Mental Health: The Impact of Crisis Services
May 10, 2022
There are many crisis services available for those struggling with a Mental Health crisis. Crisis services have different components, which are peer crisis services, mobile crisis teams, 24/7 crisis hotlines, warm lines, crisis centers, psychiatric advance directive statements, short-term crisis residential services, and crisis stabilization (Seibert). Some notable federally supported crisis lines include the National Suicide Prevention Lifeline, National Sexual Assault Hotline, and Veterans Crisis Line. Other privately funded entities are the Crisis Text Line, Seize the Awkward, and The Trevor Project’s TrevorLifeline.
In these services, psychologists play a pivotal role as supervisors, program developers, implementers, trainers, and evaluators. According to an ASPE report, ‘Crisis Services and the Behavioral Health Workforce Issue Brief ’ by Stefanie Pietras and Allison Wishon Mathematica, “Crisis service models often rely on a mix of licensed behavioral health professionals, and other staff with lower levels of training and credentials (including unlicensed providers and peer support specialists) who augment the work of licensed staff”. Therefore, crisis services are using a staff mixed with licensed professionals and others with less training to help reduce the demand for higher-cost specialists (Pietras and Mathematica). Many of these crisis services are offered as free services due to using volunteers with less experience.
Crisis services pose a big question: What is their impact on individuals seeking help? In the article, ‘Are crisis lines meeting new Mental Health Needs?’ by Tori DeAngelis, a 2018 evaluation of the SAMHSA Lifeline led by Madelyn Gould, Ph.D., Columbia University professor and psychiatric epidemiologist, was highlighted showing “That nearly 80% of callers interviewed six of 12 weeks after calling the lifeline said the follow-up calls kept them from carrying out suicide and provided them with hope, made them feel cared about, and helped them connect with further mental health resources”. Clearly, crisis services work well in connecting callers to mental health resources and in making callers feel cared for. Crisis services are a helpful addition to the existing care that is available, specifically for those who cannot or do not want to use formal care (Willems). However, it is difficult to measure the long-term effectiveness of crisis services because it is tough to ethically conduct randomized controlled trials of mental health crisis services, in particular, crisis lines. The sessions and follow-ups are also meant to be short-termed and anonymous. This contributes to the difficulty of being able to measure the long-term impact of crisis lines. Furthermore, another challenge to conducting research into the effectiveness and impact of these services is that it is unclear how long the effects of these interventions last (DeAngelis).
Crisis services are meant for those dealing with a crisis at that moment. Specifically, crisis lines have become an easy and accessible way to get immediate help. They have also become more visible due to mental health-related news stories being more widely covered in the media. An example of this is that news organizations are posting the number to the National Suicide Prevention Lifeline (NSPL) at the end of their suicide-related stories: “If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK)...” (Kazdin). This was seen in the news reports on the deaths of Anthony Bourdain and Kate Spade (Kazdin). Crisis services have been shown to decrease feelings of hopelessness and psychological pain among people in crisis (Willems). They have also been shown to prevent suicide at the moment (Willems).
When seeking out crisis services, it is important to keep this in mind. Crisis services are meant for immediate help and can help you connect to longer-term resources. The long-term use of crisis services has not been shown to be effective. On the other hand, crisis services are effective at helping individuals in crisis in the short-term. Individuals in crisis benefit from crisis services as they are easily accessible, free, and have been shown to reduce suicide risk. In general, these services have had a positive impact on people struggling with mental health crises and who seek immediate help.
DeAngelis, Tori. “Are Crisis Lines Meeting New Mental Health Needs?” American Psychological Association, American Psychological Association, 8 July 2020, https://www.apa.org/topics/covid-19/crisis-lines-mental-health.
Kazdin, Cole. “We Looked into Whether Suicide Hotlines Actually Work.” VICE, 13 June 2018, https://www.vice.com/en/article/9k884v/do-suicide-hotlines-work.
Pietras, Stefanie, and Allison Wishon Mathematica. “Crisis Services and the Behavioral Health Workforce Issue Brief.” ASPE, U.S. Department of Health and Human Services, Mar. 2021, https://aspe.hhs.gov/reports/crisis-services-behavioral-health-workforce-issue-brief.
Seibert, Julie, et al. Crisis Services: Effectiveness, Cost-Effectiveness, and Funding Strategies. Office of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration, 2014, https://nasmhpd.org/sites/default/files/SAMSHA%20Publication%20on%20Effectiveness%20%26%20Cost-Effectiveness%20of%2C%20and%20Funding%20Strategies%20for%2C%20Crisis%20Services%206-5-14_8.pdf.
Willems, Renate et al. “Impact of Crisis Line Volunteering on Mental Wellbeing and the Associated Factors: A Systematic Review.” International journal of environmental research and public health vol. 17,5 1641. 3 Mar. 2020, doi:10.3390/ijerph17051641