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SAMHSA-HRSA Presents: Improving Health through Trauma-Informed Care

Webinars - textOn July 28th at 2:00pm EDT, the Substance Abuse Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA) will present a Webinar on trauma-informed care.

Courtesty of SAMHSA/HRSA, here is the description of the webinar content:

“People who experience physically or emotionally harmful or life threatening events can have lasting adverse mental and physical health effects. Trauma-informed care can improve patient engagement with their providers and support health outcomes. In addition, a clinic environment that realizes the widespread impact of trauma can actively resist re-traumatization of the people you serve.

How can you embed trauma-informed approaches into the practice of your integrated primary care clinic?

Join this webinar to walk through what a trauma-informed clinic looks like and simple steps you can take to ensure your services and clinic environment are trauma-informed. “

Click here to learn more and register for the webinar

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Setting up your Opt-out SMS messages

As we’ve discussed in our recent webinar and white paper, an important aspect of staying compliant when texting is to ask permission of the help seeker, and to put in a STOP message to enable texters to opt-out of text conversations. As a result, all U.S.-based organizations should have their first, outbound text message configured similar to the one below:

“[Name and location of organization] Welcome! Do you give your consent to text you? Reply yes to continue, STOP to cancel. Message & data rates may apply.”

We’ve made it easy for you to set it up in iCarol. Here’s how:

1. Select ‘Messaging’ on the Left Hand Menu Messaging left menu

2. Click on the SMS/Texting link on the upper right hand side of the screen SMS Settings

3. Look for “Settings for SMS”. There will be a new pull-down menu for your portals. It will automatically be set for “default”. Select the portal for which you wish to configure the message. If you only have one, there should only be one named choice in the pull-down list. Settings for SMS

4. Your first, automated message to the texter can be configured in a new field, labeled “SMS Initial Message.” Initial Message

5. Once you’ve configured the message, click the Save Settings button at the bottom of the screen.

Don’t forget that SMS messages have a maximum of 140 characters in the U.S.! Many organizations use abbreviations for some of the wording. You may have to play with your initial message configuration to get it under the character limit.

Note that future updates to the iCarol system will include making the Initial message field a required one for U.S.-based organizations. This will help ensure you don’t forget to configure the message.

For any questions on the configuration options, please contact Support via the Help Page within iCarol.

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Using iCarol’s Built-in Suicide Risk Assessment Tools

When your volunteers are working with a help-seeker either on the phone, in-person, or online, there may come a time where assessing that person’s risk for suicide becomes necessary. Several years ago the Lifeline developed suicide risk assessment standards based on industry research. We then took these standards into consideration and developed a tool for use in iCarol that guides your volunteers and staff through that assessment process. Like other forms in iCarol, this guide can be customized to your needs.

The assessment begins with three basic and direct questions that gauge whether the person is thinking of suicide today, if they’ve thought about suicide very recently, and whether they have ever attempted to kill themselves.

three questions

Instructions guide the worker to proceed if any of the questions receive a ‘Yes’ answer. A fourth question asking about suicide in progress can help determine imminent risk, and our ‘Help tip’ reveals important questions to help quickly clarify this risk and begin rescue if that is part of your helpline’s policies.

Suicide In Progress Help

Four areas influencing risk are explored: Desire, Capability, Intent, and Buffers and Connectedness. Each section contains a number of topics, each with a ‘Help tip’ providing suggestions on the types of questions or statements that could be worked into the conversation. This can help your staff build rapport with the client and allows the interaction to continue naturally, rather than feeling like a questionnaire.

Exploring risk

As they talk with the client, they can select any of three options for each area which best captures where the client is for that particular topic. As these options are selected, our tool weights these answers and provides a measurement that helps gauge the overall level of risk.

Weighted risk gauge

Next, your worker can discuss and record the client’s reasons for living and reasons for dying. This can be a compelling tool for discussion and an important piece of the conversation. When someone is at risk for suicide, finding and focusing on reasons for living as compared to their reasons for dying can be a powerful exercise.

