Teenagers' attitudes about seeking help from telephone crisis services (hotlines)

The purpose of this study was to examine the attitudes toward the use of telephone crisis services (hotlines) among 519 adolescents in 9th through 12th grade mandatory health courses in six high schools in New York State. Few adolescents (2.1%) used hotlines and negative attitudes were stronger toward hotlines than they were toward other formal sources of help. The most common reasons for hotline nonuse related to feelings of self-reliance and shame. Objections to hotlines were strongest among students most in need of help by virtue of impaired functioning or feelings of hopelessness. The results underscore needed outreach efforts to youth.     

Awareness,Attitudes, and Use of Crisis Hotlines among Youth At‐Risk for Suicide

Crisis hotlines have been central to suicide prevention efforts; however, utilization among youth remains low. A sample of at‐risk youth was surveyed about their awareness, utilization, and attitudes toward local and national crisis hotlines. Youth reported low rates of awareness and utilization, yet expressed a strong interest in phone hotlines (41% vs. 59% for new media categories combined). Youth reported stigma, but that help‐seeking could be positively influenced by peers and adults in their support system. Implications include making crisis services available across several mediums and the importance of engaging trusted others in youth suicide awareness campaigns and prevention efforts.     

Crisis centers and hotlines: a survey

Crisis centers and hotlines are relatively new approaches to the nation's growing concern for mental health problems. In order to provide information for those beginning a center, 253 centers were surveyed regarding five major aspects of crisis center operations: screening procedures for telephone listener-counselor applicants, training procedures, services offered, types of calls received, and financing. Resources for further information and for better communication among centers are identified.     

心理咨询热线在突发性公共卫生事件中的应用分析

2003年SARS在中国一些地区的流行给社会公众在心理上带来了一定程度的影响,在SARS流行期间期间及时开通了面向公众的心理咨询热线,成为了广大公众寻求心理支持的有效途径,为缓解社会压力、促进社会正常秩序恢复起到了积极作用。该文结合中国科学院心理研究所“非典心理咨询热线”的统计数据,进一步探讨了心理咨询热线在应对突发性公共卫生事件中的作用和工作特点。     

The Garrett Lee Smith Memorial Suicide Prevention Program

In response to calls for greater efforts to reduce youth suicide, the Garrett Lee Smith (GLS) Memorial Act has provided funding for 68 state, territory, and tribal community grants, and 74 college campus grants for suicide prevention efforts. Suicide prevention activities supported by GLS grantees have included education, training programs (including gatekeeper training), screening activities, infrastructure for improved linkages to services, crisis hotlines, and community partnerships. Through participation in both local‐ and cross‐site evaluations, GLS grantees are generating data regarding the local context, proximal outcomes, and implementation of programs, as well as opportunities for improvement of suicide prevention efforts.     

Efficacy of brief telephone psychotherapy with callers to a suicide hotline

The efficacy of two types of theapy conducted exclusively over the telephone was studied. Clients (N=55) were recruited from a pool of callers to a suicide hotline and were randomly assigned to a waiting list control (WC) or Solution Focused Brief Therapy (SFBT) or Common Factors Therapy (CFT). It was hypothesized that improvements would be significantly higher in the two therapy conditions compared to the waitlist control and SFBT would be significantly more efficacious than CFT. Results confirmed that improvement was significantly higher in the two treatment conditions compared to the waitlist control, but no difference in improvement was found between SFBT and CFT. The implications of these findings for suicide hotlines are discussed.     

Impact of Applied Suicide Intervention Skills Training on the National Suicide Prevention Lifeline

We examined the impact of the implementation of Applied Suicide Intervention Skills Training (ASIST) across the National Suicide Prevention Lifeline's national network of crisis hotlines. Data were derived from 1,507 monitored calls from 1,410 suicidal individuals to 17 Lifeline centers in 2008–2009. Callers were significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful by the end of calls handled by ASIST‐trained counselors. Few significant changes in ASIST‐trained counselors' interventions emerged; however, improvements in callers' outcomes were linked to ASIST‐related counselor interventions, including exploring reasons for living and informal support contacts. ASIST training did not yield more comprehensive suicide risk assessments.     

Community responses to a suicidal crisis: implications for suicide prevention

We conducted a cross‐sectional, random‐digit‐dial survey to evaluate public responses to a hypothetical question: “If someone you knew was suicidal, what would you do first?” Younger people were more likely to call a suicide hotline, and less likely to go to an emergency room (ER) or call 911; immigrants (in the U.S. <15 years) were more likely to call 911, and less likely to call a suicide hotline; African Americans were more likely to go to the ER and call 911; Hispanics were more likely to call 911 but less likely to call a suicide hotline. These results suggest that public messages about hotlines and emergency options for suicidal patients need to be tailored to relevant population characteristics including age, education, ethnicity, and language preferences.     

