Effects of the Canadian Suicide Prevention Service's Text Interventions on Texters' Emotions, Distress Relief, Perceived Abilities, and Practices Associated With Better Outcomes.

Abstract

Aims: To describe users of the Canada Suicide Prevention Service textline (now "988"), explore their perceived impact of the service and identify characteristics of interventions associated with a greater likelihood of positive effects of exchanges.

Methods: Data from 146 transcripts were analyzed using quantitative content analysis, and data were associated with counselor assessments and pre- and post-intervention questionnaire responses. Suicide risk was assessed using the Suicidal Ideation Attributes Scale (SIDAS).

Results: 78.8% of texters exhibited "severe" suicidal ideation on SIDAS, with 26.7% reporting specific plans for suicide. Complete risk assessments were often not conducted, but counselors extensively explored texters' resources and discussed potential solutions. Positive emotional changes were associated with counselors' thorough exploration of resources. Only one technique, "Reinforcing a strength or positive action of the texter," was significantly associated with positive outcomes.

Limitations: Low response rates to post-intervention survey questions may affect the representativity of participants compared to all textline texters.

Conclusion: A large proportion of texters reported they were less upset and were better able to cope with their problems after the text exchange. However, there is a need for more training and supervision to ensure that adequate suicide risk assessments are conducted, or the development of shorter assessment procedures.