Implementing and evaluating a veterans crisis line quality improvement initiative: The safety planning pilot program

Area of Science:

• Mental Health Services
• Public Health Initiatives
• Crisis Intervention

Background:

• The Veterans Crisis Line (VCL) is crucial for suicide prevention among veterans.
• A pilot project evaluated the effectiveness of six-part safety plans (SPs) versus standard risk mitigation plans.

Purpose of the Study:

• To assess the impact of pilot six-part safety plans (SPs) on veteran caller characteristics and Veteran Health Administration (VHA) utilization.
• To forecast the operational implications of VCL-wide SP implementation.

Main Methods:

• A pilot study offered six-part SPs to eligible VCL callers.
• Parametric and nonparametric statistical methods compared call characteristics and VHA utilization between SP completers and non-completers.
• Operational impact was forecasted based on increased call times.

Main Results:

• 27.37% of calls were eligible for SPs, with 27.23% completing them.
• SP completers showed increased VHA clinical referral acceptance and outpatient mental health appointments.
• Calls with SPs took 175% longer (87.78 min) than those without (49.66 min).

Conclusions:

• Six-part safety plans are adaptable to the VCL but present logistical challenges.
• Widespread implementation would necessitate 4.12% more responders per hour to maintain service speed.
• While beneficial for VHA engagement, SPs require careful resource planning for operational sustainability.