title: Frequent callers to crisis helplines: who are they and why do they call?
abstract: OBJECTIVE
  Frequent callers present a challenge for crisis helplines, which strive to achieve optimal outcomes for all callers within finite resources. This study aimed to describe frequent callers to Lifeline (the largest crisis helpline in Australia) and compare them with non-frequent callers, with a view to furthering knowledge about models of service delivery that might meet the needs of frequent callers.
  
  
  METHODS
  Lifeline provided an anonymous dataset on calls made between December 2011 and May 2013. We assumed calls from the same (encrypted) phone number were made by the same person, and aggregated call level data up to the person level. Individuals who made 0.667 calls per day in any period from 1 week to the full 549 days for which we had data (i.e. 4.7 calls in 7 days, 20 calls in 30 days, 40 calls in 60 days, etc.) were regarded as frequent callers.
  
  
  RESULTS
  Our analysis dataset included 411,725 calls made by 98,174 individuals, 2594 (2.6%) of whom met our definition of frequent callers. We identified a number of predictors of being a frequent caller, including being male or transgender, and never having been married. The odds increased with age until 55-64 years, and then declined. Suicidality, self-harm, mental health issues, crime, child protection and domestic violence issues all predicted being a frequent caller.
  
  
  CONCLUSIONS
  Collectively, frequent callers have a significant impact on crisis lines, and solutions need to be found for responding to them that are in everybody's best interests (i.e. the frequent callers themselves, other callers, telephone crisis supporters who staff crisis lines, and those who manage crisis lines). In striking this balance, the complex and multiple needs of frequent callers must be taken into account.
authors: Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia m.spittal@unimelb.edu.au.
authors: Matthew J
authors: MJ
authors: Spittal
authors: Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia Mental Health Center, Copenhagen, Denmark.
authors: Izabela
authors: I
authors: Fedyszyn
authors: General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, Australia.
authors: Aves
authors: A
authors: Middleton
authors: Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors: Bridget
authors: B
authors: Bassilios
authors: General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, Australia.
authors: Jane
authors: J
authors: Gunn
authors: Lifeline Foundation for Suicide Prevention, Canberra, Australia.
authors: Alan
authors: A
authors: Woodward
authors: Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
authors: Jane
authors: J
authors: Pirkis
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001315:Australia; D002649:Child Abuse / Q000706:statistics & numerical data; D003415:Crime / Q000706:statistics & numerical data; D003419:Crisis Intervention / Q000379:methods* / Q000706:statistics & numerical data*; D003625:Data Collection / Q000706:statistics & numerical data; D017579:Domestic Violence / Q000706:statistics & numerical data; D005260:Female; D015277:Hotlines / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017533:Marital Status; D001523:Mental Disorders / Q000628:therapy; D008875:Middle Aged; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000517:prevention & control; D017678:Sex Distribution; D063106:Transgender Persons / Q000706:statistics & numerical data; D055815:Young Adult; D000092864:Suicide Prevention
keywords: Crisis helplines; frequent callers; self-harm; suicide