An evaluation of crisis hotline outcomes. Part 2: Suicidal callers

In this study we evaluated the effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' suicide state from the beginning to the end of their calls to eight centers in the U.S. and again within 3 weeks of their calls. Between March 2003 and July 2004, 1,085 suicide callers were assessed during their calls and 380 (35.0%) participated in the follow-up assessment. Several key findings emerged. Seriously suicidal individuals reached out to telephone crisis services. Significant decreases in suicidality were found during the course of the telephone session, with continuing decreases in hopelessness and psychological pain in the following weeks. A caller's intent to die at the end of the call was the most potent predictor of subsequent suicidality. The need to heighten outreach strategies and improve referrals is highlighted.     

Medication Administration By Family Members of Dependent Elders In Shared Care Arrangements

Twenty-three long-term care family caregivers whose care-recipients were enrolled in adult day care programs participated in face-to-face, semistructured interviews designed to learn more about their medication administration experiences. Two distinct styles of decision making were identified: self-directed and physician-directed. To help them with their medication administration responsibility, both groups used primary (physicians, pharmacists, or both) and secondary sources of information (the internet, information hotlines, nurses, more experienced caregivers, and family members with health backgrounds). Self-directed caregivers, who were significantly younger than the physician-directed caregivers, were twice as likely to report use of secondary sources of information to manage their medication administration tasks. Secondary sources of information appear to be important for the development of a caregiver's maturation and critical thinking skills over the long term and need more attention from formal providers in shared care relationships with family caregivers.     

African American and White Women’s Experience of Sexual Assault and Services for Sexual Assault

This article presents the results of a study assessing the needs and experiences of African American and White female survivors of sexual assault in the state of Maryland. Eight specific hypotheses regarding differences in the needs and experiences of African American as compared to White women receiving partial or no support through analyses of interview data drawn from 213 survivors (African American survivors, n = 133; White survivors, n = 80) were explored. No differences were reported in medical care received; however, in comparison to their White counterparts, African American women reported decreased use of sexual assault crisis centers and mental health services, and postassault help-seeking through use of sexual assault hotlines. Barriers and facilitators associated with treatment experiences differed by ethnicity. Findings are discussed in relation to future directions for research, and service and policy improvement for survivors of sexual assault.     

An evaluation of crisis hotline outcomes. Part 1: Nonsuicidal crisis callers

The effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' crisis state from the beginning to the end of their calls to eight centers in the U.S. and intermediate outcomes within 3 weeks of their calls, was evaluated. Between March 2003 and July 2004, 1,617 crisis callers were assessed during their calls and 801 (49.5%) participated in the followup assessment. Significant decreases in callers' crisis states and hopelessness were found during the course of the telephone session, with continuing decreases in crisis states and hopelessness in the following weeks. A majority of callers were provided with referrals and/or plans of actions for their concerns and approximately one third of those provided with mental health referrals had followed up with the referral by the time of the follow-up assessment. While crisis service staff coded these callers as nonsuicidal, at follow-up nearly 12% of them reported having suicidal thoughts either during or since their call to the center. The need to conduct suicide risk assessments with crisis callers and to identify strategies to improve referral follow-up is highlighted.     

Characteristics of Telephone Crisis Hotline Callers with Suicidal Ideation in Japan

Hotline callers do not always have suicidal ideation and previous studies have noted that the rate of such callers is limited. Crisis hotline counselors must be able to identify high‐risk callers in order to provide appropriate support. This study investigated the characteristics of Japanese crisis hotline callers in 2012 (N = 541,694) and is the first to analyze crisis hotline data for all parts of Japan over 1 year. About 14% of the callers had suicidal ideation and 6% had a history of attempted suicide. The odds ratio for suicidal ideation among those with a history of attempted suicide was 15.5. The suicidal ideation rate was much smaller compared to previous studies in other countries. There is a psychological barrier that must be broken for high‐risk people to use support hotlines. In addition, attempted suicide is a strong exclusive predisposing factor for death due to suicide; therefore, counselors should pay careful attention to callers with a history of attempted suicide. The characteristics of Japanese crisis hotline callers and the features of suicidal ideation revealed in the present study are expected to be useful in developing telephone crisis hotline strategies.     

