Helplines play a pivotal role in global suicide prevention efforts. However, only a limited number of studies examine which specific aspects of the provided support are evaluated as most helpful.
As part of a broader pre-post-follow up study, in this study 65 individuals were interviewed one to two weeks after they reached out to the Flemish Suicide Prevention Helpline (Zelfmoordlijn1813). After completing a pre- and post-call questionnaire, these 65 individuals consented to a semi-structured interview, where they were asked to reflect about which aspects of their conversation with the helpline they experienced as (un)helpful. Furthermore, respondents were inquired about suggestions for follow-up actions (for example follow-up calls) sustaining or improving the impact of the conversation on the long term.
Participants expressed their appreciation of the immediate availability of the helpline. Several actions were highlighted as particularly beneficial, including attentive listening, establishing a genuine connection demonstrating empathy and authenticity, providing support and validation. Moreover, the following factors were identified as important regarding perceived helpfulness: the perceived competence of responders, their ability to de-escalate crises, the absence of perceived time constraints, the freedom to openly discuss suicidal thoughts and behaviors, and the avoidance of stigmatization.
75% percent of participants reported gaining new insights through their helpline interaction, such as cognitive restructuring, alternative future perspectives, discovering help-seeking avenues, and rejecting suicide as a viable solution. Moreover, 70% of participants reported undertaking helpful actions following their call to the helpline, with half of them attributing these actions, at least in part, to their helpline experience. 85% of respondents expressed openness to receiving follow-up calls had this option been available.

Overall, our findings provide valuable insights into the needs and experiences of individuals reaching out to a suicide prevention helpline. This information can offer valuable contributions to training protocols for suicide helpline responders and helps to identify potential areas for aligning existing practices with caller expectations.