Idaho Suicide Prevention Hotline Analysis of Options for Decision Making

Transcription

1 Idaho Suicide Prevention Hotline Analysis of Options for Decision Making Ann D. Kirkwood, MA Beth Hudnall Stamm, PhD Amy C. Hudnall, MA Susan L. Blampied, BA

2 First printing: June 2010 Second printing: September 2010 Available online at: Cover art by: Joey Gifford Report design by: Kirstina Beck Suggested Reference Kirkwood, A. D., Stamm, B. H., Hudnall, A. C., & Blampied, S. L. (2010). Idaho suicide prevention hotline: Analysis of options for decision making. Meridian, ID & Pocatello, ID: Idaho State University. Funding Credit This report is funded in part by a Community Collaboration Grant appropriated by the Idaho Legislature under Contract No. 4C administered by the Idaho Department of Health and Welfare, State of Idaho, and the Idaho Youth Suicide Prevention and Idaho Awareness to Action Youth Suicide Prevention Projects, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, Grant Nos. 1U79SM & 5U79SMo Many Idaho organizations have supported this project, specifically the Region IV Mental Health Board, which nominated the project for state funding. The contents are the sole responsibility of the authors and do not necessarily represent the official views of DHHS, the State of Idaho, or Idaho State University.

3 iii Contents C H A P T E R 1 I n t r o d u c t i o n Hotline Options Report. 1 Background. 2 Idaho s Suicide Rate. 3 The Creation of the Hotline Options Report. 5 Chapter Summaries. 5 Project Partners. 6 C H A P T E R 2 B a c k g r o u n d Suicide in Idaho. 7 Suicide by Population. 8 Hotline Effectiveness and Benefits. 13 A Hotline s Role in a Statewide Mental Health System. 16 Conclusion. 17 C H A P T E R 3 D a t a Introduction. 19 Summary of Studies and Data Sources. 20 STUDY 1: Highest 15 State Suicide Rates Per 100,000 People in the United States. 21 STUDY 2: Analysis of Accreditation Criteria for Suicide Prevention Hotlines in the United States. 26 STUDY 3: Review of Policies for SuicidePrevention Hotlines. 27 STUDY 4: Analysis of Training Curricula for Suicide Prevention Hotline s. 33 STUDY 5: The Use of Scripted Mock Phone Calls in the Quality of Training for Suicide Prevention Hotline s. 34 STUDY 6: Key Informant Interviews with Key Decision Makers About Housing a Suicide Prevention Hotline in Idaho. 36 STUDY 7: National Directors Phone-based Key Informant Interviews. 39 STUDY 8: National Survey of Directors of Accredited Suicide Prevention Hotlines in the United States. 41 STUDY 9: Estimating Call Volume for an Idaho Suicide Prevention Hotline. 49 STUDY 10: Estimating Costs for an Idaho Suicide Prevention Hotline. 50 STUDY 11: The Economic Cost of Suicide in Idaho and the United States. 51 STUDY 12: Review of a Suicide Prevention Hotline Sustainability Sources. 58 STUDY 13: A Marketing Plan for an Idaho Suicide Prevention Hotline. 59 C H A P T E R 4 A c c r e d i t a t i o n a n d C e r t i f i c a t i o n What is Accreditation and Certification?. 61 Why Should an Idaho Hotline be Accredited?. 61 How Does Accreditation Work?. 62 What Are The Accreditation Options?. 63 AAS and CUSA Accreditation. 65 The National Suicide Prevention Lifeline Network. 68

4 iv C H A P T E R 5 S a m p l e P o l i c i e s Introduction. 85 Issues of Confidentiality. 85 Issues Involving Hotline Calls. 86 Issues Involving the Care of s and Supervisors. 95 C H A P T E R 6 T r a i n i n g Introduction. 97 Training Paid and/or Volunteer Staff. 97 Accreditation and Training Protocols. 99 Training Content. 100 Standard Phases of Training. 102 Training to Policies. 103 An Idaho-Specific Training Program. 106 C H A P T E R 7 C a l l V o l u m e & C o s t E s t i m a t e s Estimating Call Volumes. 121 Funding Sources and Ongoing Funding. 126 Configuration Comparisons. 131 Other Considerations. 150 Budget Sample Line Item Explanations. 151 C H A P T E R 8 S u s t a i n a b i l i t y Finding Potential Funding Sources for Hotlines. 157 Finding Grant or Foundation Funding. 157 Procuring Grant or Foundation Money. 158 Summary and Recommendations. 169 C H A P T E R 9 M a r k e t i n g P l a n Introduction. 171 Marketing Plan. 171 Materials. 174 C H A P T E R 1 0 C o n c l u s i o n s & R e c o m m e n d a t i o n s Introduction. 177 Findings. 178 Accreditation and Certification. 179 Sample Policies. 180 Training. 181 Call Volume and Estimates. 182 Sustainability. 184 Marketing Plan. 185 Costs of Suicide in Idaho. 186 Conclusion. 187 R e f e r e n c e s Marketing Plan. 189

5 CHAPTER 6: TRAINING 109 Text of the Basic Scripted Role Play Figure 23: Basic Scripted Role Play Basic Scripted Role Play The goal of this scripted role-play is to help you learn what sort of things might happen in a call. The dialog is provided for you so you can concentrate on learning the process. There are two things to focus on. First, at each step you will notice a brief explanation of what the step does. The second thing to focus on is the concept of branching. In this scenario you will see that the script starts with a set caller-operator dialog and then breaks into two paths the call could take. You will notice at the end, the two paths merge. This demonstrates that the start and the finish of a call may be the same but the middle sections are not. The operator is the person who selects the path, based in large part on how the caller responds to the set questions. In the first script, you are the caller and I am the operator. Thus, I will pick the path. In the second scenario, you are the operator and you will pick the path. If you pick path A, you will follow through with A until the script merges at the end. If you are on the path B, follow the B column. Here is a diagram that looks like the path. When the script starts branching, you pick A or B and then follow that path. For this section of the training, we want the trainees to follow the script. Later in your training you will complete mock calls where there is no script. Institute of Rural Health

