The development of a core outcome set for crisis helplines: A three-panel Delphi study

Abstract

Background: Evidence for the effectiveness of crisis helplines is limited by inappropriate and inconsistent outcome measurement. The aim of this study was to develop a core outcome set that reflects the most relevant and important outcomes to help-seekers accessing a crisis helpline via any delivery mode (e.g., phone, SMS text, online chat). Method: We used a three-panel Delphi method to compare and integrate the views of three expert groups: people with lived experience of accessing crisis helplines (n = 32), researchers with experience assessing crisis helpline outcomes (n = 25), and crisis helpline supporters (n = 58). Across two online survey rounds (89 % retention rate), participants rated the importance of 33 potential outcomes for help-seekers accessing a crisis helpline. Participants also provided open-text comments and suggestions. Outcomes that reached consensus (≥75 % agreement) by at least two panels were included in the core outcome set. Results: Ten outcomes met the criteria for inclusion in the core outcome set. In order of importance, these were: distress, feeling heard, suicide risk, connectedness/support, hopelessness, overwhelm, non-suicidal self-injury risk, service experience, helplessness, and next steps. Limitations: Participants self-selected and were mainly from English-speaking countries. Conclusions: We recommend future outcome and evaluation studies minimally measure and report the 10 outcomes identified in this study. Assessing an agreed set of meaningful outcomes will improve comparability and facilitate a deeper understanding of crisis helpline effectiveness. More work is needed to determine how best to assess these outcomes in the crisis helpline context.

Keywords

• Crisis support
• Helpline
• Suicide
• Mental health
• Outcome measurement
• Delphi