The number of calls to the Cuyahoga County suicide hotline increased during two suicide-prevention media campaigns. The hotline is operated by the MHS Mobile Crisis Team. Although many communities have instituted media campaigns urging suicidal people to get counseling, almost no research has examined the effectiveness of these campaigns.

Calls by and about people with suicidal concerns to the Mobile Crisis Team increased 29% during the first media campaign, decreased 10% after the end of the campaign, and increased 15% during the second media campaign.

Separate analyses showed that calls increased during each month of the campaign, compared with the number of calls in corresponding months of the prior year. There were no differences in the sex or age of callers after the campaigns began and ended.

The research was conducted by MHS and the Alcohol, Drug Addiction & Mental Health Services Board of Cuyahoga County, and published in late April 2008 in the journal Suicide and Life-Threatening Behavior. MHS has been working with the Board to implement the County's suicide prevention plan. An important part of this plan is a public information campaign designed to increase community awareness of the 24/7 suicide hotline and crisis services provided by the MHS Mobile Crisis Team.

The campaign message was Suicide is Preventable. Its Causes Are Treatable. For Immediate Help, Call 216-623-6888. During each of the four-month campaigns, the message was carried on 350 public buses, 33 billboards, and kiosks at five shopping malls throughout Cuyahoga County. A public-service radio message aired the campaign message 288 times. The Board also created a 15-second public service video. You may watch the video here.

Billboards and placards similar to the one depicted here were placed throughout Cuyahoga County as one part of the suicide prevention campaign. The telephone number on the actual billboards and placards is the local number of the Mobile Crisis Team, 216-623-6888. (Calls to 1-800-Suicide from Cuyahoga County are automatically forwarded to the Mobile Crisis Team.)

The bar graph below presents the rate of monthly suicidal calls to MHS during four periods: (1) the 15-month, pre-campaign baseline period; (2) Phase One, the four months of the first campaign; (2) the four-month campaign hiatus; and (4) Phase Two, the five months of the second campaign. The rate was the number of suicidal calls per month per 100,000 people. Rates were used instead of the number of calls in order to adjust for the 2% decline in the population of Cuyahoga County during the study periods.

As shown in the graph above, calls increased during each of the two suicide prevention media campaigns. Both increases were statistically significant, meaning it is unlikely they could have occurred solely by chance. Other analyses, presented in the table below, showed that the rate of calls increased each month of the campaign, compared with the rate of calls in corresponding months of the prior year. Because there was no control or comparison group, it is possible, although highly unlikely, that factors other than the media campaign could have led to the increased number of calls. No suicidal call data were available from surrounding counties that were not implementing a similar campaign during the study period.

The research was undertaken after Rick Oliver, MHS Director of Crisis Services, noticed that suicidal calls to the Mobile Crisis Team had increased after the media campaign had begun. (See this for the original discussion of these data.)  As shown in the bar-graph below, during the fifteen months (March 2005 to May 2006) since the campaign began, the average monthly number of new calls in which suicide was the caller's primary concern (the red vertical bars) was 393. This is 27% higher than the average monthly number of suicidal calls for the fifteen months (November 2003 to January 2005) before the start of the public information campaign. The average monthly number of total new crisis calls (represented by the blue bars) to the Mobile Crisis Team increased 6% (from 1,027 to 1,089) after the campaign began.

The increased number of calls is encouraging, because it shows that efforts to increase public awareness of suicide prevention resources in the community do, in fact, result in greater use of those resources. The best indication of effectiveness would, of course, be a decrease in the County's suicide rate in future years. We will continue our work with the Alcohol, Drug Addiction & Mental Health Services Board of Cuyahoga County to evaluate the effectiveness of the County's suicide prevention plan, and to plan future prevention activities.

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