[Federal Register Volume 73, Number 226 (Friday, November 21, 2008)]
[Notices]
[Pages 70663-70665]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-27696]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Agency Information Collection Activities: Proposed Collection;
Comment Request
In compliance with Section 3506(c)(2)(A) of the Paperwork Reduction
Act of 1995 concerning opportunity for public comment on proposed
collections of information, the Substance Abuse and Mental Health
Services Administration (SAMHSA) will publish periodic summaries of
proposed projects. To request more information on the proposed projects
or to obtain a copy of the information collection plans, call the
SAMHSA Reports Clearance Officer on (240) 276-1243.
Comments are invited on: (a) Whether the proposed collections of
information are necessary for the proper performance of the functions
of the agency, including whether the information shall have practical
utility; (b) the accuracy of the agency's estimate of the burden of the
proposed collection of information; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d) ways
to minimize the burden of the collection of information on
[[Page 70664]]
respondents, including through the use of automated collection
techniques or other forms of information technology.
Proposed Project: Evaluation of Networking Suicide Prevention
Hotlines--Revision (OMB No. 0930-0274)
This proposed project revision includes the continuation of two
previously approved data collection activities [Evaluation of
Networking Suicide Prevention Hotlines Follow-Up Assessment (OMB No.
0930-0274) and Call Monitoring of National Suicide Prevention Lifeline
Form (OMB No. 0930-0275)], and a revision to expand the scope of the
ongoing evaluation in an effort to advance the understanding of crisis
hotline utilization and its impact. The Substance Abuse and Mental
Health Services Administration's (SAMHSA), Center for Mental Health
Services (CMHS) funds a National Suicide Prevention Lifeline Network
(NSPL), consisting of two toll-free telephone numbers that routes calls
from anywhere in the United States to a network of local crisis
centers. In turn, the local centers link callers to local emergency,
mental health, and social service resources.
The overarching purpose of the proposed Evaluation of the
Networking Suicide Prevention Hotlines--Revision is to (1) continue to
monitor and ensure quality of calls and gather follow-up information
from the callers themselves, (2) expand the number of centers
participating in order to assess whether the two national suicide
prevention hotline numbers (i.e., 1-800-273-TALK and 1-800-SUICIDE)
reach similar or complimentary populations of at risk callers, and, (3)
to evaluate additional but related activities (e.g., motivational
interviewing and safety planning) recently funded through a new
cooperative agreement between SAMHSA and crisis hotline centers in the
NSPL. In total this effort proposed evaluation includes six data
collection activities.
Clearance is being requested to continue the following two
previously approved data collection activities to continue call quality
monitoring and caller follow-up assessment activities. The number of
centers proposed to participate in these continuing activities is
sufficient to address the additional question related to use of the two
existing hotline numbers.
(1) To ensure quality, the vast majority of crisis centers conduct
on-site monitoring of selected calls by supervisors or trainers using
unobtrusive listening devices. To monitor the quality of calls and to
inform the development of training for networked crisis centers, the
national Suicide Prevention Lifeline proposes to remotely monitor calls
routed to sixteen crisis centers during the shifts of consenting staff.
The procedures are anonymous in that neither staff nor callers will be
identified on the Call Monitoring Form. The monitor, a trained crisis
worker, will code the type of problem presented by the caller, the
elements of a suicide risk assessment that are completed by the crisis
worker as well as what action plan is developed with and/or what
referral(s) are provided to the caller. No centers will be identified
in the reports.
During the shifts of consenting crisis staff, a recording will
inform callers that some calls may be monitored for quality assurance
purposes. Previous comparisons of matched centers that did and did not
play the recordings found no difference in hang-up rates before the
calls were answered or within the first 15 seconds of the calls.
The 18 centers to be monitored are selected based on the geographic
region(s) they serve and center call volume. A total of 1,320 calls
will be monitored during year 1 of the proposed 3-year clearance
period.
(2) With input from multiple experts in the field of suicide
prevention, a telephone interview survey was created to collect data on
follow-up assessments from consenting individuals calling the Lifeline
network.
During year 1 of the proposed 3-year clearance period, a total of
1,095 callers will be recruited from 18 of the approximately 100 crisis
hotline centers that participate in the Lifeline network. Trained
crisis workers will conduct the follow-up assessment (``Crisis Hotline
Telephone Follow-Up Assessment'') within one month of the initial call.
Assessments will be conducted only one time for each client. Strict
measures to ensure confidentiality will be followed.
The resulting data will measure (a) suicide risk status at the time
and since the call, (b) depressive symptoms at follow-up, (c) service
utilization since the call, (d) barriers to service access, and (e) the
client's perception of the efficacy of the hotline intervention.
Clearance is also being requested for four new activities that are
being proposed to evaluate the process and impact of motivational
training and safety planning (MI/SP) with callers who have expressed
suicidal desire. Five centers will train counselors to implement an
intervention with callers during the initial call to a center, which
incorporates aspects of motivational interviewing and safety planning
(MI/SP) and utilizes an evidence-based practice model to provide
follow-up to callers who have expressed a suicidal desire. An
assessment of MI/SP fidelity and process measures will be incorporated
into the design through the observation of calls via silent monitoring
and the administration of two self-administered questionnaires to
crisis center counselors. The impact assessment of MI/SP counselor
training will include silent monitoring of calls and follow-up
telephone interviews with callers to assess their emotions and
behaviors following their interaction with the MI/SP trained counselor.
