Ontario Online and Text Crisis Services program (ONTX) recently marked a year of service to their communities, and shared data with constituents in their latest newsletter. In the report they describe response to the program as “overwhelmingly positive” while allowing contact with many individuals who otherwise would not have reached out for help.
Some key findings:
Total chats and texts: 8,921
75% of visitors were under 24 years old, while that same demographic makes up a very small portion of their phone callers
Over 200 specialists trained to take chats and texts
They receive an average of 5 suicide-related contacts each time the service is open
More than half of visitors said that in the absence of an online emotional support service like ONTX, they would not have spoken to anyone about their problem
For a full look at the released findings click here, or read a summary here. Want future updates from ONTX and other services of DC Ontario? Be sure to sign up for Distress and Crisis Ontario’s newsletter by emailing your request to .
We’re thrilled by the success of our friends at ONTX, though it comes as no surprise to us that they’ve had this response. The caring people at the Distress and Crisis Ontario have been providing listening support and crisis intervention to Ontario for nearly 50 years. Their latest step to make their services available in a way that works for everyone in need demonstrates their commitment to helping people and saving lives.
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
De-escalate
Subsequent calls:
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.
Thoughtful Suggestions:
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.
Peer Supports for Transition-Aged YouthDate: Wednesday April 6, 2016
Time: 2pm EDT
Transition-Aged Youth(TAY), including foster youth, youth who have been through the juvenile justice system, and youth with mental health diagnoses, have unique needs that are often unaddressed. At this crucial stage . . . Read more and register
Peer-Run Respite ProgramsDate: Thursday, April 14, 2016
Time: 2pm EDT
Peer-Run Respite Programs serve as successful alternatives to hospitalization or other traditional crisis services with focuses on support, hope, and . . . Read more and register
Best Practices in the Use of Self-Directed Care to Support Recovery in WomenDate: Thursday, April 21, 2016
Time: 2pm EDT
Building relationships and support systems is an important part of recovery. Mental Health America’s highly innovative It’s My Life: Social Self-Directed Care program combined . . . Read more and register
Right now the information and referral industry is in the midst of transformation. In a time where there are varying challenges facing our communities, help-seekers need the expertise and hands-on guidance of information and referral specialists now more than ever. And, in an ever-evolving mobile and connected world, consumers are hanging up their phones in favor of the convenience of communication via texting, live chat, and simply finding the right resources on their own via the web. Meanwhile, stakeholders desire access to data about the needs of the clients served by helplines, the efficacy of the services, and the gaps between human needs and the availability of services to meet them. These changes, and the need to adapt to them in order to stay relevant, can understandably overwhelm members of the industry, from visionaries and leaders to helpline staff.
Coming from helpline backgrounds ourselves, we’ve always been passionate about creating tools that make helping people even easier. We want to share our insights with you, and that’s why this year we’re holding a special day long intensive training summit just before the AIRS conference in St. Louis. Whether you’re a long-term customer or are considering iCarol for use in your I&R center, please join us to focus on best practices using iCarol, led by our staff of Certified Resource Specialists. Focused on 2-1-1 Directors, Call Center Directors and Resource Managers, you’ll learn about:
Strategies for getting the most out of the software
Cases studies from our clients using iCarol for innovative solutions
Serving clients by phone, web, chat and text in one integrated system
Applying the AIRS Standards and using the taxonomy well
Advanced training on existing iCarol features and a peek at features coming soon
This day long event will be conveniently located at the same hotel as the AIRS conference, and lunch will be provided.
We’d like to introduce you to an extremely versatile new feature with tons of potential uses: Online Forms. Watch our short video for more information, and contact our support team with questions or to get started.
These past six months, the Ontario Online and Text Crisis Services program has been in a soft launch phase, and on Monday in their monthly newsletter they released some initial data for that period.
Some key findings:
Total chats and texts through January 31: 4,700
73% of visitors are under 25 years old
Interpersonal and mental health issues were the most common topics of discussion
Visitors are reporting a decrease in distress following their chat
55% of visitors said they wouldn’t contact someone else if they couldn’t reach ONTX
For a full look at the released findings click here, and for future updates be sure to sign up for Distress and Crisis Ontario’s newsletter by emailing your request to .
We thank them for sharing these findings — we are often asked by others looking to add online emotional support to their service what they can expect. Data like this is very helpful as other prepare to make the critical shift of bringing their services online.
As often is the case, an interesting topic was recently posed on the AIRS networker, to which many of the Information and Referral industry professionals added their own thoughts and experiences.
The original question was one many can identify with: What database search method works best for your specialists? With a number of options available, such as your own home-built hierarchy of categories and keywords, or the taxonomy as another example, which do you prefer and use?
