On Wednesday, October 4th at 1pm EST, iCarol will host a webinar on the topic of Crisis Center/Emergency Department (ED) partnerships, specifically those where crisis centers make follow-up calls to discharged patients who came to the ED presenting with suicidal thoughts or behaviors.
Research shows that for about 1 in 5 deaths by suicide, the person had actually visited their local emergency department in the weeks before their death. While hospital EDs can keep a person safe in the short-term and provide referrals to long-term care, they aren’t often the best resource to handle the complex and ongoing mental health and emotional needs of someone who is struggling with thoughts of suicide. Most people who visit an ED for concerns related to suicide are discharged after a very short period of time, and the discharge plan often doesn’t involve ongoing direct contact to check and see how the person is doing following their visit, potentially leaving the patient feeling lost and unsupported.
This is where more and more helplines are stepping in. Crisis Centers across North America have engaged in partnerships with their local emergency department to help provide care for ED visitors or discharged patients in the form of follow-up calls. Because crisis center professionals have the best knowledge, training, and resources to provide ongoing care such as this, EDs will make connections between the ED visitor to the crisis center. From there, crisis centers talk to the patient and make a series of follow-up calls or texts to the visitor to keep them feeling supported and engaged with a safety plan. Crisis centers are also best-equipped to see that a person receives referrals to more long-term mental health care or other needed referrals that can help resolve issues compounding a person’s distress and desire to end their life.
During this hour-long webinar, we’ll invite presenters to discuss first-hand experience of these partnerships:
Charissa Tvrdy is a Lead Crisis Clinician and Hospital Follow-Up Coordinator at Rocky Mountain Crisis Partners. Ms. Tvrdy is responsible for oversight and project management of RMCP’s Hospital Follow-Up program. She works as a liaison between RMCP and participating Colorado emergency departments. Ms. Tvrdy assists call center staff in the training, implementation, quality assurance and daily operations of the program. Ms. Tvrdy received her Master of Science in Counseling Psychology from The University of Kansas. She has experience working in a call center serving people experiencing behavioral health crisis. Ms. Tvrdy also has clinical experience within a Community Mental Health Center.
Dr. Michael Allen built the model Comprehensive Psychiatric Emergency Program at Bellevue Hospital. He was chair of the APA’s Task Force on Psych Emergency Services, president of the Am Assoc for Emerg Psychiatry, member the NIH Emergency Medicine Roundtable, a National Suicide Prevention Lifeline steering committee member, a STEP-BD, ED SAFE and PRISM investigator and an author of the Suicide Prevention Resource Center’s ED Decision Support Guide. He has served as a subject matter expert for the US DOJ Civil Rights Div, CMS, NIMH, the Joint Commission and SAMHSA. He was instrumental in forming the Colorado Suicide Prevention Commission and the Colorado National Collaborative. He is currently Professor of Psychiatry and Emergency Medicine at the Johnson Depression Center, University of Colorado Anschutz Campus and Medical Director of Rocky Mountain Crisis Partners.
Caitlin Peterson is the Coordinator of Best Practices in Care Transitions for the National Suicide Prevention Lifeline, working closely with crisis centers, professional organizations, community partners, and mental health providers to support and advocate for follow-up and partnership with crisis centers. Caitlin has worked in the mental health, crisis intervention, and suicide prevention field for over 10 years, 7 of those in various positions, and later manager, of a blended suicide prevention and information and referral hotline. She has a Master of Science degree in Marriage & Family Therapy from the University of Rochester School of Medicine and Dentistry.
We hope you can attend — space is limited so please register ASAP if you’re interested in joining the live presentation. For those who can’t join us, we’ll have the recording available on our website at a later date. To learn more about this webinar and to register, click the button below.