(1) The ``MI/SP Counselor Attitude Questionnaire'' attitude
questionnaire will be administered to counselors at the conclusion of
their MI/SP training and be used as a possible predictor of fidelity of
the MI//SP intervention. Information to be gathered includes (a)
counselors' views of the applicability of the MI/SP for preparing them
to conduct safety planning and follow up with callers; (b) possible
anticipated challenges (i.e., impeding factors) to applying the MI/SP
training in their centers; (c) the relationship of the MI/SP model to
their centers; (d) the extent to which individuals have time, energy,
and mental space in their work lives to make changes required to
transfer learning on the job; (e) the degree to which training has been
designed and delivered to give trainees the ability to transfer
learning to the job; (f) how well training instructions match job
requirements; (g) the extent to which trainees are provided with or
obtain adequate resources to enable them to use training on the job;
(h) impeding and facilitating factors; and (i) attitudes about
counselors' self-efficacy to use MI/SP and views on its utility. It is
expected that a total of 225 counselors will be trained over the course
of 3 years in an effort to maintain 175 counselors at any given time.
Thus, a total of 225 counselors are expected to complete this
questionnaire during the 3-year data collection period.
(2) Research monitors, trained crisis counselors not affiliated
with the centers in the project, will access a remote ``real-time''
monitoring system through the Internet to conduct silent monitoring.
Monitors will complete the ``MI/SP Silent Monitoring Form,'' to gather:
(a) Call specifics for each call such as date, time, and length; (b)
suicide risk status of the caller; (c) information on elements of
safety planning, such as making the environment safe and identifying
triggers that led to the caller's suicidality; (d) types of referrals
the counselor gave and to what services; (e) ratings of counselor
behaviors and caller
[[Page 70665]]
behavioral changes that occurred; and (f) re-contact permission status.
At the end of the call and once the counselor deems the intervention to
be complete, counselors will ask all appropriate callers, using the MI/
SP Caller Initial Script, for permission to be re-contacted by research
staff for a follow-up interview. Only a caller whose call has been
silently monitored is eligible to be followed by the research team;
thus, counselors will state that the caller may be contacted by the
research team if randomly selected for a follow-up call. A total of
1,110 calls will be monitored across the 3-year data collection period.
(3) Counselors will be asked to complete the ``MI/SP Counselor
Follow-up Questionnaire'' for each call that is monitored. The
questionnaire will incorporate an assessment of the outreach,
telephonic follow-up and/or other strategies that the center has
proposed to implement, and whether the counselor was able to implement
the center's site plan as originally conceived. The questionnaire will
also include items on the demographic characteristics of the caller,
whether contact was successfully made with the caller, whether the
caller followed through with the safety plan and/or referral given by
the counselor, whether MI/SP was re-implemented during the follow-up
contact, whether another follow-up is scheduled, the educational and
crisis experience of the person attempting re-contact with the caller,
and that person's prior experience with follow-up. Barriers to
implementing the follow-up, as well as types of deviation from the
site's follow-up plan will also be assessed. Open-ended questions about
what led to deviations from the site's follow-up plan will also be
included. In total, it is expected that counselors will complete the
questionnaire for each of the calls that were monitored.
(4) Researchers will begin conducting follow-up interviews with
callers approximately 6 weeks after the initial call to the center.
This follow-up telephone interview (``MI/SP Caller Follow-up
Interview'') will be conducted to collect information on demographic
characteristics, gather caller feedback on the initial call made to the
center, suicide risk status at the time of and since the call, current
depressive symptomatology, follow through with the safety plan and
referrals made by the crisis counselor, and barriers to service. Taking
into account attrition and the number of callers who do not give
consent, it is expected that the total number of follow-up interviews
conducted by the research team will not exceed 885.
The estimated response burden to collect this information,
annualized over the requested three year clearance period, is presented
below:
Total and Annualized Averages: Respondents, Responses and Hours
----------------------------------------------------------------------------------------------------------------
No. of
Instrument No. of responses per Hours/ Response
respondents respondent * response burden *
----------------------------------------------------------------------------------------------------------------
National Suicide Prevention Lifeline--Call 10 44 .58 249
Monitoring Form................................
Crisis Hotline Telephone Initial Script......... 365 1 .08 29
Crisis Hotline Telephone Consent Script......... 365 1 .17 62
Crisis Hotline Telephone Follow-up Assessment... 365 1 .67 245
MI/SP Silent Monitoring Form.................... 10 37 .58 214
MI/SP Caller Initial Script..................... 368 1 .08 29
MI/SP Call Follow-up Consent Script............. 368 1 .17 63
MI/SP Caller Follow-up Interview................ 295 1 .67 198
MI/SP Counselor Consent......................... 75 1 .08 6
MI/SP Counselor Attitudes Questionnaire......... 75 1 .25 19
MI/SP Counselor Follow-up Questionnaire......... 175 2 .17 89
---------------------------------------------------------------
Total....................................... 2,471 .............. .............. 1,203
----------------------------------------------------------------------------------------------------------------
* Rounded to the nearest whole number.
Send comments to Summer King, SAMHSA Reports Clearance Officer,
Room 7-1044, One Choke Cherry Road, Rockville, MD 20857 AND e-mail her
a copy at [email protected]. Written comments should be
received within 60 days of this notice.
Dated: October 16, 2008.
Elaine Parry,
Acting Director, Office of Program Services.
[FR Doc. E8-27696 Filed 11-20-08; 8:45 am]
BILLING CODE 4162-20-P