The themes expressed in suicide calls to a telephone help line.
BACKGROUND: Little is known about the suicidal ideation of callers to telephone help lines even though these services are in the front line of suicide prevention efforts. Where thematic data are collected by telephone counseling agencies, it is rarely clear how the categories were constructed and the measurement properties of the instruments are rarely reported. METHODS: The call sheets kept by counselors on 409 suicide calls were content-analyzed, resulting in a reliable checklist comprising nine major themes. The prevalence of these themes within the sample was then determined and age and gender differences in the themes expressed by first-time callers (n = 189) were examined using logistic regression analysis. RESULTS: Almost equal numbers of male and female calls were received and the nine themes were mentioned a total of 981 times. Among first-time callers, males under 35 years were around 75% more likely to refer to relationship breakdown in their calls than were same-age females. Male callers were also around twice as likely to refer to material hardship. Females were four times more likely to refer to being the victim of abuse and nearly 60% more likely to refer to interpersonal and family problems. CONCLUSION: The vast majority of suicide callers expressed dissatisfaction with the quality of their intimate relationships, which suggests that the promotion of intimacy and coping strategies for relationship breakdown are central to the primary prevention of suicide.