Reasons for living and dying

Finally, your worker can record the level of risk as determined through their discussion with the client or from the measurement tool. A series of instructions can help guide them towards resolution, referral, and other outcomes.

Again, because our forms are customizable to your own practices, this guide can be used exactly as delivered or you can make your own adjustments and edits if needed.

Providing a safe place for open, honest discussion about suicide, free of judgment, is the cornerstone of any crisis service. This powerful risk assessment tool will help your volunteers and staff feel supported, equipped, and confident when working with callers at risk for suicide, all while helping your center conform with industry standards.

Want to know more about our Suicide Risk Assessment tools, or want to enable them in your system? Please , or existing users can open a support case.

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Search on up to three categories simultaneously

We’ve got a new optional tool for searching for resources using custom categories. This tool lets you conduct category searches on up to three categories (sometimes also referred to as “keywords”) simultaneously.

Those using the taxonomy are familiar with this already; what’s new is the ability for everyone with custom categories to use this.

multiple category searching

So how can this be helpful to your searches?

You could use this new tool to search for resources tagged with both “rent help” and “utility help” (if you had those categories set up, for example). That could be helpful if your caller had transportation issues, and needed a single place to go for both. The search results would only include resources tagged with both of those custom categories.

As another example, you could also use the tool to search for “rent help” OR “utility help.” That could be helpful if the caller had general financial issues, and you wanted to find any resource that might be able to help. In that case, the search results would return resources tagged with at least one of the categories you indicated. You’d get more search results with this method than you would for the first example.

If you’d like this tool enabled in your system, there’s no added charge. Please submit a support case, and our team will take care of that for you.

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New Tools for Finding Follow-ups and Surveys Due

We understand how important the follow-up process is at your helpline. There are many different reasons to follow-up with a help seeker after your initial conversation has ended. Safety planning and ongoing contact with support systems are extremely important for people who are having thoughts of suicide. Or perhaps you’d like to see if the referrals a caller was given were able to help them. Many centers also use a follow-up call as an opportunity to conduct a satisfaction or quality assurance survey.

helpline flowWhatever reason you are following up with a client, our follow-up activity within a call report form makes it easy to schedule these follow-ups. You can collect the important information you’ll need to conduct the follow-up call, not just the person’s name and phone number but important information to preserve confidentiality, like knowing whether or not it’s okay to leave a voicemail, or to say where you’re calling from if a third party answers the phone. Your volunteers can even sign up for an email notification to tell them a follow-up call has been scheduled and assigned to them. There’s also a handy “inbox” on the main calls page where they can quickly navigate to the list of follow-ups that are scheduled.

With our next release we’ll be launching improvements to the pages that list Follow-ups and Surveys due. Those pages, as always, are accessed from the Calls menu. Here are highlights of the changes, which you’ll see soon:

  • New arrows on the top bar let you change the sort order of each column: call report form number, due date, client name, phone worker, assigned to, and subject.
  • To make the date column sortable, that’s now in YYYY/MM/DD format.
  • A new search box lets you more quickly find the call reports you need by typing in a search term.
  • You can still reassign followups, but it looks a little different — the pulldown is gone. Instead, please just click on the “assigned to” name, and then you’ll see the list of names from which you can choose.

We hope this enhancement helps save time in your daily work; making it so you can quickly and efficiently find the information you need when conducting follow-up interactions.

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A Verified Timesaver

With February nearly over, are you finding you and your team are still working on items from your January to-do list? So much to do, so little time.

Perhaps it’s time to consider shifting to new timesaving workflows. One of the best ones: Automated Resource Verification (ARV). It’s particularly helpful if you have more than a couple hundred resources, and/or your certifications require regular updates.

Benefits copyThis handy tool – a well-integrated add-on to your iCarol system – makes short work of keeping your resource information up to date. Say goodbye to the headaches and time-eaters of the old way of verifying resource information: Endless games of telephone tag, bloated email inboxes, and hours cross-checking resource records to see if they include the latest information.

