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\"Germaine Johnson doesn't need friends. She has her work and her Sudoku puzzles. Until, that is, an incident at her insurance company leaves her jobless--and it turns out that there are very few openings these days for senior mathematicians with zero people skills. Soon enough though, Germaine manages to secure a position at City Hall answering calls on the Senior Citizens Helpline. But it turns out that the mayor has something else in mind for Germaine: a secret project involving the troublemakers at the senior citizens center and their feud with the neighboring golf club\"-- Provided by publisher.

Background During the Covid-19 pandemic, a number of hotlines/helplines/call centers was implemented to provide remote services and support public health. The objective of this study was to investigate the characteristics, challenges and lessons learned of implementing Covid-19 hotlines/helplines/call centers during the pandemic. Methods PubMed, Web of Science, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest databases as well as Google Scholar were searched between 1st January 2020 and 31st December 2023 to retrieve relevant articles published in English. The quality and risk of bias of the studies were assessed using the Appraisal tool for Cross-Sectional Studies (AXIS), the Mixed Methods Appraisal Tool (MMAT), and Critical Appraisal Skills Programme (CASP) Checklist. Results In total, 43 out of 1440 articles were included in this study. About half of the hotlines/helplines/call centers were launched in March 2020 ( n  = 19). Providing psychological support ( n  = 23), reliable information about Covid-19 ( n  = 10), healthcare advices about Covid-19 ( n  = 8), and triage ( n  = 7) were the most common purposes of implementing these services. The most common challenges included a lack of physical examination, unavailability of hotlines/helplines/call centers at the point of need, and delay in updating Covid-19 information. The most common lessons learned were employing qualified staff, providing proper training, and getting feedback from the callers and operators. Conclusion According to the results, most of the Covid-19 hotlines/helplines/call centers were launched in the early months of the pandemic, and about half of them were active seven days a week. Most of the operators were mental health providers and clinicians. The findings show the importance of continuous psychological support during crises, particularly when adequate information about the situation is not available. The challenges experienced by the callers and operators as well as the lessons learned by the service providers also need to be considered for future crises to increase the effectiveness of similar services.

\"Gabriella Mallory, AP student and perfect-daughter-in-training, stands barefoot on a public toilet for three hours while her school is on lockdown. Someone has planted a bomb and she is hiding. The bomb is defused but the would-be-bomber is still at large. And everyone at Central High School is a suspect. The school starts a top-secret crisis help line and Gabi is invited to join. When she does, she is drawn into a suspenseful game of cat and mouse with the bomber, who has unfinished business. He leaves threatening notes on campus. He makes threatening calls to the help line. And then he begins targeting Gabi directly. Is it because her father is the lead police detective on the case? Is the bomber one of her new friends. Could it be her new boyfriend with his complicated past? As the story unfolds, Gabi knows she is somehow connected to the bomber. Even worse she is part of his plan. Can Gabi reach out and stop him? Or will she be too late?\"--Provided by publisher.

Building therapeutic relationships and social presence are challenging in digital services and maybe even more difficult in written services. Despite these difficulties, in-person care may not be feasible or accessible in all situations. This study aims to categorize crisis counselors' efforts to build rapport in written conversations by using deidentified conversation transcripts from the text and chat arms of the National Child Abuse Hotline. Using these categories, we identify the common characteristics of successful conversations. We defined success as conversations where help-seekers reported the hotline was a good way to seek help and that they were a lot more hopeful, a lot more informed, a lot more prepared to address the situation, and experiencing less stress, as reported by help-seekers. The sample consisted of transcripts from 314 purposely selected conversations from of the 1153 text and chat conversations during July 2020. Hotline users answered a preconversation survey (ie, demographics) and a postconversation survey (ie, their perceptions of the conversation). We used qualitative content analysis to process the conversations. Active listening skills, including asking questions, paraphrasing, reflecting feelings, and interpreting situations, were commonly used by counselors. Validation, unconditional positive regard, and evaluation-based language, such as praise and apologies, were also often used. Compared with less successful conversations, successful conversations tended to include fewer statements that attend to the emotional dynamics. There were qualitative differences in how the counselors applied these approaches. Generally, crisis counselors in positive conversations tended to be more specific and tailor their comments to the situation. Building therapeutic relationships and social presence are essential to digital interventions involving mental health professionals. Prior research demonstrates that they can be challenging to develop in written conversations. Our work demonstrates characteristics associated with successful conversations that could be adopted in other written help-seeking interventions.

\"While dealing with the recovery of his mentally ill father, sophomore in high school Billy volunteers at a suicide prevention line and falls for one of the incoming callers\"-- Provided by publisher.

