Client Key Informa Client Key Informant Interview Third Party Contact

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988 Suicide & Crisis Lifeline and Crisis Services Program Evaluation

Client Key Informant Interview Protocol – Third Party Contacts

(C-KII-TPC)

Introduction

Today, I want to hear your story of your experiences accessing the 988 Lifeline out of concern for someone in an emotional or behavioral health crisis. We appreciate your willingness to share your story. It’s important to us to understand what helped you – or didn’t help you – so that we can keep improving crisis services and make sure everyone has access to the kind of help they need. We understand that this may be a difficult topic to remember and share. If at any point you would like to pause or stop the interview, just let me know. I want to create a safe space in this interview so that you can be comfortable sharing what you think and feel.       

To get us started, please tell me your first name and where you’re joining us from today. 

Crisis Experience and Services Used

1. We understand that you contacted the 988 Lifeline on [date of referral], to receive help for someone you were concerned about. This person may have been at risk of suicide or violence toward others or may have been experiencing substance use issues. I would like to hear your story of what was going on at that time that led you to reach out. Please share all that you would like to share, in your own words, and in your own way.   

   1. How do you know this person?

   2. How did you come to know that this person was in crisis?

   3. As far as you know, was this person having thoughts of suicide or thoughts of violence toward others, or were you concerned they might accidentally overdose on a substance they were using?

   4. Were you concerned they might lose their life on that day if you or someone else didn’t do something to help them?

2. Thank you for sharing that with me. Now I’d like to ask some questions about the kinds of help you were able to access that day. In addition to your contact with 988 on [date of referral], what other types of supports or services were involved in helping you or the person you were concerned about?

1. As far as you know, did the person you were concerned about end up getting connected with 988 themselves that day? How did that connection get made?

2. As far as you know, did the person you were concerned about get connected to a Mobile Crisis Service or visit a Crisis Stabilization Facility? Can you tell me about that?

3. Did emergency services, like 911 or EMS, get involved, or did the person you were concerned about visit an emergency room? Please walk me through how that happened.

   1. Did this happen with the consent of the person you were concerned about, or without their consent?

4. Did you get connected with any other supports or services to meet your needs that day, separately from the needs of the person you contacted 988 about? What was that like for you?

3. Now I’d like to hear about the days, weeks, and/or months following your contact with 988 on [date of referral]. Walk me through what has happened since then.

1. As far as you know, has the person you were concerned about that day been connected to crisis services again since then? This could be 988 Lifeline, Mobile Crisis, or a Crisis Stabilization Facility.

2. What other services or programs, if any, has the person you were concerned about connected to since that time? This could include other family or friends, therapy or counseling, or any kind of social services.

3. Have you contacted 988 again since that date? This could have been for the same person you were concerned about before, for yourself, or for someone else entirely. Please tell me a little about that.

4. What other services or resources, if any, have you connected with since then that have been helpful to you?

988 Lifeline

4. Thinking again about your interaction with the 988 Lifeline on [date of referral]: Walk me through what happened when you decided to contact 988 for the person you were concerned about. What was the process of contacting the 988 Lifeline like for you?

   1. How did you choose 988 as a source of help?

   2. Did you reach out to 988 by phone, or by chat or text? What made that mode of connecting feel most helpful for you?

   3. Had you ever contacted the 988 Lifeline (or the National Suicide Prevention Lifeline at 1-800-273-TALK) before that day? Can you tell me a little about those experiences? [Interviewer note: If the participant has contacted 988 on their own behalf in the past, be sure to remind them that the next questions are about the time they reached out because they were concerned about someone else.]

5. What barriers, if any, did you experience in connecting to the 988 Lifeline on [date of referral]?

   1. Did you experience any hesitation in connecting to the 988 Lifeline? If so, why?

6. Tell me about your experience after you connected with the 988 Lifeline counselor that day.

   1. What, if anything, did you like or find helpful about your experience?    

   2. What, if anything, did you NOT like or find helpful about your experience?

7. What, if anything, did the 988 Lifeline counselor do to increase the safety of the person that you were concerned about?

8. What, if anything, got in the way of the 988 Lifeline counselor’s ability to help you and/or connect you to further resources?

9. Would you say there was any part of your identity or background that was relevant to the kind of help you needed from 988 Lifeline? Can you tell me what that was for you?

   1. If anything like that was relevant to your experience at that time, were you able to share these with the 988 Lifeline counselor?

      1. What made you feel able or unable to share them?

   2. Would you say there was any part of the identity or background of the person you were concerned about that was relevant to the kind of crisis they were having or the kind of help they needed? Can you tell me about that?

   3. How sensitive, if at all, do you think the 988 Lifeline counselor was to aspects of your identity, or the identity of the person that you were concerned about?

      1. Can you share examples of their sensitivity (or lack thereof)?

10. What, if anything, changed for you from the beginning to the end of the conversation with the 988 Lifeline counselor? 

    1. How did you feel at the end of the conversation?   

11. What plans, if any, did you and the 988 Lifeline counselor make for what you could do to help yourself or the person you were concerned about after the conversation ended? 

    1. What hesitations or concerns, if any, did you have about these plans?

    2. Have you been able to put these plans into practice? How helpful have they been?

12. What else can you recall about your conversation with the 988 Lifeline counselor?

13. What, if anything, would have made the experience better for you?

    1. What recommendations, if any, would you have for someone else who is contacting the 988 Lifeline about a person they are concerned about?

Crisis Services Satisfaction and Outcomes

14. Overall, how well did the help you received from the 988 Lifeline counselor meet your needs?   

15. I’d like to hear more about what you feel happened because you connected to 988. What positive things, if any, happened because of your involvement with 988? You can take some time to think about your response.  

    1. What negative things, if any, happened because of your involvement with 988?

16. How would you describe the current mental health and/or substance use of the person you were concerned about?

    1. What mental health and/or substance use programs and services, if any, is the person you were concerned about currently engaged in?

17. What suggestions or recommendations do you have for improving the 988 Lifeline and crisis services continuum to better support people like you and the person you were concerned about?

Demographics

18. Would you mind telling me how old you are?

19. What is your sex?

20. How would you describe your race and/or ethnicity?

Closing

Thank you for sharing your feedback with us. Before we wrap up, is there anything else you’d like to share today about your experiences with crisis services?   

I also want to check in to see how you’re feeling after talking through that together and remind you that if answering any of these questions has made you want to talk to someone about your feelings and experiences, there are resources available to you. Can I help connect you with someone to support you right now?  This could be a trusted friend or family member, a therapist or counselor, or 988.    

   

[Interviewer: if requested, support the participant in connecting directly with a trusted support person or 988. Stay on the call until they have connected with this person or 988. If participant declines, continue:]

Okay. Please remember you can reach out to a crisis counselor at any time by calling or texting 988 or visiting https://988lifeline.org/chat/ to chat with someone who can help. Thank you again for spending time with me today.