Check out the time-saving workflow you’d use with this tool:

  • In just a few clicks, create a list of resources that need to be verified, right from your iCarol resource search page. Verification-specific filters, such as “date last verified” can be combined with standard resource search filters to find just the resources you need.

  • Use radio buttons and pull-downs to select options, such as the email address the request will originate from, how to handle parent/child records, which email address to try first in the record, etc. The “visibility settings” area of iCarol lets you designate exactly which resource fields verifiers will and will not see.

  • With one click, have iCarol send verification requests for all resource records in your list. Each email will automatically include your custom message, plus iCarol will drop in a custom link that leads the recipient to information about just their resources.

  • Recipients click that link to view online the resource information you have in your database. They suggest changes to individual fields.

  • In your iCarol system – not in your email inbox, hooray! – you’ll get a prompt when responses have arrived, and you can review them. The fields with suggested changes are highlighted, making it fast and easy to focus on the changes. Feel free to make edits to the suggested information as needed, then click “Save.”

  • Your resource has now been updated and the changes are live in your database.

Clients who use ARV tell us the manpower savings, improved response rate, and greater precision over the process more than makes up for the add-on subscription cost.

If you’d like to find out more about this tool, add it to your subscription, or would like a free trial, please open a support case if you’re a current iCarol client, or if you’re not yet using iCarol. And if you’ve looked at Automated Resource Verification in the past, I invite you to take another look – we’ve added lots of enhancements in the past year.

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When Wintry Weather Wreaks Havoc on your Helpline

blizzard

With a blizzard moving up the north east coast today and tomorrow, many helplines in its path are brainstorming ways to keep their services up and running. Snowy and icy conditions can spell trouble for seamless shift coverage. How do you keep your hotline operating in spite of dangerous travel conditions for your volunteers and staff?

Depending on the severity of the storm, you may have no special plan at all except to tell workers they are expected to be there for their shift or find a substitute to cover for them. In many snow storms, travel is possible so long as precautions are taken, such as driving at slower speeds and being extra vigilant. Call centers in urban settings may also benefit from having volunteers living within walking distance or taking public transportation.

But sometimes travel conditions can become extremely hazardous or even impossible. What then? Here are some methods we’ve commonly seen:

  • The show must go on – Shifts go on as scheduled no matter what. Workers who realize they can’t make it in must give ample notice and find substitutes who are able to travel. If all else fails, the task falls to an essential staff of supervisors or managers to keep things running.

  • Transfer your calls – In some instances there may be a partner agency, satellite office of your program, or a back-up center in an area unaffected or less affected by the weather, and they can take the calls for a period of time. Our Call Report form sharing functionality makes it easy for you to pass your calls on to other centers, while they use your preferred call report form to log the calls they’re taking on your behalf.

  • Work from home – Technology has made it easier than ever to turn any setting into a call center, even your worker’s home. Calls could get forwarded to that worker’s personal phone or a phone loaned to them from the office. Using iCarol, chats or texts can be taken from virtually anywhere as well. Special tip for iCarol users who might employ this method: You must either turn off ‘Restriction’ (the feature that makes it so your workers can’t see call reports from a personal computer outside the office) or give your worker permissions to install the iCarol Certification Tool on their computer. You can read more about this here.

  • Camping out – Marshmallows optional. When the forecast calls for dangerous weather and snow accumulations that might make travel impossible, make a decision ahead of time to suspend the usual schedule, and instead have a crew arrive prior to hazardous road conditions developing. This crew will stay for a period of time until travel is safe again and shifts can resume. You’ll need sufficient kitchen and bathroom facilities, and workers should bring food. If this goes on for longer than the typical shift length, your crew can set up their own internal shifts of who works and who gets a break. By following the weather and traffic reports, the Director can decide when it’s time for normal shifts to resume.

Do you handle scheduling in wintry weather some other way? We’d love to hear about it! Leave us a comment!

