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Detecting Suicidal Youth in Text-Based Helplines
1. The challenges of
detecting suicidal
callers in text-based
youth helplines
LOUIS-PHILIPPE CÔTÉ; BRIAN L. MISHARA
CENTER FOR RESEARCH AND INTERVENTION ON SUICIDE, ETHICAL ISSUES AND END-OF-LIFE PRACTICES
UNIVERSITÉ DU QUÉBEC À MONTRÉAL, CANADA
2. The challenges of detecting suicidal
callers in text-based youth helplines
Challenges related to ….
Mission and objectives of youth helplines
Staff and training issues in youth helplines
Nature of text-based communication
We will illustrate these challenges by presenting the results of a study in
progress
3. Youth helplines are general helplines
They are used by youth …
To get information on a wide variety of
topics
To discuss sensitive topics with a trusted
adult anonymously
To express distress (sometimes suicidal
ideations) and get help
4. Youth helplines are general helplines
No systematic suicide risk assessment
policies
Handling suicidal callers is a minor aspect
of their overall training
Suicide risk assessment skills are not
practiced often
5. Youth helplines helpers are not (usually)…
Psychologists or psychiatrists
No comprehensive clinical
interviews
Scientists or suicidologists
No complex validated
scales
Psychics or magicians
No thoughts reading…
7. In summary, the main challenges …
Suicide risk assessment is an uncommon practice in youth general helpline
Suicide risk assessment in text-based youth helplines is more about helpers
perceptions than objective description or prediction
Gathering data on suicidality in text-based youth helplines is a complex
operation
8. Research questions
How effective are text-based youth helpline in detecting
suicidal children?
Generally speaking, Is there an underestimation of the
number of suicidal callers in text-based youth helplines
statistics?
9. Current study
Evaluation of text-based youth helpline in
Quebec (Canada)
Good public image
Often given as a reference in newspaper
articles or in tv show
10. This study has three main objectives:
1) to estimate the proportion of suicidal individuals among the youths
contacting a text-based youth helpline
2) to determine the proportion of the suicidal youths who mention their
suicidal ideations in their conversation with the service
3) to assess the proportion of interventions with suicidal youths where the
counselor performs a suicidal risk assessment
11. Method
Post-intervention questionnaire
Satisfaction (3 items)
During the past 12 months, did you ever
seriously consider attempting suicide?
Have you ever tried to commit suicide?
BDI-13 Suicide item
postintervention suicidal ideations
Content analysis
Callers
Age, gender
Reason (s) of the call
Apparent suicidality
No (no indications)
Maybe (indirect verbalizations)
Yes (explicit verbalizations)
Helpers
Suicide risk investigation & action plan
12. Sample
Postintervention
questionnaire
•n.2820
•Response rate ≈15%
Suicidal ideations –
12 months
•n.1314 (42%)
Suicide attempt(s)
•n. 671 (21%)
Content analysis (in
progress)
•n.283
2820 youths who contacted the
service answered the postintervention
questionnaire
42% reported having experienced
serious suicidal ideation in the past 12
months
35% reported having attempted
suicide in their lifetime
13. Sample
Postintervention
questionnaire
•n.2820
•Response rate ≈15%
Suicidal ideations –
12 months
•n.1314 (42%)
Suicide attempt(s)
•n. 671 (21%)
Content analysis (in
progress)
•n.283
2820 answered the postintervention
questionnaire
42% reported serious suicidal ideation in
the past 12 months
35% reported having attempted suicide in
their lifetime
Content analysis (n.283)
Recent suicidal ideation + suicide
attempt(s)
Age: 16.52 / Female: 88 %
14. First reason for
contact
45% of kids who talked
about their suicidal
ideations called to talk
about suicide
55% of kids who talked
about their suicidal
ideations called for
another reason than
suicide
Mental illness
symptoms is the most
common reason
15. Exploration & revelation
of suicidal ideations (SI)
All interventions involving
suicidality
78% SI revealed by the
caller
Primary reason for contact
90 % SI revealed by the
caller
Secondary reason for
contact
66 % SI revealed by the
caller
19. Post-intervention
suicidal ideation
kids who did talked about
suicide
10 % reported no post-
intervention ideations
45 % reported they think
that death would free them
45 % reported explicit
suicide ideations
20. Post-intervention
suicidal ideation
kids who did not talked about
suicide:
35 % reported no post-
intervention ideations
39 % reported they think
death would free them
26 % reported explicit
suicide ideations
21. Conclusion
We need to find creative ways to identify suicidal youth
Pre-intervention questionnaire?
Machine learning and NLP ?
Post-intervention questionnaire with follow up?
Better training in handling suicidal callers in text-based youth helpline
Evidence based practices