Concerned significant others (CSOs) play a significant role in supporting individuals with substance use disorders. There is a lack of tailored support services for these CSOs, despite their substantial contributions to the well-being of their loved ones (LOs). The emergence of helplines as a potential avenue for CSO support is outlined, culminating in the focus on the Partnership to End Addiction's helpline service, an innovative public health intervention aimed at aiding CSOs concerned about an LO's substance use. The article analyzes the demographics and use patterns of the Partnership to End Addiction's helpline service, highlighting the critical role of such services, and advocating for expanded, tailored support models. This observational study draws data from 8 data platforms spanning April 2011 to December 2021, encompassing 24,096 client records. Surveys were completed by helpline specialists during synchronous telephone calls or self-reported by CSOs before helpline engagement. Collected information encompasses demographics, interaction language, substance of concern, CSO-LO relationship, and the LO's \"use state,\" that is, their location on the continuum of substance use. CSOs primarily comprised women (13,980/18,373, 76.1%) seeking support for their children (1062/1542, 68.9%). LOs were mostly male (1090/1738, 62.7%), aged 18-25 years (2380/7208, 33%), with primary substance concerns being cannabis (5266/12,817, 40.9%), opioids (2445/12,817, 19%), and stimulants (1563/12,817, 12.1%). CSOs primarily sought aid for LOs struggling with substances who were not in treatment (1102/1753, 62.9%). The majority of CSOs were looking for support in English (14,738/17,920, 82.2%), while the rest (3182/17,920, 17.8%) preferred to communicate in Spanish. Spanish-speaking CSOs were significantly more likely to call about cannabis (n=963, 53.7% vs n=4026, 38.6%) and stimulants (n=304, 16.9% vs n=1185, 11.3%) than English-speaking CSOs (P<.001). On the other hand, English-speaking CSOs were more likely to be concerned about opioids than Spanish-speaking CSOs (n=2215, 21.3% vs n=94, 5.2%; P<.001). The study illuminates the helpline's pioneering role in aiding CSOs grappling with an LO's substance use. It highlights helplines as crucial resources for CSOs, revealing key demographic, substance-related, and use-state trends. The dominant presence of women among users aligns with other helpline patterns and reflects traditional caregiving roles. While parents form a significant percentage of those reaching out, support is also sought by siblings, friends, and other family members, emphasizing the need for assistance for other members of an LO's social network. Spanish-speaking individuals' significant outreach underscores the necessity for bilingual support services. Substance concerns revolve around cannabis, opioids, and stimulants, influenced by age and language preferences. The helpline serves as an essential intermediary for CSOs, filling a gap between acute crisis intervention services and formalized health care and treatment services. Overall, the study highlights this helpline's crucial role in aiding CSOs with tailored, accessible support services.

Crisis hotlines serve as a crucial avenue for the early identification of suicide risk, which is of paramount importance for suicide prevention and intervention. However, assessing the risk of callers in the crisis hotline context is constrained by factors such as lack of nonverbal communication cues, anonymity, time limits, and single-occasion intervention. Therefore, it is necessary to develop approaches, including acoustic features, for identifying the suicide risk among hotline callers early and quickly. Given the complicated features of sound, adopting artificial intelligence models to analyze callers' acoustic features is promising. In this study, we investigated the feasibility of using acoustic features to predict suicide risk in crisis hotline callers. We also adopted a machine learning approach to analyze the complex acoustic features of hotline callers, with the aim of developing suicide risk prediction models. We collected 525 suicide-related calls from the records of a psychological assistance hotline in a province in northwest China. Callers were categorized as low or high risk based on suicidal ideation, suicidal plans, and history of suicide attempts, with risk assessments verified by a team of 18 clinical psychology raters. A total of 164 clearly categorized risk recordings were analyzed, including 102 low-risk and 62 high-risk calls. We extracted 273 audio segments, each exceeding 2 seconds in duration, which were labeled by raters as containing suicide-related expressions for subsequent model training and evaluation. Basic acoustic features (eg, Mel Frequency Cepstral Coefficients, formant frequencies, jitter, shimmer) and high-level statistical function (HSF) features (using OpenSMILE [Open-Source Speech and Music Interpretation by Large-Space Extraction] with the ComParE 2016 configuration) were extracted. Four supervised machine learning algorithms (logistic regression, support vector machine, random forest, and extreme gradient boosting) were trained and evaluated using grouped 5-fold cross-validation and a test set, with performance metrics, including accuracy, F -score, recall, and false negative rate. The development of machine learning models utilizing HSF acoustic features has been demonstrated to enhance recognition performance compared to models based solely on basic acoustic features. The random forest classifier, developed with HSFs, achieved the best performance in detecting the suicide risk among the models evaluated (accuracy=0.75, F -score=0.70, recall=0.76, false negative rate=0.24). The results of our study demonstrate the potential of developing artificial intelligence-based early warning systems using acoustic features for identifying the suicide risk among crisis hotline callers. Our work also has implications for employing acoustic features to identify suicide risk in salient voice contexts.

