Comparing Models of Helper Behavior to Actual Practice in Telephone Crisis Intervention: A Silent Monitoring Study of Calls to the U.S. 1–800-SUICIDE Network


  • This study was conducted under contract with the American Association of Suicidology in fulfillment of the evaluation requirements of Grant No. 6079SM54–27–01–1 from the Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Thanks to Reese Butler, the Kristin Brooks Hope Center staff, Jerry Reed, and the directors and workers at the crisis centers who participated in this study.

Director, Center for Research and Intervention on Suicide and Euthanasia, University of Quebec at Montreal, c.p. 8888, Succ. Center-Ville, Montreal, Quebec, Canada, H3C 3P8; E-mail:


Models of telephone crisis intervention in suicide prevention and best practices were developed from a literature review and surveys of crisis centers. We monitored 2,611 calls to 14 centers using reliable behavioral ratings to compare actual interventions with the models. Active listening and collaborative problem-solving models describe help provided. Centers vary greatly in the nature of interventions and their quality according to predetermined criteria. Helpers do not systematically assess suicide risk. Some lives may have been saved but occasionally unacceptable responses occur. Recommendations include the need for quality assurance, development of standardized practices and research relating intervention processes to outcomes.