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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. (Contains 2 figures and 4 tables.)

A total of 2,611 calls to 14 helplines were monitored to observe helper behaviors and caller characteristics and changes during the calls. The relationship between intervention characteristics and call outcomes are reported for 1,431 crisis calls. Empathy and respect, as well as factor-analytically derived scales of supportive approach and good contact and collaborative problem solving were significantly related to positive outcomes, but not active listening. We recommend recruitment of helpers with these characteristics, development of standardized training in those methods that are empirically shown to be effective, and the need for research relating short-term outcomes to long-term effects.

Problem Statement. Modern changes in football complicated the goalkeepers' role. It is impossible to improve the technical & tactical preparedness of young skilled goalkeepers without finding new approaches in the organization of their training process. The purpose of the research was to determine the indicators of physical and technical-tactical readiness of 13-14-year-old goalkeepers and the relationship between them. Methods: theoretical analysis and generalization of scientific and methodological literature, pedagogical testing, and mathematical statistics. Participants: 46 young players of 13-14-year-old of football club "Arsenal" in Kharkiv city, including 6 goalkeepers, 8 central defenders, 8 full-back defenders, 8 central midfielders, 8 wing midfielders, 8 forwards. Results: Quantitative indicators of motor actions of 13-14-year-old football players of different game role according to the results of 10 calendar games were determined. It was established that the quality of performance of technical and tactical actions of young football players was not the same for players of different game roles. Goalkeepers mainly make long and short passes (29.8 ± 1.19 and 27.2 ± 1.16 % of the total number of technical and tactical actions). The largest number of movements with the back forward, cross step and additional step was made by the goalkeeper (12.3; 7.0; 2.6 % of game actions per game), which were statistically significantly higher in relation to all field players (p <0.001). Goalkeepers during the game perform more jumps (32.4 ± 1.48 % of all motor actions) and throwing the ball (26.4 ± 1.48 %). Goalkeepers' indicators of speed and power capabilities (in the test "Standing high jump") were statistically significantly superior (p <0.05) to players of all other lines. The correlations between the test indicators that reflect the level of goalkeepers' physical fitness were determined. A statistically significant correlation was established between the indicator "Standing high jump" and "Running 30 m" (ρ= -0.82, p <0.05), indicators of starting and distance speed (ρ = 0.84 and ρ = 0.86, p<0.05), the indicator "Running 10 m" with "Running in 6 min", which characterized the overall endurance (ρ = -0.83, p <0.05). Conclusions: Goalkeepers are characterized by the relationship between all technical & tactical actions of the game and the level of motor skills development, namely the statistical significance of the correlation between speed and speed-power qualities and technical & tactical indicators was confirmed. [ABSTRACT FROM AUTHOR]

Abstract Background From a retrospective study of youth centres (YCs) and coroner's files, we investigated youths' history of medical service utilization who died by suicide. This is the second of two papers on YCs population, the first paper having shown that the rate of psychopathology was higher in the YCs population compared to the general adolescent population. Methods From 1995 to 2000, 422 youths, aged 18 years and younger, died as a result of suicide in Quebec. More than one-third received services from YCs at some point. Using the provincial physician payment and hospitalization database, we examined physical and psychiatric service utilization according to time intervals, as well as hospitalization for psychiatric reasons in the individuals' lifetime and in the year preceding suicide. Suicides were matched to living YCs youths for age, sex, and geographic area. YCs controls were then subdivided into two groups based on file information pertaining to the presence or absence of suicidal behavior or ideation. Results Compared to living YCs youths, suicides had a higher rate of psychiatric service utilization in the week, month, 90 days, and year preceding suicide, as well as higher levels of lifetime hospitalization for psychiatric reasons than controls with or without a history of suicidal behavior or ideation. We found that 28.3% YCs suicides made use of psychiatric services in the year preceding suicide. Conclusion The rate of psychiatric service utilization by YCs youth suicides is substantially inferior to the needs of this population. Our study underscores the need for appropriate recognition of psychiatric and suicidal problems among YCs population by social and psycho-educational professionals. At the same time, it highlights the issues of general practitioners' risk identification, psychiatric referral and treatment. Our findings suggest the need for improved organization and coordination of psychiatric services to ameliorate treatment delivery.

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers. [ABSTRACT FROM AUTHOR]

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Objective: To examine the clinical characteristics of adolescent girls consulting in a mood disorder clinic with a history of physical or sexual abuse., Method: A retrospective review was conducted of the charts of 55 adolescent girls consulting in a mood disorder clinic. An analysis grid was used to gather data on demographics, personal antecedents, symptoms and diagnoses. Girls with a history of physical or sexual abuse were compared with girls without such a history. Univariate analyses and a logistic regression analysis were performed., Results: Adolescent girls with a history of physical or sexual abuse did not differ statistically from those without such a history in terms of depressive symptoms or type and number of diagnoses. However, proportionally more girls with a history of physical or sexual abuse presented self-harm and relational problems with their parents and peers., Conclusion: Both history of physical or sexual abuse and self-destructive behaviors are rooted in relational problems. The results show that these are related to one another among those adolescent girls. Clinically, these findings suggest that it is important for clinicians do a thorough exploration of self-destructive behaviors and family and peer relations when assessing depressed adolescent girls.