Researchers also listened in on calls at 10 of the hotline call centers. They found a wide range of percentages of callers who were actually at risk for suicide (from 3 to 57%) and a wide range of responders’ compliance with guidelines on asking about current suicide risk, past ideation, and past attempts. Most responders established good rapport with the callers, and almost half of the callers “experienced reduced distress” (Acosta et al., 2017). Although some centers put no calls on hold, overall, 7% of callers were put on hold. A little more than half of the callers were women, and a third of the callers had called on other occasions. Third parties (“someone concerned about another individual”) made up 13% of the callers, and just over 50% of the callers seemed to have mental health or substance abuse problems. Calls lasted 14 minutes on average. Many callers discussed crises other than suicidal ideation, and of all callers, 26% brought up the subject of suicide and 21% reported thinking about committing suicide (Acosta et al., 2017). The RAND Corporation report mentions that there are other kinds of crisis lines and that many members of the general public may not know the difference. According to the RAND Corporation report, “not all callers to suicide hotlines are at immediate risk of suicide” (Acosta et al., 2017, p. X). Of the 241 calls researchers monitored, only five were considered urgent. Although 30% of calls required referrals, half were rated as being limited, in many cases because the referrals required were beyond the reach of counselors’ typical knowledge, because National call centers that serve California In 2005, the Substance Abuse and Mental Health Services Administration (SAMHSA) established the National Suicide Prevention Lifeline (Suicide Prevention Resource Center [SPRC], 2019). As of 2019, 13 California crisis centers were members of the Lifeline. During the second half of 2019, 113,767 Californians called the Lifeline, and 89% of those callers were able to receive help in California. Unfortunately, 13,065 Californians who called the Lifeline could not be answered by a local call center in Suicide prevention in the California state prison system The third-largest prison system in the United States – after the federal Bureau of Prisons and the Texas Department of Criminal Justice – is the California Department of Corrections and Rehabilitation (CDCR). However, the CDCR has a higher suicide rate than any other system, even the federal and Texas state systems. Within the California prison system, female prisoners die by suicide at higher rates than male prisoners (Lyon, 2020). As elsewhere, suicide has been increasing in California’s state prisons. In 2018, 34 California inmates died by suicide (CDCR, 2019; Lyon, 2020). In an attempt to address the problem of suicide in California’s prison system: Senate Bill 960 (Leyva) (Chapter 782, Statutes of 2018) added Penal Code Section 2064.1 to require CDCR to submit a report to the Legislature on or before October 1 of each year, to “include, among other things, descriptions of progress toward meeting the department’s goals related to the completion of suicide risk evaluations, progress toward completion of 72 hour treatment plans, and progress in identifying and implementing initiatives that are designed to reduce risk factors associated with suicide.” (CDCR, 2019, p. 1) The California Department of Corrections and Rehabilitation, which in 1990 had no formal suicide-prevention training and very few mental health services, currently: ● Provides suicide prevention training to all staff members every year.
resource guides were hard to navigate or out of date, or because there were no suitable community resources to meet callers’ needs (Acosta et al., 2017). The researchers, rating caller satisfaction on a scale of 1 to 5, assessed the average rating as 3.4, with the range of satisfaction between centers being fairly narrow (3.2 to 3.9; Acosta et al., 2017). Some hotlines, such as the San Francisco Institute on Aging’s CalMHSA-funded Friendship Line, make outgoing calls to check in on older or disabled adult clients. Research has shown that such calls can delay or prevent re-attempts at suicide. Some call centers are “blended,” with different responders taking different types of calls, or with all responders taking various types of calls (Acosta et al., 2017). As is true elsewhere in the United States, some California hotline staff members are paid, and some are volunteers. Many of the volunteers are students earning credits, making for a high turnover and the need for more frequent training. Also, volunteer staff may require more flexible scheduling (Acosta et al., 2017). A general problem with hotlines is that they are financially precarious and sometimes shut down. If their numbers have been promoted to the public, a desperate caller might end up dialing a number that is no longer in service (Acosta et al., 2017). California; in such cases, callers were routed to a backup center elsewhere in the country. Although national call centers such as the Lifeline can route callers to a crisis line in California, the area code of a cell phone number may not reflect the caller’s general location, meaning that callers may be routed to a call center out of their area (Acosta et al., 2017). ● Makes sure that all potential first responders to suicide attempts are trained in life-saving emergency procedures. ● Provides extensive training to CDCR clinicians in suicide risk assessment and risk management. ● Has systems in place for identifying and referring inmates at risk of committing suicide. ● Provides special care for those placed in administrative segregation settings. ● Offers inmates suicide-prevention information in various forms. (CDCR, 2019) The California Department of Corrections and Rehabilitation conducts more than 5,000 risk evaluations per month. The Department also strives to identify common stressors that lead to suicide attempts among inmates, as well as points at which incarcerated people are at increased risk. The Department is also analyzing cultural factors for the purpose of better assessing suicide risk (CDCR, 2019). Incarcerated individuals are not the only people at risk. In 2018, the University of California, Berkeley, published a study showing a heightened risk among correctional workers for depression, posttraumatic stress disorder, and suicide. Although the study focused on California workers, employment in corrections is generally considered difficult and demanding (University of California, Berkeley, Public Affairs, 2018).
Suicide prevention among California first responders and medical personnel In 2019, Governor Gavin Newsom signed AB1116 – the
Governor Gavin Newsom, 2019). According to Assemblyman Tim Grayson, who sponsored the bill, “In 2017 when our state experienced some of the deadliest wildfires in its history, more California firefighters died by suicide than in the line of duty” (Office of Governor Gavin Newsom, 2019). At the same time,
California Firefighter Peer Support and Crisis Referral Services Act – into law. This legislation established “statewide standards for first responder peer support programs to provide an agency- wide network of peer representatives available to aid fellow employees on emotional or professional issues” (Office of
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