This prompted another related question: With the many thousands of potential taxonomy terms available for assignment and searching, how many terms account for the majority of your searches? Could your top 20 or even top 10 terms searched actually account for a very large number of your overall searches? Meaning that many of the terms assigned to your resource records are rarely if ever being keyed into searches.
Neil took a look at the data available to us to shed some light on this. Here are Neil’s findings as posted in the AIRS networker thread:
Looking at all iCarol clients in North America, which represent a substantial portion of 2-1-1’s and I&R’s, yields some interesting results.
In addition to tracking the actual Needs using the taxonomy, we also track what was searched as a possible Need (whether it was marked as a Need or not) by the I&R Specialist.
In Q4’2015, here are the percentage of Needs searched out of all searches for phone, chat and text interactions by an I&R Specialist (but for now, not public website searches):
Top 10 Needs searched = 45%
Top 20 Needs searched = 57%
This echoes what others have posted here. Granted, due to the season, there was a bit of a skew toward holiday-related Needs, but I wanted to work with a relatively recent date range.
Rolling up to Level 3 of the taxonomy, to filter out the (significant) variation at lower levels:
Top 10 Needs searched = 55%
Top 20 Needs searched = 71%
…which not surprisingly shows even more consolidation.
So on a wider scale, this confirms what you’re seeing locally.
It does make me wonder what the cause and effect may be. Are these truly the majority of caller Needs needing consideration during a call/chat/text? Or do we have a bias towards searching for Needs with which we are more familiar? The truth is probably somewhere in the middle, but I’d be keen to hear ideas about changes we could make in training, in our software, and possibly in the taxonomy that could help I&R Specialists familiarize themselves with less-used Needs, as [name omitted] is pointing out in this thread using the medical and dental examples.
For this and more great discussion, as always we suggest you look at AIRS membership for networker participation.
We welcome your thoughts and input on Neil’s findings above, please leave us a comment below to continue the discussion.
We’ve talked before about how sometimes the need for silence will influence people to use texting instead of a voice call. Sometimes silence isn’t preferred, but necessary, such as in this recent instance of a deaf woman who texted 9-1-1 after she noticed some children left unattended at a shopping mall. Luckily texting to 9-1-1 was enabled in her area.
Texting to 9-1-1 is continuing its expansion throughout the United States and Canada. The Canadian Wireless Telecommunication Association has set up an extensive and detailed website giving overview of the Text-to-911 process in Canada.
In the United States, it seems like each month more and more jurisdictions are adding on texting capabilities. A quick scan of recent news articles about texting 9-1-1 in the US produces alerts about the greater Kansas City area, Minnesota, areas in Texas, and northern California. Note that each of those articles was published this week. It all points to rapid expansion of that technology.
Just another sign of the times as we continue to see just how convenient, efficient, and often necessary texting can be when reaching out for help. We hope helplines will take note as this capability expands and explore texting for the helpline service to follow suit. If you want to learn how Texting works in iCarol, please join me for a Messaging webinar sometime!
Call report exports in iCarol contain a lot of data, and it can be challenging to understand what is being shown or where to find the particular data you are looking for. This article will review how to request a call report export, the different files one receives when they complete a call report export, and what data is shown in these files.
Requesting a Call Report Export
To request a call report export, users with Admin security will click Admin Tools, in the left hand menu, then the Tools tab, then the link “Extract all of your data” in the Data Export section.
On the data export page, the right hand column will be used to request a call report export.
The first drop-down menu, which shows “7 days ago” in the screenshot above, is a quick suggestion list you can use to denote what time frame you want to use for the resource export. If you would like to indicate a specific time frame for the export, use the two date field to denote a start and end date. Next, there are 3 check boxes to indicate what kind of export you would like to request; place a check mark next to “Call Reports”.
Under the title “Call Report export options”, you will see some information that says “Custom field columns will be ordered alphabetically. If you prefer a specific form’s fields to be first, please choose it below”. This is referring to the custom categories, groups and field that are in your call report. In the call report export, there will be one column for every custom group in your call report form, and these will be identified in this format: Category Name – Group Name. For example, Demographics – Gender. These columns will be arranged alphabetically by Category name. If your export will contain data from several different call reports, all categories from all call reports will be listed alphabetically. To say this another way, the columns, representing Categories, will not be in the order you see in the call reports, and categories from different call reports will follow each other, instead of all Categories from one call report first, then followed by the second call report, and so on. By choosing a particular call report with this option however, you can have all the categories from that call report come first, in alphabetical order, then followed by all the rest of the categories from all the rest of the call reports.