Like many others, we’ve been watching the effects of Hurricane Harvey in southeast Texas, stunned by the images of record setting flooding and the impact on residents. In particular we’ve been thinking of all of our friends and clients in this area. As is typical of helpline work, they have an important role to play in disaster planning, relief and recovery, all while their own homes and families are at risk. We’re told that 2-1-1 Texas has remained operational throughout — a truly amazing feat in the wake of this historic hurricane. As we hear from them and gain permission to share their experience and stories of those they helped, we hope to bring that information to you.
Harvey serves as a reminder to all non-profit services and particularly helplines, contact centers, and 2-1-1s that you have a role to play in your community’s disaster plan as government services look for partner organizations that can disseminate life-saving information, offload call volume to government switchboards, and provide information across a variety of communication methods to make sure everyone is reached. Meanwhile, these not-for-profits naturally have to concern themselves with the safety of their own staff and their own infrastructure in order to remain operational. With Hurricane Irma now making its way towards North and Central America, and months left in hurricane season, it’s time to consider your disaster plan. And of course disaster goes far beyond tropical storms and flooding. Wild fires, earthquakes, tornadoes, blizzards, and other forms of disaster threaten communities across the globe.
We’ve recently been made aware of a website that provides a number of free resources helpful to any organization as they plan and prepare for disasters. You can access these resources here.
If you are interested in aiding in Harvey relief efforts, the United Way has announced establishment of a Harvey Recovery Fund. In the midst of these events it’s usually recommended to donate money rather than items, as storage space tends to be in short supply but cash allows organizations to purchase items on the ground for immediate distribution. They’ve offered information on the various ways you can make meaningful contributions on their website.
We extend our warm thoughts to everyone impacted by Hurricane Harvey. If you have information about relief efforts or if your organization has been directly impacted by Harvey and you would like to share your stories, please .
Photo appears courtesy of the United States Department of Defense. U.S. Marine Corps photo by Lance Cpl. Niles Lee.
Returning to the classroom after an extended break is a stressful event. Knowledge of one’s mental health or the health of one’s children, and learning about how to address mental health concerns, can be valuable assests for a smoother transition for parents and students of all ages. Some degree of sadness or anxiety is perfectly normal, but what happens if those feelings begin more deeply impacting a student’s life? How do you combat the more serious mental health concerns stemming from or exacerbated by the transition?
Below are some resources to keep on hand for yourselves or clients that will help get the new school year off to a healthy start:
We’re excited to announce, on behalf of our friends at the National Association of Crisis Organization Directors (NASCOD) and Contact USA, that registration for the 2017 National Crisis Centers Conference is now open!
The conference will take place from October 18th through 20th in beautiful Buffalo, NY. The event kicks off with a tour of world-renowned Niagara Falls and a welcome dinner Wednesday evening, and concludes with a closing banquet on Friday evening. In between kickoff and closing will be tons of educational and enlightening workshops and sessions aimed at enriching your staff and improving your ability to serve your community. To make sure you don’t miss out on any of the fun, the conference organizers encourage you to schedule your departure for no earlier than Saturday morning.
If you are a manager or director of any sort of crisis, supportive listening, counseling, or suicide prevention helpline or similar service, then we strongly encourage you to attend this conference. We have personally been attending for a number of years — in fact it was the very first event we began attending when iCarol was created so many years ago! Over the years we’ve developed treasured relationships with the organizations that organize and attend the conference, and we deeply value their service to their communities as well as their committment to increasing the impact of crisis centers everywhere. The workshops and sessions presented at this conference each year are NOT to be missed!
But you don’t have to take our word for it. According to the conference website, the event promises:
- To enhance your Vision and Leadership skills to aid your success
- Workshops that focus on management and leadership skills that will cultivate your effectiveness as a program Director/Manager
- National networking opportunities available with experts in the crisis center field
- Information on specific issues and challenges that you are facing as a Director/Manager
For more information, or to register you and your staff, head over to the conference website. We hope to see you in Buffalo this October!
On June 20th at 1pm EST iCarol will host a webinar with Dustin MacDonald of Distress Centre Durham, aimed at providing helplines and other non-profit organizations with helpful information and insight on best practices for serving the LGBTQ community.
