Predictive value of suicidal risk assessment using data from China's largest suicide prevention hotline

Suicide hotlines are widely used, with potential for identification of callers at especially high risk. This prospective study was conducted at the largest psychological support hotline in China. From 2015 to 2017, all distressed callers were consecutively included and assessed, using a standardized...

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Bibliographic Details
Published in:Journal of affective disorders 2023-05, Vol.329, p.141-148
Main Authors: Tong, Yongsheng, Yin, Yi, Conner, Kenneth R., Zhao, Liting, Wang, Yuehua, Wang, Xuelian, Conwell, Yeates
Format: Article
Language:English
Subjects:
Crisis Intervention
Hotline
Hotlines
Humans
Prediction
Prospective Studies
Risk Assessment
Risk Factors
Suicidal Ideation
Suicidal risk assessment
Suicide attempt
Suicide Prevention
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Summary:Suicide hotlines are widely used, with potential for identification of callers at especially high risk. This prospective study was conducted at the largest psychological support hotline in China. From 2015 to 2017, all distressed callers were consecutively included and assessed, using a standardized scale consisting of 12 elements, yielding scores of high risk (8–16), moderate risk (4–7), and low risk (0–3) for suicidal act. All high-risk and half of moderate- and low-risk callers were scheduled for a 12-month follow-up. Main outcomes were suicidal acts (nonlethal attempt, death) over follow-up. Of 21,346 fully assessed callers, 5822, 11,791, and 3733 were classified as high-, moderate-, or low-risk for suicidal acts, with 8869 callers (4076 high-, 3258 moderate-, and 1535 low-risk) followed up over 12 months. Over follow-up, 802 (9.0 %) callers attempted suicide or died by suicide. The high-risk callers (15.1 %) had 3-fold higher risk for subsequent suicidal acts than moderate- (5.1 %) and 12-fold higher risk than low-risk callers (1.3 %). The weighted sensitivity, specificity, and positive predictive value of high risk scores were 56.4 %, 74.9 %, and 14.4 %. Assessed callers with different risk levels were followed disproportionally. Suicidal risk assessment during a hotline call is both feasible and predictive of risk, guiding resource allocation to higher risk callers. •A comprehensive suicidal risk assessment scale for suicide prevention hotline has been developed.•Of 21,346 fully assessed hotline callers, 8869 callers were followed up over 12-month.•Findings of this prospective study indicate that predictive validities of the scale are acceptable.•Suicidal risk assessment is viable for determination of intervention plan in hotline in resources-limited countries.
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2023.02.095