In the next section, you will choose which call reports you would like to export. By default, all call reports in your system are checked. If you would only like to export certain call reports, you will uncheck those you do not want to export. For those clients that only have one call report in their system, you will not see a list of call reports.
Finally, to run the call report export, you will click the “Start creating” button, found under the list of call reports.
As indicated in the note above the “Start creating” button, you will get an email when the export is ready. At that time, you will return to this page and you will find a link, on the right hand side of the screen, which you will click to download the export files. Usually, exports will be ready in an hour or two, but sometimes will take longer. Exports that contain a lot of data and cover a large period of time will take longer to generate, and if you request an export at a time when many other clients are requesting exports (for example, at the beginning of the month), your export will take longer to generate.
Call Report Export Files Received
When you return to the exports page after receiving the email that your export is ready, the export will be found on the right hand side of the screen as below.
Click on the download you would like to open. When it opens, you will see you have received several different files, as shown below.
Call Report Export Files Explained
CallReports
This is the most often referred to call report export file, as it contains all the data collected for every call report submitted in the time frame indicated for the call report export. This file has a column for every field in the call report, both “standard” iCarol fields, and custom categories, groups and fields. Some highlights of this export are outlined below.
Click on the image above to see a larger version
Column C, LinkedToCallReportNum, will only have data in it if you are using embedded call reports. Embedded call reports are call reports that are related to each other. Many clients embed separate risk assessments to call reports, and other clients embed follow-up forms, for example. If there is an embedded call report linked to the call report shown in the row in the export, the call report number of the linked call report will be noted in this column.
Column G, CallerNum, will only show something different than -1 if a caller profile was chosen for the call report. iCarol gives a number to all caller profiles which will be noted in this column.
Column K, PhoneWorkerNum, will show the number iCarol assigned to each of your users.
Click on the image above to see a larger version
Columns M through R refer to an old way of tracking non-transactional calls that we are not using for newer clients. Older clients may still be using this tool, which places a horizontal list of checkboxes just below the Contact Information section at the top of the call report, as shown below.
If you are not using this tool, you will always see Yes in column M, and No in columns N-R. If you are using this tool, No will be shown in Column M if Yes is shown in in one of the columns N through R, indicating that the call was a hangup, obscene, prank, wrong number, or silent call.
Columns U-AA indicate the caller’s location as noted in the location fields in the Contact Information section (shown in the screenshot above). Each iCarol client can determine which of these location fields appear; some clients choose to turn some or all of these location fields off. Even if these fields are turned off in all your call reports, these columns will still appear in the export, they will just be blank.
Click on the image above to see a larger version
Columns AF-AP all refer to fields in the Contact Information section of the call report. Again, some clients choose to turn some or all of these fields off. Even if they are turned off, they will still appear in the export, but will be blank.
Click on the image above to see a larger version
Column AQ is first default text field on the Content Tab of the call report. By default, this field is called “Call Description”, though this name can be changed.
Column AR is the “Worker’s Comments” text field on the Content tab. This field can be turned off; even if it is turned off, this column will still show on the export, but will be blank.
Column AS is the “Feedback from supervisors and staff” text field on the Content tab. This field, and therefore, the feedback function, can be turned off but again, the column will still appear in the call report export.
Column AT is the “Caller’s Feedback” text field on the Content tab. This field can be turned off but again, the column will still appear in the call report export.
Columns AU-BC are additional text fields that can be added to the Content tab. These additional text fields are added via the “Overall settings for this call report form” page when editing call reports using the call report editor. Again, even if these additional fields are not used, they will appear in the call report export.
Click on the image above to see a larger version
Column BD will contain a number other than -1 if the worker who entered the call report is not a deleted user. iCarol assigns a Worker Number to all users in your system.
Column BH refers to the “reviewed for accuracy” function that clients can turn on via the Calls tab in Admin Tools.
Columns BI-BK refers to the feedback function in iCarol. If feedback is being given on call reports, there will be data in these columns.
Column BL will show all the referrals given to the caller, both those found in the resource database and linked to the call report, and out of database referrals, if that functionality is turned on. Please note that if more than one referral was given, the referrals will be separated by semi-colons in this column of the export.
Column BM refers specifically to instant messaging call reports where the IP address of the visitor is recorded in the call report.
Click on the image above to see a larger version
The custom categories and groups added to the call report begin at column BN. All columns before this point were “standard” iCarol fields, some of which can be turned off in the call report. All custom categories and groups, as stated earlier, are arranged alphabetically by Category name, then Group name. In the example call report export shown in the screenshot above, you can see the first 5 custom groups in the call report listed by their Category name, then Group name. The data you find in each row for these columns will indicate what Field was selected in the Group if it is a drop-down or checkbox Group, or what text was entered if the Group is formatted as a text Group.