Follow‐up with Callers to the National Suicide Prevention Lifeline: Evaluation of Callers’ Perceptions of Care

Continuity of care for suicidal individuals engaged with a variety of health and mental health care systems has become a national priority, and crisis hotlines are increasingly playing a part in the risk management and continuum of care for these individuals. The current study evaluated a national initiative to have crisis centers in the National Suicide Prevention Lifeline network provide follow‐up care to suicidal callers. Data were obtained from 550 callers followed by 41 crisis counselors from 6 centers. Two main data sources provided the information for the current study: a self‐report counselor questionnaire on the follow‐up activities completed on each clinical follow‐up call and a telephone interview with follow‐up clients, providing data on their perceptions of the follow‐up intervention's effectiveness. The majority of interviewed follow‐up clients reported that the intervention stopped them from killing themselves (79.6%) and kept them safe (90.6%). Counselor activities, such as discussing distractors, social contacts to call for help, and reasons for dying, and individual factors, such as baseline suicide risk, were associated with callers’ perceptions of the impact of the intervention on their suicide risk. Our findings provide evidence that follow‐up calls to suicidal individuals can reduce the perceived risk of future suicidal behavior.     

建设同他者交互关系的未来

本文的核心主题是如何建立同他者的交互关系。作者认为,伦理行为应该从呼吸开始,这是人类最为原初的举动,但在西方文化中一直未得到尊重。忘却呼吸的结果造成了精神和身体的分离,也形成了二元对立的文化传统。要建立二者的伦理关系,首先就要拥有自我爱慕的能力,这是一种栖居在自我状态、能够主宰自己行动和思维的能力,是维持自己家园的前提。在此基础上,作者认为应该开放自我的世界迎接他者的到来,把自己封闭在自我世界的结果将导致对他者异质性的排斥。同时,有必要保持沉默,要耐心倾听,更要换一个方式讲话,充分开发知觉感受,以尊重他者完成自我的超越。二者关系也因此得以建立,这一尊重差异基础之上的二者关系不仅适用于处理性别关系,也可以应用于处理其他文化差异中的二者关系,而无数的二者关系最终组成了多元的世界。     

The Tragedy of the Commons as an Essentially Aggregative Harm

This article identifies ‘the tragedy of the commons’ as an essentially aggregative harm and considers what agents in such a scenario owe to one another. It proposes that the duty to take reasonable precautions requires that agents make efforts to establish collective solutions to any essentially aggregative harm to which they would otherwise contribute. Baylor Johnson has argued that the general obligation to promote the common good requires that agents make efforts to establish a collective agreement to avert a potential tragedy of the commons. This article agrees with Johnson's analysis but argues that there are also negative duties, which give commons users additional moral reason to take collective action to prevent the destruction of the utility of the commons. These duties link commons users to resolving this particular problem and provide grounds to demand that they make greater efforts to prevent the destruction of the commons compared to bystanders. The article suggests that fulfilling negative duties can require establishing collective institutions with the power to regulate human action and interaction. This analysis could be applied to a range of social problems which result from the aggregation of actions and practices.     

治疗决策十题

治疗决策是临床决策中的重要组成部分。为了提高治疗决策水平,临床医生可以从以下几个基本环节入手深究决策依据、明确治疗目标、坚持疗效优化、强调安全第一、注意条件约束、注重时效原则、突出救治重点、减损方案危害、分析失悔程度和了解敏感阈值。     

论生态学的马克思主义的人道主义

生态学的马克思主义基于对人类命运的关照,立足人道主义,反对以单纯保护生态为目的的生态中心主义和企图转嫁生态矛盾的生态帝国主义;认为资本主义的生产、分配和消费方式是引发生态危机的根源;要想摆脱已经上升为人和自然之主要矛盾的生态危机,不仅需要建立“无增长的”经济模式,倡导“劳动闲暇一元论”和日常生活的“简朴主义”,根除虚假需求,克服异化消费,使生产过程分散化、民主化和管理科学化,变控制自然为解放自然,提倡技术为全人类服务,使生态学充满人道主义,而且需要根除资本主义生产的利润动机,杜绝独裁主义的政治和生产逻辑,反对技术法西斯主义,最终废除资本主义制度,建立非极权的、更易于生存的、以实现生态与社会和谐发展为目标的“稳态社会主义”。     

个人目标相关性对非临床抑郁者未来想象的影响

通过两个实验考查了非临床抑郁者未来想象的异常是否受到个人目标相关性的调节。实验1采用未来想象任务, 实验2采用可能性评估范式, 两个实验一致发现, 抑郁倾向者想象未来积极事件的异常, 受到了与个人目标相关性的调节：相对于非抑郁倾向者, 抑郁倾向者对未来与个人目标相关的积极事件的预期减弱, 而对未来与个人目标无关的积极事件的预期则没有表现出异常; 同时还发现, 抑郁倾向者表现出了对未来消极预期的普遍增强, 不受与个人目标相关性的影响。