Background Overdose response hotlines, such as the SafeSpot and Never Use Alone phone hotlines and Brave smartphone application, are promising tools to reduce fatal overdose risk among people who use drugs (PWUD). These free and confidential services connect callers to a trained operator who monitors them for adverse reactions during and after drug use. We explored PWUD’s perceptions of overdose response hotlines. Methods PWUD receiving substance use treatment in a facility in a Midwestern US city were screened for eligibility using the NIDA-Modified ASSIST questionnaire and invited to enroll if they had a moderate or severe substance involvement score for use of street or prescription opioids. Ten participants completed a 30–45-minute in-depth interview focused on overdose prevention, including perceptions and use of overdose response hotlines, in February 2022. Inductive content analysis was used to describe perspectives on overdose response hotlines. Results Only 1 of the 10 participants had heard of overdose response hotlines, but most were optimistic about their potential benefits for PWUD. One participant said, “I believe that if word was out there, people would use it.” Another stated, “I would trust it today. I know that there is [sic] people trying to change what’s going on in our culture with opiates.” Participants described several potential barriers to utilization, including distrust, especially in the context of drug-induced paranoia and concerns about being arrested, and the cost of an emergency medical response if an overdose occurred. One participant stated, “people get paranoid when they’re using drugs. And to be like, ‘I’m using!’ over the phone, that’s not too easy.” Another said, “If you call 911, the police are coming and if you’re using, you’re going to jail.” Conclusions Overdose response hotlines are acceptable and trustworthy fatal overdose prevention tools. However, several barriers may limit their utilization, including distrust, drug-induced paranoia, and the cost and potential consequences should an overdose occur, including arrest or cost of emergency response. Further study of utilization, acceptability, and policy and practical solutions addressing perceived barriers to utilizing these services are needed.

Background Investigating experiences of staff and callers of call centers/hotlines during the Covid-19 pandemic is essential to identify perceived strengths, challenges, and opportunities for improving service delivery. This study aimed to explore experiences and perspectives of staff and callers of the 4030 call center during the Covid-19 pandemic. Methods This was a qualitative study in which data were collected via conducting semi-structured interviews with the call center’s staff ( n  = 5), consultants ( n  = 24), and callers ( n  = 35). The data were analyzed using the framework analysis approach. Result The results included four main themes emerged from interviewing the staff and consultants of the call center: the rationale behind establishing the 4030 call center, its operational processes, strengths, and challenges. Interviews with the callers included three key main themes: reasons for contacting the call center, its strengths, and challenges. Conclusion During the Covid-19 pandemic, the 4030 call Center played an important role in reducing the burden of in-person visits to healthcare centers as well as providing psychological support to the public. Despite advantages such as preventing disease spread and alleviating public concerns, challenges including the large number of calls, long waiting times, and limitations of telephone counseling were reported. Therefore, healthcare policymakers need to pay more attention to the strengths and challenges of the call centers during health crises to improve service delivery and use past experiences for future planning.

PurposeTo evaluate the utility of a telephone outcall program for cancer caregivers and to examine longitudinal changes in their distress levels and supportive care needs.MethodsAs part of the PROTECT trial, caregivers assigned to the intervention arm (N = 108) received three telephone outcalls from a Cancer Council 13 11 20 nurse at three time points (7–10 days post-randomization, 1 and 4 months later). During each call, caregivers were screened for distress using the Distress Thermometer (range: 0–10) then six supportive care issues were raised for discussion. Participants completed a utility survey 1 month post-intervention.ResultsThe outcall program was highly acceptable and perceived as beneficial by caregivers. Overall, 95% reported it was worth their time to take part in the outcall program and 82% stated that the program was very relevant to them. Level of distress and impact of distress decreased over time (p = 0.0031, p < 0.0001, respectively). Average call duration decreased over time (p < 0.0001) and was longer for female than male caregivers (p = 0.0009). The frequency of caregivers discussing issues related to psychological distress (p = 0.0003), health literacy (p < 0.0001), financial (p = 0.0014), and practical concerns (p = 0.0121) decreased over time. Psychological distress was more often discussed by female than male caregivers (p = 0.0153), and family issues more often by younger (< 55 years) than older caregivers (p = 0.0071).ConclusionsUtility of this outcall program was high. Caregivers’ level of distress and unmet needs decreased over time. Gender and age differences emerged, which warrants the need for tailored support. Further research is necessary to identify the best method of improving access to 13 11 20 services for caregivers.