Adolescent help-seeking on a psychological support hotline: latent classes, predictors, and distal outcomes

Adolescents who contact psychological hotlines present with diverse problems and levels of risk. Recognizing common patterns quickly can help counselors match responses to need. This study aimed to identify distinct profiles of adolescent help-seeking and examine how those profiles relate to caller characteristics and near-term outcomes.

We analyzed de-identified records from a municipal hotline in Dongguan, China (January 2020-December 2024). The analytic cohort included 2,300 callers aged 10-19 years. Latent class analysis used routinely recorded indicators: presenting problems (family, non-family interpersonal/peer, study/academic) and counselor ratings of hope, psychological pain, and wish-to-die/suicidal ideation (treated as ordered categories). Model selection balanced information criteria, likelihood-ratio tests, entropy, and interpretability. Misclassification corrected three-step models related caller and call characteristics to class membership, and distal outcomes included near-term suicidal-ideation intensity, 30-day re-contact, and referral/triage.

A four-class solution best balanced fit and parsimony. Academic Strain (39.2%) featured academic concerns with comparatively high hope and low immediate risk. Family Conflict (28.8%) showed moderate distress and intermediate risk. Peer Conflict (22.1%) was marked by higher psychological pain and elevated ideation. Acute Suicidal Crisis (9.9%) combined low hope, severe pain, and frequent active ideation. Females had higher odds of Family Conflict and Acute Suicidal Crisis; later school stages were associated with Peer Conflict. Prior psychiatric diagnosis, past self-harm, and longer calls distinguished the crisis class. Distal outcomes followed a clear gradient: mean near-term suicidal-ideation intensity and the probabilities of re-contact and referral rose stepwise from Academic Strain to Acute Suicidal Crisis. Class distributions were similar across study periods.

Adolescent hotline callers can be understood through four recurring profiles that are visible in routine records and meaningfully predict near-term risk and service actions. This typology offers a practical scaffold for triage: prioritize intensive safety planning for crisis presentations; pair social and follow-up supports with peer-related distress; and scale problem-solving and coping support for academic strain.