2023-11-02 10:03:32
This psychology thesis contributes to improving the state of knowledge on text message intervention in suicide prevention. It also constitutes a plea in favor of recognition of the role of youth lines in the prevention of youth suicide, for their greater integration into the suicide prevention community, and for their access to the resources necessary to carry out their mission with young people at risk of suicide.
The author attempts here to describe the profile of users at suicidal risk of text message intervention services, the practices of identifying and evaluating the suicidal risk of those involved in these services, and to estimate the impact of these services for their users, to evaluate the transferability of intervention practices currently used in suicide prevention centers to intervention by text message, and to identify promising practices of intervention by text message in suicide prevention.
Résumé
Context. Over the past 20 years, several suicide prevention telephone intervention lines have been equipped with text intervention services. However, these services were launched in the absence of scientific literature on good text message intervention practices. It is in this context that the Research Center, Ethical Issues and End-of-Life Practices (CRISE) launched a research project whose objective was to produce knowledge that might guide the development of guides to good intervention practices. by text message for suicide prevention. To meet this general objective, two complementary research projects were carried out with the Canadian Suicide Prevention Service (SCPS), which works with the general English-speaking population in Canada, and with the Tel-jeune youth line, which works with of French-speaking adolescents in Quebec.
Goals. Study 1: The objectives of the evaluation carried out at the SCPS were to describe the profile of callers to their text intervention service, to describe the impacts of the service, to describe the intervention and suicide risk assessment practices of the stakeholders, and to identify intervention techniques that are associated with positive and negative impacts. Study 2: Method objectives. Study 1: The method used in the evaluation of the SCPS text intervention service consisted of a quantitative content analysis of intervention verbatims (Krippendorff, 2018), a documentary analysis of intervention reports completed by the interveners , and an analysis of responses to a short pre-intervention questionnaire covering callers’ age, gender, degree of distress and reason for contact. Study 2: The method used in the evaluation of the Tel-Jeunes text intervention service consisted of a quantitative content analysis of intervention verbatims (Krippendorff, 2018), an analysis of responses to a short post-intervention questionnaire covering the callers’ age, gender, impact of interventions, suicide risk, and a qualitative content analysis of young people’s comments on their appreciation of the interventions (Elo & Kyngas, 2007).
Results. Study 1: In total, 112 intervention verbatims, intervention reports and pre-intervention questionnaires were analyzed. The results indicate that 68.8% of users were female and the average age was 25 years old. The most common reasons for contact were mental health problems, relationship difficulties, difficulties at work or school, and feeling isolated. SCPS responders typically asked users if they were thinking regarding suicide, but the elements of suicidal planning (how, where, and when) were rarely explored. The speakers generally explored the callers’ resources and possible solutions to their problems in an exhaustive manner. Only the frequency of use of the intervention technique Pointing out a strength or a good move was a significant predictor of the positive effects of the interventions. The quantity of words exchanged was correlated with the effectiveness of interventions. Study 2: A total of 2,276 young people responded to the post-intervention questionnaire. 46.5% of post-intervention survey respondents had seriously considered suicide in the past 12 months, 33.7% had attempted suicide in the past, and 35% had suicidal thoughts at the time of contact . Only 33.8% of young people who had suicidal thoughts at the time of contact benefited from a suicide risk assessment. Only the frequency of use of the intervention technique Highlight a strength or a “good move”* was a significant predictor of the positive effects of the interventions. Frequency of use of the Setting Boundaries technique was the only technique that was a significant predictor of the negative effects of the interventions. Several young people deplored the little time given to them.
Conclusions.
As part of this thesis, the author used different methods of direct and indirect observation in order to describe
It established that text intervention services were mainly used by adolescent girls and young women, that a significant proportion of young people who use text intervention services from the Tel-jeunes youth line present a suicidal risk, that text intervention services present significant shortcomings in identifying and assessing the suicide risk of users at risk of suicide, that it is possible to comprehensively explore user resources and solutions in the interventions by text message, that the duration of interventions is an important factor in the quality of interventions, that the reception and establishment
of a bond of trust at the start of contact is an essential element in the deployment of a quality intervention, that emphasizing the strengths and “good moves” of users represents a promising practice for intervention by text message, that the services of intervention by text message do not always meet the needs and expectations of users, that intervention by text message is similar in effectiveness to intervention by telephone, that young people who are at risk of suicide benefit less than young people who are not suicidal from interventions by text message , and that several clues suggest the existence of a subgroup of more difficult users or a phenomenon of frequent callers in
text response services.
Establishing a bond of trust at the start of contact seems to be a central element to the success of text message interventions. Highlighting a strength or “a good move”* was the only intervention technique associated with better results, in both an adult and adolescent population. Both studies identified significant gaps in texting suicide risk assessment practices.
This thesis therefore contributes significantly to the advancement of knowledge on text message intervention in suicide prevention. It also constitutes a plea in favor of recognition of the role of youth lines in the prevention of youth suicide, for their greater integration into the suicide prevention community, and for their access to the resources necessary to carry out their mission with young people at risk of suicide.
Côté, Louis-Philippe (2023). “Study of best practices for text message intervention in suicide prevention” Thesis. Montreal (Quebec, Canada), University of Quebec in Montreal, Doctorate in psychology.
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* A good move is a gesture, an initiative or the attitude of an employee or a work team which improves care, services
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