The Development of a Core Outcome Set for Crisis Helplines: A Three-Panel Delphi Study

Introduction: Evidence for crisis support service effectiveness is limited by inappropriate and inconsistent outcome measurement. The purpose of this study was to identify what outcomes should be measured. Method: We used a Delphi method with three expert panels: 32 people with lived experience of accessing crisis support, 25 researchers, and 58 crisis supporters. Across two online survey rounds (89% retention rate), participants rated the importance of 33 potential help-seeker outcomes of accessing a crisis support service via any delivery mode (e.g., phone, text, online chat). Participants also had the opportunity to provide open-text comments and suggestions. Outcomes that reached consensus (≥75% agreement) by at least two panels were included in the core outcome set. Results: Ten outcomes met the criteria for inclusion in the core outcome set. In order of importance, these were: distress, feeling heard, suicide risk, connectedness, hopelessness, overwhelm, non-suicidal self-injury risk, service experience, helplessness, and next steps. Conclusion: Our findings provide new insight into what outcomes matter most to help-seekers accessing crisis support. We recommend future service evaluations minimally measure and report the 10 outcomes identified in this study. More work is needed to determine how best to assess these outcomes in the crisis support service context.