The Use of Voice-Based AI in 988 Crisis Counseling

Primary outcomes

1. Post-Call Survey

   Time frame: Through study completion, an average of 22 weeks.

   9 item survey utilizing LifeLine crisis call questions that measures changes in distress, perceived helpfulness, and call-taker relationship at the conclusion of a crisis call. The survey is completed by callers to ProtoCall's 988 crisis line, facilitated by the call-taker. .

2. Call-taker crisis counseling fidelity

   Time frame: Through study completion, an average of 22 weeks.

   Crisis counseling fidelity will be assessed by AI-generated scores for every recorded call, which will be analyzed via Lyssn during both SAU and LyssnCrisis phases of the study. Key fidelity metrics will include empathy, use of active listening skills, and whether the counselor asked any of the 7 key risk assessment questions (e.g., ideation, plan, past attempts).

3. System Usability Scale (SUS)

   Time frame: Through study completion, an average of 22 weeks.

   10 item survey that is a general measure of technology usability [ Rated from 1-5, 1= strongly disagree, 5 = strongly agree]

4. Acceptability of Intervention Measure; AIM

   Time frame: For Pilot: at end of 2 week LyssnCrisis period; for RCT, at end of 12-week LyssnCrisis period.

   The Acceptability of Intervention (AIM) to measure target core implementation outcomes and assess if crisis tool is acceptable, appropriate, or feasible for its stated goals. A brief, 4-item measure of a mental health professional's perception of how acceptable an innovation would be for use in their context. Each statement about the acceptability of the innovation is rated on a 5-point ordinal scale ranging from "completely disagree" to "completely agree," where higher scores indicate higher levels of acceptability.

5. Intervention Appropriateness Measure; IAM

   Time frame: Through study completion, an average of 22 weeks.For Pilot: at end of 2 week LyssnCrisis period; for RCT, at end of 12-week LyssnCrisis period.

   The Intervention Appropriateness (IAM) to measure target core implementation outcomes and assess if crisis tool is acceptable, appropriate, or feasible for its stated goals. A brief, 4-item measure of a mental health professional's perception of how appropriate an innovation would be for use in their context. Each statement about the appropriateness of the innovation is rated on a 5-point ordinal scale ranging from "completely disagree" to "completely agree," where higher scores indicate higher levels of appropriateness.

6. Feasibility of Intervention Measure; FIM

   Time frame: For Pilot: at end of 2 week LyssnCrisis period; for RCT, at end of 12-week LyssnCrisis period.

   The Feasibility of Intervention (FIM) to measure target core implementation outcomes and assess if crisis tool is acceptable, appropriate, or feasible for its stated goals. A brief, 4-item measure of a mental health professional's perception of how feasible an innovation would be for use in their context. Each statement about the feasibility of the innovation is rated on a 5-point ordinal scale ranging from "completely disagree" to "completely agree," where higher scores indicate higher levels of feasibility.