6 110 Figure 23: Basic Scripted Role Play, cont. Scenario #1: Third Party Call SCENARIO A woman has called concerned about her daughter. Her daughter s behavior has changed drastically in the past couple of weeks. She used to be a very good student, but has started skipping school and talking back to her teachers. She has isolated herself from her friends and will not discuss the issue with her mother. The caller has called the hotline requesting help because she is concerned about her daughter s safety and is unsure what to do in this situation. In this case, the daughter s grandfather died. None of the family has realized the connection between the youth s behavior and the loss of her grandfather. In this scenario we will work together to identify the presence of the loss and make a referral to something that will help the youth with her grief. The recommendations can be informal such as suggesting that the mother talk with her daughter directly about the loss, letting her daughter know that grief is hard and that the family will be with her to talk about it. Other recommendations could direct the family to a grief self-help group or to a faith-based leader. A school counselor or teacher could help. A recommendation to talk with the family health professional is appropriate also. CALL SCRIPT Hello, how may I help you? My daughter has suddenly started skipping school and talking back to her teachers. She was always a good student. She won t talk to me or her friends. I don t know what to do. Have you tried to talk to your daughter? I tried, but she won t talk to me. A Solicit Information about caller s guess as to what might have happened. Is there anything you know of that may have caused her to react like this? B Solicit information about other people daughter might talk with. Ok. Is there anyone else in your family that she may be more open with? A Provides information about what might be happening. For example, No, everything has been fine recently. B Provides information about who the daughter might talk with. For example, She is normally close to her grandparents. A Solicit Information about caller s guess as to what happened. When did she starting acting like this? B Solicit information about other people daughter might talk with. Is she still close with them? Institute of Rural Health

7 CHAPTER 6: TRAINING 111 Figure 23: Basic Scripted Role Play, cont. A Provide information about caller s guess as to what might have happened. It has been a couple of months. It started right after her grandfather died. B Provide information about other people daughter might talk with. She used to talk to her grandfather but he died a few months ago and she doesn t talk with anyone that I know of. Talk with mother about how grief can affect different people differently. Provide a few referrals and suggestions A youth grief self-help group that is run through the local hospice. Faith-based grief group School counselor Always suggest that the family check with their health professional. Thank you for your help. I m glad that you called. I hope your daughter will be better soon. Scenario #2: SUICIDE RISK CALL SCENARIO A male calls and is showing the warning signs of suicide. He talks about being hopeless, alone, and having trouble sleeping. He finds himself drinking a lot, and putting himself in danger. He has not said directly that he wants to attempt suicide but has said he does not want to be alive anymore. CALL SCRIPT Hello, how may I help you? I just called because I m hopeless and alone. The only thing that helps is drinking. I just don t want to be alive anymore. Opening statement requires use of suicide risk assessment A risk assessment checks for (1) hopelessness, (2) thoughts of wishing being dead, (3) thoughts of suicide, (4) suicide plan, and (5) history of previous attempts. Questions 1 and 2 were addressed in the callers opening statement. Proceed to Questions 3-5. Question 3. Have you thought about taking your life? I ve thought about it but I wouldn t do it. Somehow, today, it does seem more like a good idea. Question 4. So today is different. Are you seriously considering taking your own life? Have you made a plan? Well, I have been sitting here thinking about it. I thought about my guns but I don t think I would use one. Still. Question 5: Have you felt this way before? Have you ever tried to take your life? No, I haven t tried to kill myself. It seems too hard. I feel alone. So, you feel alone but you don t think you re going to try to kill yourself. I guess so. Institute of Rural Health

8 112 Figure 23: Basic Scripted Role Play, cont. A Solicit Information about people or animals who are connected to the caller. Do you have any family or pets? B Solicit information about people that the caller may be able to talk to. Do you have any friends you spend time with? A Provide information about family connections. For example, I have a dog. B Provide information about social activities or friendships. For example, A couple of my friends go camping together. A Solicit Information about the caller s family connections. Do you spend time with your dog? B Solicit information about the caller s plans with friends. Do you have any plans to go with them? A Provide information about caller s relationships with family. Well my sister helps me look after him. B Provide information about caller s plans with friends. They were talking about going camping in a couple weeks. A Solicit Information about caller s connection to his sister. Could you talk to your sister about what you re feeling? B Solicit information about the caller s concrete plans with his friends. Why don t you make plans to go camping with them next time? A Provide information about connection to sister. For example, I guess I could talk to her. B Provide information about social activities or friendships. For example, I guess I could do that. Check suicide risk assessment again. So how are you feeling now? Do you still feel like you want to be dead? I guess not. I m glad to hear that you re not feeling like taking your life now. PAUSE, allow caller time to respond or not as they wish. If you are not convinced that the caller is ok, return to the assessment and probe more. I want you to promise to call back if you start feeling like taking your life. Will you do that? OK. But I think I am going to be ok. I guess I should not drink so much alone. Provide a few referrals and suggestions 1. Making plans with friends and family members 2. Becoming more involved in social groups that he is already a part of, like faith-based or school groups 3. Suggest talking with his health professional 4. Provide the hotline s information and hours in case the caller wants to call back Thank you for your help. I m glad that you called. Please call again if you need to. Institute of Rural Health