Dustin will discuss a range of topics including:
- Suicide ideation and suicide rates among LGBTQ individuals
- Common issues and topics to be aware of
- How to best provide emotional support to LGBTQ individuals
- And much more!
We hope you’ll join us for this special event in celebration of Pride Month. You can learn more about this webinar and register by clicking the button below.
Learn More and Register
From April 26th through the 29th, members of our team will be in Phoenix for the 50th American Association of Suicidology Conference.
We’ll have a booth at the conference and you’ll see us at many of the events and sessions, too. It’s important to us to learn about and be aware of all the latest research and the expanding needs of helplines as they work to build suicide-safer communities.
We hope you’ll stop by our booth and let us know how things have been going for your organization, and tell us about the exciting initatives you’ve had going on. We’ll be available to answer any questions you may have about iCarol, and we’ll have some fun activities to check out that are brand new this year!
In particular we’d really enjoy hearing your feedback about the new iCarol Ideas Portal we recently released. We’re excited to hear from our users about how it’s going, what you like about it, and any other feedback you may have. So if you’ve used the Ideas Portal, we definitely want to see you!
With all the excitment and so much going on, the time at the conference goes by quickly, so please look us up at the conference, or
beforehand to schedule some time to chat so we’re sure not to miss the opportunity to see you!
We look forward to seeing you and learning about all the latest in the life-saving work being done by the helpline industry so that we can continue to build our systems to support you.
My former employer’s Executive Director used to always say that as long as people still used phones, our crisis lines would answer them, but if people used ESP to communicate, well, we’d use that too. While most humans haven’t yet figured out a way to use ESP for communication, our society is using different forms of communication and even non-communication to get information, assistance, and support.
Text and chat communication has grown exponentially across most age ranges within the past five years. On top of that, a growing trend has also arisen with the internet: self-service tools. There is a big opportunity for helplines of all kinds to use self-service tools to promote their services and increase partnership agreements.
Because we here at iCarol are committed to providing helplines and others the tools they need to reach people across multiple platforms, we created Online Forms. With Online Forms, website visitors can submit information which comes into your iCarol system as a completed report form. Since the forms are essentially a public facing version of an iCarol report form, you can view, edit, and report on the form in the same way as all of your other report forms.
Several possible applications exist for using iCarol’s Online Forms. Let’s explore two use cases:
Assessment and Program Intake
Elmdale Crisis Center (a fictitious organization) operates numerous crisis lines through various contracts with mental health authorities, public and private health providers, and local municipalities. Elmdale’s management team is looking at ways to increase contract amounts by providing additional services without adding too much burden on their staff. After reviewing their current service offerings, they found a few contract required assessments that could be offered through an additional avenue, Online Forms.
They designed the following workflow:
With this workflow, Elmdale Crisis Center can extend the service offerings of the contract with the goal of increasing the number of people who request an assessment and intake into the service provider’s programs.
Consumer Satisfaction Survey
Elmdale Crisis Center’s management team wants to capture a consumer’s satisfaction and risk levels after using their crisis services so that they can report on outcome achievements and demonstrate their social return on investment, necessary for future funding requests. They decided to use iCarol’s Online Forms so that the consumer’s responses and information comes into their system automatically and their front line staff is notified if the person submitting the form would like additional follow-up.
Elmdale placed the consumer satisfaction survey on their website and created an iCarol resource record containing the online survey link, so that their consumers can receive the link directly via a texted or emailed referral from the iCarol system. They instructed their workers to provide the survey link to consumers at the end of their conversations.
The management team designed the following online survey:
Pre-screening question – if answered “no”, visitor cannot complete the survey.