CallReportCustomFields
This report shows the selections made in custom categories, groups and fields for all call reports submitted in the time frame of your export. Each block of color in the screenshot above represents one call report, as indicated by the call report number in column A. Please note that column F is labeled “SubCategoryName” which is also known as the Group, and column G is labeled “Answer”, also known as the Field. If a Group is formatted as text, the text entered into that group will be shown in column I.
CallReportFollowups
This file will show follow-up activities created or edited during the time frame of the call report export. Please note, a follow-up activity created outside of the time frame indicated will not be included in this file, but if that same activity was edited in the time frame, it will be shown in this file. The columns in this file refer to the fields found in the “Schedule a Follow-up activity section” on the Finish tab of call reports. Each client can control which fields appear in this section via the Calls tab of Admin Tools. However, all of the columns will appear in the export even if you have turned off a specific field, they will just be blank.
Please note columns J-L. These fields will be populated if the client has turned on, via the Calls tab in Admin Tools, the function to note follow-ups with a purpose (assistance, advocacy or survey). If this function is turned on, the follow-up purpose will be selected from a drop-down menu that will appear at the top of the “Schedule a Follow-up activity” section.
CallReportNeedsMetAndUnmet
Click on the image above to see a larger version
Click on the image above to see a larger version
Click on the image above to see a larger version
This export only applies to those clients using the Needs by Taxonomy function, where each call report notes a need, and any referrals made are noted as meeting the need or not. This file includes:
the referral made (columns D and E)
the Need noted (columns F and G)
the caller’s location and phone number (columns H-N)
if the Need was unmet, and if so, the reason (columns O-P)
the breakdown of the taxonomy term chosen as the need (columns Q-Z)
the AIRS Need Category the need falls into (column AD)
the parent agency the referral belongs to (columns AF and AG)
CallReportsLinkedTogether
This very small export (only 2 columns of data) only applies to those clients using embedded call reports. As noted earlier, embedded call reports are a way to link two different call reports together. Two common ways this is being used is for separate risk assessment call reports, and follow-up call reports. This report will show the call report numbers of those call reports that are linked together, or related.
CallReportsOutofDatabaseReferrals
For those clients using the Out of Database Referrals functionality, this file will contain the details of the out of database referrals made during the time frame of the export. Any details of the resource that the call taker included (Agency name, Program name, phone number, address, website, etc.) will be shown in this file.
Analysis of Export Files
The files are exported in .csv format, which can be displayed by Microsoft Excel. It is highly recommended that one have some knowledge of how to use Excel and its various functions to aid in analysing the data in the export files. There are many books, websites and courses that can teach one to use Excel.
One particularly helpful function is filtering. Using filtering, one can find very specific call reports. For example, you could use filtering to find all call reports from male callers (assuming, of course, that the gender of the caller is recorded in the call report). You can add an unlimited amount of filters to find increasingly specific call reports, such as male callers over the age of 60 who lives in Beverly Hills and discussed physical health concerns during their call.
In some cases, the particular data you might like to analyse will be contained in separate export files. For example, details on follow-ups are not contained in the same file as selections made in custom Groups. In this case, learning how to create pivot tables in Excel is very useful. In this way, you can link two files together to get a full picture of the call itself and the follow-up.
One last note – if you would like to save an export file to your hard drive, ensure you save it as an Excel file extension (.xlsx or .xls for example).
Mental Health Professionals concerned that automated self-help programs will put them out of business can take some comfort in a new study — it found that when it comes to mental health care for depression, computerized self-help simulators offered no additional benefits over traditional therapies one might receive from their primary care physician. In fact, the study found that nearly 25% of participants dropped out within four months and failed to engage with the self-help program.
Dr. Christopher Dowrick of the University of Liverpool wrote an accompanying editorial in which he commented, “It’s an important, cautionary note that we shouldn’t get too carried away with the idea that a computer system can replace doctors and therapists . . . We do still need the human touch or the human interaction, particularly when people are depressed.”
Such simulators have been around for awhile and have increased in popularity as access to technology increases and the stigma surrounding mental health treatment continues. These programs are run purely on artificial intelligence, that is to say there is no human being at the other end giving their feedback or any empathetic response.
So, while it seems looking online for help is a growing trend, taking the human element out of that interaction may not be the best way to go. This is good news, however, for helplines, counselors, and others looking to offer live chat capabilities to their service. Clearly people want to take advantage of the anonymity, and desire a less-threatening way of asking for help, but connecting with a human being on the other end of the online conversation is an all-important element of that process.
NPR published an article about this study which you can read here, or read the study itself here.
