[Federal Register Volume 77, Number 164 (Thursday, August 23, 2012)]
[Notices]
[Pages 51037-51039]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-20720]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Agency Information Collection Activities Under Emergency Review 
by the Office of Management and Budget

    The Substance Abuse and Mental Health Services Administration 
(SAMHSA) has submitted the following request (see below) for emergency 
OMB review under the Paperwork Reduction Act (44 U.S.C. Chapter 35). 
OMB approval has been requested by August 31, 2012. A copy of the 
information collection plans may be obtained by calling the SAMHSA 
Reports Clearance Officer on (240) 276-1243.
    Title: Monitoring of National Suicide Prevention Lifeline Form.
    Frequency: Annually.
    Affected public: Non-Profit Institutions.
    SAMHSA is requesting an emergency extension for this data 
collection. The data collection expires on August 31, 2012 and the 
Agency has determined that this information must be collected beyond 
the expiration date. This information is essential to the mission of 
SAMHSA so that the Agency may monitor the extent to which crisis 
hotline networks are preventing suicides and saving lives.
    SAMHSA cannot reasonably comply with the normal clearance 
procedures because an unanticipated event has occurred in that 
additional funds have become available this month to continue this 
important monitoring effort. This is ongoing monitoring and data 
collection, as such a disruption in the ability to collect this data 
would result in lost information.
    This emergency request is to extend data collection activities of 
the Monitoring of National Suicide Prevention Lifeline Form (OMB No. 
0930-0274). 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 a two toll-free telephone number 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 this data collection is to continue 
to monitor calls and gather follow-up information from the callers 
themselves in order for SAMHSA to understand and direct their crisis 
hotline lifesaving initiatives.
    Clearance is being requested to continue call monitoring and caller 
follow-up assessment activities; as well as the process (silent 
monitoring) and impact of motivational training and safety planning 
(MI/SP) with callers who have expressed suicidal desire (follow-up 
interviews with callers and counselors). These activities are 
enumerated below:
    (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.
    (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 three 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 privacy will be followed. Telephone 
scripts provide potential participants with standardized information to 
inform their consent decision. Using the Crisis Hotline Telephone 
Initial Script, trained crisis counselors will ask for permission to 
have the staff re-contact the caller. The Crisis Hotline Telephone 
Consent Script, used at the time of re-contact, incorporates the 
required elements of a written consent form. 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

[[Page 51038]]

client's perception of the efficacy of the hotline intervention.
    (3) Call 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 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 data collection staff for a follow-up 
interview. Only a caller whose call has been silently monitored is 
eligible to be followed by the data collection team; thus, counselors 
will state that the caller may be contacted by the data collection team 
if randomly selected for a follow-up call. Prior to monitoring and 
collecting of the data, crisis counselors must have read and signed a 
MI/SP Counselor Consent. This form explains the purpose of the data 
collection, privacy, risks and benefits, what the data collection 
entails, and participant rights.
    (4) 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 trainees are provided with or 
obtain adequate resources to enable them to use MI/SP on the job; (h) 
impeding and facilitating factors; and (9) attitudes about counselors' 
self-efficacy to use MI/SP and views on its utility.
    (5) 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.
    (6) Follow-up interviews will be conducted 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 data collection team will not exceed 885. The MI/SP 
Caller Initial Script protects the privacy of callers by asking the 
caller how and when they want to be contacted, and what type of message 
(if any) can be left on an answering machine or with the person picking 
up the telephone. The caller also has the option of not providing 
contact information to the crisis center if he/she prefers to call the 
data collection team back directly. The telephone script used when the 
data collection team contacts the participant for their follow-up 
interview (MI/SP Caller Follow-up Consent Script, see Attachment H) 
includes (1) the fact that the information collection is sponsored by 
an agency of the Federal Government, (2) the purpose of the information 
collection and the uses which will be made of the results, (3) the 
voluntary nature of participation, and (4) the extent to which 
responses will be kept private.
    The estimated response burden to collect this information is as 
follows annualized over the requested three year clearance period is 
presented below:

                         Total and Annualized Averages--Respondents, Responses and Hours
----------------------------------------------------------------------------------------------------------------
                                                     Number of
           Instrument                Number of     responses per   Total number       Hours/         Response
                                    respondents    respondent *    of responses      response        burden *
----------------------------------------------------------------------------------------------------------------
National Suicide Prevention                   10              44             440             .58             249
 Lifeline--Call Monitoring Form.
Crisis Hotline Telephone Initial             365               1             365             .08              29
 Script.........................
Crisis Hotline Telephone Consent             365               1             365             .17              62
 Script.........................
Crisis Hotline Telephone Follow-             365               1             365             .67             245
 up Assessment..................
MI/SP Silent Monitoring Form....              10              37             370             .58             214
MI/SP Caller Initial Script.....             368               1             368             .08              29
MI/SP Caller Follow-up Consent               368               1             368             .17              63
 Script.........................
MI/SP Caller Follow-up Interview             295               1             295             .67             198
MI/SP Counselor Consent.........              75               1              75             .08               6
MI/SP Counselor Attitudes                     75               1              75             .25              19
 Questionnaire..................
MI/SP Counselor Follow-up                    175               2             350             .17              89
 Questionnaire..................
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    Total.......................             918  ..............           3,436  ..............           1,181
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* Rounded to the nearest whole number.


[[Page 51039]]

    Emergency approval is being requested to begin on August 31, 2012.
    About four months after OMB approval, SAMHSA will publish a 60-Day 
Federal Register Notice to request comments during that period. SAMHSA 
encourages comments at anytime.

Summer King,
Statistician.
[FR Doc. 2012-20720 Filed 8-22-12; 8:45 am]
BILLING CODE 4162-20-P