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Why we should work to debunk the myth about suicide and the holidays

I distinctly remember the first time I learned the truth about a common myth related to suicide. It was nearly 14 years ago, and I was sitting with my fellow would-be hotline volunteers in our training class, ready to tackle the lesson we were all most nervous about: Suicide. We filled out a pre-test, designed to gauge our base knowledge about the topic, and see what sorts of preconceptions we were bringing with us to our volunteer experience. The true or false quiz seemed simple enough to me at the time, a college junior who had been through her share of advanced psychology classes and was about a year from graduation, in spite of those classes having provided very little mention of suicide. I arrived at one that gave me pause. “True or False: The suicide rate increases around the holidays.”

Hmmm…

I was a little stumped. “Gosh…I feel like I hear a lot about suicide during the holiday season,” I thought to myself. “And I know I’ve heard that statistic…somewhere. And hey, what time of year is more stressful for people than that whole period between Thanksgiving and the New Year? It makes sense. True.” My pencil checked the box.

Well (spoiler alert!) I was wrong. We all listened intently to the correct answers and found that much of what we thought was true about suicide was, in fact, false. And I remember feeling almost angry about this, like why was this whole topic so taboo, so secretive, that complete fallacies could be out there in the universe parading around as truths all these years. But that particular myth about the holidays was really stuck in my craw.

So stuck, in fact, that it’s become a running joke between me and my husband because he’s been witness to my missionary-like commitment to setting the record straight. I yell at the TV when I see a show reinforcing the myth. We’d be at a party and someone would find out where I worked and inevitably I’d get lots of questions about suicide, mental health, and other topics. Without a doubt someone would ask if it’s true, or make a comment about how more suicides happen around the holidays. My eyes would widen (another potential convert to help spread my gospel of truth!) as I got to explain (my husband might prefer the term “lecture”) that this was false, and that December can actually be a month where there are fewer suicides, but that springtime does seem to be a time where we lose more people to suicide than other times of year.

In addition to the fact that falsehoods in general just bug me, something about this one would set me over the edge, and I think it’s because I feel it’s actually a bit dangerous to have myths such as this one circulating.

Look, I’m glad that there are articles about suicide this time of year, any time of year for that matter, but too many of them use the myth as a means to drive traffic to their site or increase readership without clearly and categorically setting the record straight that there’s really no relationship between suicide and the holiday season. They also tend to leave out important information about prevention, according to a report by the Annenberg Public Policy Center.

What ends up happening is that people continue to feel there is a relationship (look at all these articles that come out about suicide in December, it must be true!) and I think, from that, two things happen.

First, attention to the topic of suicide is heightened at a time of year when incidents are typically at their lowest. Again, awareness is a good thing anytime, but where are all these articles during the rest of the year, particularly in springtime through summer when the incidents of suicide actually do increase? We end up with an abundance of articles and material when the myth creates a demand for content yet incidents are at their lowest, and a lack of attention when they’re at their highest in the spring and the public’s heightened awareness and knowledge of prevention methods could especially be put to good use.

Second, I think the perpetration of this myth promotes a sort of romanticism of, or glamorizes the idea of a holiday suicide. While you cannot put the thought of suicide in someone’s head by simply talking about it (another myth we frequently try to squash), irresponsible reporting of suicide in the media can contribute to the contagion phenomenon, which is very real. This idea that the holidays are a “good” time or a normal time to complete one’s suicide plan, or that a person “should” feel extra depressed, lonely, and susceptible to their thoughts of suicide this time of year can put someone already contemplating suicide in an especially vulnerable place.

It’s true that the holidays can be a stressful time of year. For someone who is already lonely, depressed, or otherwise suffering it can be a tough time. But there’s no evidence to suggest that this results in more people ending their own life around the holidays. I hope everyone will join me in what’s become a personal crusade to stop this myth in its tracks, and replace it with more productive information and education towards suicide prevention all year round.

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