title: Frequent callers to telephone helplines: new evidence and a new service model.
abstract: BACKGROUND
  This paper describes a program of work designed to inform a service model to address a challenge for telephone helplines, namely frequent callers.
  
  
  METHODS
  We conducted a systematic literature review and four empirical studies that drew on different data sources-(a) routinely collected calls data from Lifeline, Australia's largest telephone helpline; (b) data from surveys/interviews with Lifeline frequent callers; (c) data from the Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) study; and (d) data from Australia's National Survey of Mental Health and Wellbeing.
  
  
  RESULTS
  Frequent callers represent 3 % of callers but make 60 % of calls. They are isolated and have few social supports but are not "time wasters"; they have major mental and physical health problems and are often in crisis. They make use of other services for their mental health problems. The circumstances under which they use telephone helplines vary, but current service models reinforce their calling behaviour.
  
  
  CONCLUSIONS
  The findings point to a service model that might better serve the needs of both frequent callers and other callers. The model involves offering frequent callers an integrated, tailored service in which they are allocated a dedicated and specially trained telephone crisis supporter (TCS), and given set calling times. It also involves promoting better linkages between telephone helplines and other services that provide mental health care, particularly general practitioners (GPs) and other primary care providers. The next step is to refine and test the model.
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Pirkis
authors.affiliation: Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Australia.
authors.forename: Aves
authors.initials: A
authors.lastname: Middleton
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Bridget
authors.initials: B
authors.lastname: Bassilios
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Australia ; Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, Australia.
authors.forename: Meredith
authors.initials: M
authors.lastname: Harris
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Spittal
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Izabela
authors.initials: I
authors.lastname: Fedszyn
authors.affiliation: Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Australia.
authors.forename: Patty
authors.initials: P
authors.lastname: Chondros
authors.affiliation: Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Gunn
keywords: Crisis; Frequent callers; Helpline; Telephone