1. Have you contacted Elmdale’s crisis services? Yes/No
1. When did you last contact Elmdale’s crisis line?
- This week
- Last week
- Earlier this month
- Last month
- Longer than two months ago
2. How did you contact Elmdale?
- Other, please specify
3. On a scale of 1-10, how upset were you at the beginning of your conversation with an Elmdale crisis worker?
- 1-10 Scale
4. On a scale of 1-10, how would you rate the level of empathy and understanding the Elmdale crisis worker demonstrated during your conversation?
- 1-10 Scale
5. One a scale of 1-10, how upset were you at the end of your conversation with an Elmdale crisis worker?
- 1-10 Scale
6. Will you contact Elmdale’s crisis services again?
- Yes, definitely
- Yes, possibly
- No, probably not
- No, definitely not
7. Would you recommend Elmdale’s crisis services to a friend or family?
- Yes, definitely
- Yes, possibly
- No, probably not
- No, definitely not
8. Would you like an Elmdale crisis worker to contact you regarding this survey?
- Yes +
+ Contact Information
First Name ________________
Phone Number __ (____) ___________
Best time of day to call _______________
The versatility of iCarol’s Online Forms opens up entirely new methods for those in need to contact you. Using Online Forms provides additional opportunities to increase and improve service offerings, which can translate into more funding to support your helpline.
Do you have other ideas about how Online Forms can be used? Leave a comment below. Want to discuss some of these ideas with an iCarol staff member? Contact us.
Guest blogger Brenda Patterson is the Executive Director of CONTACT the Crisis Line in Jackson, Mississippi, and serves on the Board of Directors for CONTACT USA.
With all callers/chat visitors we practice active listening and unconditional acceptance. We try to use open ended questions when facilitating conversations and summarize the caller/chat visitor’s plan as we close the conversation. When talking to an individual with an intellectual/developmental disability there can be additional considerations. Let’s look at five:
- Person first language is a topic all by itself. Whether or not you know at the beginning of a call or chat if the individual has a disability using person first language in any conversation is important. Person first language emphasizes the person, not the disability. By placing the person first, the disability is no longer primary, but one of several aspects of the whole person. Examples include: “person with an intellectual disability,” “person who has autism,” “person who is blind,” rather than “the mentally retarded,” “the autistic,” or “the blind.” Also consider how you refer to their challenge and devices that help them adapt. Using phrases such as “person with an addiction/mental health concern” “one who uses a wheelchair” instead of “mental patient,” “drunk,” “druggie,” “invalid,” or “wheelchair bound” is preferable.
- Consider that people with intellectual/developmental disabilities often share the following thought processes:
- Difficulty with fluidity and flexibility of thinking
- A dislike of ambiguity (black and white thinking)
- Difficulty prioritizing and breaking down tasks into manageable projects
- A tendency for poor generalization skills (a person belongs in one and only one
environment and utilization of a skill in one situation but not others)
Recognize that individuals with an intellectual/developmental disability may think logically about concrete events, but have difficulty understanding abstract or hypothetical concepts. The use concrete examples when facilitating problem solving is helpful.
It’s important to dispel the myth that people with intellectual/developmental disabilities cannot benefit from therapy. In reality many different types of therapy have been found to be effective in treating people with developmental disabilities. Do not hesitate to mention therapy as an option. Although it generally takes longer for people with developmental challenges to make changes, those changes are stable once made.
Because there are higher incidents of abuse in people with any disability, the likelihood of trauma related symptoms occurring are greatly increased, which can be mistakenly attributed to the person’s developmental disability or pre-existing mental illness. Trauma responses generally represent a change from the person’s normal level of functioning.
While there are a number of additional tips to consider when talking to an individual with an intellectual/developmental disability, and there are tips which are specific to individuals with Autism Spectrum Disorder these are primary and apply to all individuals with a developmental disability.
With all callers we want to empower them to advocate for themselves and to generate their own solutions, as well as connecting them with services that can further assist them. Whether you are talking to the individual with an intellectual/developmental disability or their family, it’s important to ask if they are receiving Home and Community-Based Services (HCBS) as provided in the state they live in. HCBS provide opportunities for Medicaid beneficiaries to receive services in their own home and community. While waiting lists can be long, the services provided are invaluable and making application early in the individual’s life is important. It can mean they will have the support they need to be independent in adulthood and be happy and content in the life choices they have made.
