Search Results (5)

Texting-based crisis counseling is increasingly used to reach young people in acute crisis. Drawing on the online disinhibition effect (ODE), this U.S. study explored how asynchronicity and invisibility contribute to how users reveal their presenting problem and engage with counseling. A random sample of 49 text crisis line sessions with youth averaging 18 years was used to assess response lag times and flow as well as their impact on the session. Interviews with crisis counselors provided supplemental context. Content analysis identified patterns in the presenting problem, reasons for response lags, and patterns in how the sessions ended. The overall duration of text sessions was substantially longer than that of voice calls, to cover comparable content. Users frequently multitasked or become engaged in other activities between texts, creating a more disjointed flow. This also allowed the user to take time with responses to difficult questions. Counselors had to match their pace with users, make decisions when to discontinue the session, and use intentional language to develop a therapeutic connection. In line with the ODE framework, the findings suggested that the invisible nature of texting allowed users to reach out for help at the moment they needed it, regardless of their location. Implications for using texting-based interfaces are discussed. Full article

We present the opportunities and challenges of Open Up, a free, 24/7 online text-based counselling service to support youth in Hong Kong. The number of youths served more than doubled within the first three years since its inception in 2018 in response to increasing youth suicidality and mental health needs. Good practice models are being developed in order to sustain and further scale up the service. We discuss the structure of the operation, usage pattern and its effectiveness, the use of AI to improve users experience, and the role of volunteer in the operation. We also present the challenges in further enhancing the operation, calling for more research, especially on the identification of the optimal number of users that can be concurrently served by a counsellor, the effective approach to respond to a small percentage of repeated users who has taken up a disproportional volume of service, and the way to optimize the use of big data analytics and AI technology to enhance the service. These advancements will benefit not only Open Up but also similar services across the globe. Full article

Evidence indicates that stigma impedes an individual’s chance of seeking professional help for a mental health crisis. Commonly reported aggregate-level results for stigma-reduction efforts obfuscate how much stigma reduction is needed to incur a practically meaningful change within an individual, defined here as an attitudinal shift and openness towards seeking mental health for oneself and/or support for others. When basing conclusions and recommendations about stigma-reducing interventions on aggregate scales, it is unclear how much stigma reduction is needed to incur meaningful change within an individual. We explored the impact of reductions in stigma of help-seeking scores in response to an online suicide prevention video among young adults in the United States, using online surveys to collect qualitative and quantitative data. We compared mean changes in the stigma scores from pre- to post-test (video exposure) of 371 young U.S. adults using standard t-tests and individual level analysis. A separate thematic analysis of free-text responses was also conducted from a smaller, randomly-selected subgroup, capturing individuals’ attitudes towards help-seeking for mental health problems. Great attention was given to participants to ensure that they were in a campus setting where counseling services were available. Four main themes emerged: (1) small changes in stigma scores were associated with individual reports of meaningful reductions in their attitudes towards professional counseling; (2) increased empathy towards victims of suicide and other mental health problems sometimes indicated increased empathy for victims of suicide and decreased openness in professional help; (3) empathy towards victims sometimes took the form of increased scores and grief or sadness, possibly thwarting the potential for help-seeking; and (4) self-reports of decreased stigma were not always associated with increased openness towards help-seeking. Results also indicated that small stigma score charges, not meeting statistical significance, were often associated with increased openness towards seeking help. These findings, discovered using mixed-methods, contribute to the body of literature regarding stigma towards suicide and help-seeking by demonstrating deficits in the aggregate-only analysis of stigma-reducing interventions specifically aimed at suicide prevention. Such individuation in stigma experiences indicates that public education on how to reduce the stigma of help-seeking for suicide prevention needs to consider individual-level analyses for improving target populations. Recommendations for future research include additional studies prior to releasing suicide prevention videos to public forums where they may be seen by individuals without access to help. Full article

Counselling helplines or hotlines are key support services for young people with mental health concerns or in suicide and self-harm crises. We aimed to describe young peoples’ use of a national youth helpline (Kids Helpline, Australia, KHL) to understand how usage changed over time. A descriptive analysis was conducted on 1,415,228 answered contacts between 2012–2018. We described the trend of service usage over the observed period, the types of youth who used the service, and the problems young people contacted the service about. Phone (APC = −9.1, KHL: −10.4 to −7.8, p < 0.001) and email (APC = −13.7, 95%CI: −17.1 to −10.2, p < 0.001) contacts decreased over time whereas webchat contacts increased (APC = 16.7, 95%CI: 11.7 to 22.0, p < 0.001). With this increase in webchat contacts, there was an associated increase in total webchat contact duration. Concerns raised in contacts to the service were primarily related to emotional wellbeing and mental health concerns (53.2% phone, 57.3% webchat, 58.2% email) followed by social relationship issues (20.4% phone, 20.3% webchat, 16.8% email) and family relationships (19.4% phone, 17.2% webchat, 21.8% email). The increased preference for online text-based information and counselling services can help inform development of services for young people and allocation of staff/service training and resources. Full article

A variety of new sources describing community pharmacy-based take-home naloxone (THN) programs have emerged recently in the literature. There is a need to define the types of take-home naloxone programs being offered to support future research designs in implementing and evaluating standardized programs that fill pharmacist and patient knowledge gaps and lift current barriers for optimal community pharmacy naloxone provision. The objective of this paper is to summarize the literature on community pharmacy-based THN programs, including specific program interventions used to increase naloxone dispensing, naloxone availability and dispensing patterns, facilitators and barriers for the THN programs, and knowledge gaps. Online databases such as PubMed, EMBASE, Scopus, and International Pharmaceutical Abstracts (IPA) and a search of the grey literature were used to identify eligible sources. Sources were screened by two reviewers for eligibility in COVIDENCE software. Both reviewers compared screening results and resolved conflicts through discussion. A data extraction form for all identified full texts was completed by both reviewers and results were compiled through reviewer discussion. Fifty-two sources met the eligibility criteria. The top three barriers identified were: cost/coverage of naloxone, stigma, and education/training for pharmacists. THN program interventions included screening tools, checklists, pocket cards, patient brochures, and utilizing the pharmacy management system to flag eligible patients. Patient knowledge gaps included naloxone misinformation and lack of awareness, while pharmacists demonstrated administrative, clinical, and counselling knowledge gaps. Naloxone availability was found to be highly variable, where independent and rural pharmacies were less likely to stock or dispense naloxone. Further, pharmacies located in districts with higher rates of opioid overdose deaths and lower household income were also less likely to have naloxone available. This review identified multiple new programs, showcasing that the implementation and evaluation of THN programs are an expanding area of research. Future research should focus on implementing and evaluating a THN program through a randomized controlled trial design that incorporates solutions for the barriers and knowledge gaps identified in this study. Full article