text-based youth helpline Evidence based practices