This post was so popular, it’s found a new home on our site! Click here to read 10 Reasons to add Live Chat or Texting to your service.
Crisis Hotlines have been around for over 40 years, and so have individuals that call regularly. These types of repeat calls are often referred to as exhausting, challenging and frustrating. Viewing these calls as such can introduce the danger that someone in actual need may not receive the full benefit of the services offered. Though the caller may not be presenting a crisis at the moment, your support and empathic listening can aid in the prevention of escalating into a crisis. Often times, the callers are utilizing the same unsuccessful maladaptive coping skills to try to resolve their situation. They have most likely burned many bridges, have very little or no support from family and friends, and feel lonely and isolated. They are often turned away and told no or that nothing more can be done. It is important to remember that these callers can also experience crises.
As many centers are adopting a trauma informed care approach, the use of recovery oriented language and care is emerging. The term Frequent or Chronic caller is being replaced with Familiar or Experienced caller, to name a few.
Some centers or crisis workers struggle with setting limits and boundaries. Callers can benefit from the structure and learn to develop and rely on their own strengths. The callers are the experts on what helps them and it varies for every person.
Challenge yourself and your center to create a thoughtful approach to handling these calls, while maintaining boundaries, consistency, and setting limitations. Establish firm and consistent boundaries in a respectful manner. Some centers have time limits per call, others have limits on how many times an individual can call. Once you decide on a limit, it is important for all crisis workers to remain consistent. Create a clear guideline for crisis workers to follow. Example below:
Initial call of the day:
- Listen, reflect feelings
- Don’t dictate
- What has changed since your last call?
- What was your plan when your last call ended? Have you tried…?
- Have you followed through with your plan?
- What else can you try?
When speaking with someone who has been contacting your center several times per day, it is okay to ask the individual:
- To restate their crisis plan
- Who else can they call besides the crisis hotline?
Be cautious of providing the same intervention techniques each time, it can be beneficial to treat each call like a brand new call every time. Perhaps something has changed and what didn’t work yesterday may work today. Remember there is value in listening and acknowledging their reality. Consider what it must feel like to live with this every day.
1. Help the individual identify the precipitating event that caused them to call/chat/text. “What has happened/changed since your last call?”
2. Help the individual prioritize and stay focused. Acknowledge that it seems there has been a lot that has affected their lives. “I’m wondering, which situation is most important for you to resolve.” “What can I help you with today?” “From what you have shared, there seems to be a lot going on for you. Which one is the most worrisome for you today?”
3. It is better to interact than react. Validate that they are doing the best they can. “It sounds like you are doing the best you can. What can you try differently to cope with this?”
4. Identify coping skills. “What has helped you in the past? Have you tried that today?”
5. Help them explore new, healthy coping skills. “I’m wondering if you have thought of new ways of coping.”
6. Explore the importance of retelling their story repeatedly, “How is this helpful for you?” “What are you hoping to get from this conversation today?”
7. Empower them to work toward recovery.
8. Limit exploration of the situation and problem solving.
9. Help the caller focus on what he/she can do to help him or herself today.
10. Support the caller in developing a reasonable, specific and attainable plan. Provide additional resources, such as a warm line for support.
Other helpful statements:
“You really seem comfortable doing what you have always done, that’s more familiar to you. How would it be for you to try…”
“It sounds like you feel scared to make any changes.”
“It sounds like you have a sense of what it is going to take to change and you’re not sure you want to do that.”
“It seems discussing your past experiences are more comfortable for you than trying to make changes.”
For research on Familiar callers, please use link below for information:
Guest blogger Lisa Turbeville is Manager of the Resource and Crisis Helpline and Legal Services at Common Ground, and serves on the Board of Directors for CONTACT USA.