Suicide hotline saved at the 11th hour

The National Hopeline Network, the oldest nationwide suicide prevention hotline, nearly shut down at the end of August because of a budget shortfall.

But, in order to make sure that those in crisis who reach out for help get it, the board of the Kristin Brooks Hope Center, the organization that runs the line, voted to donate their number, 800-SUICIDE, to the Substance Abuse and Mental Health Services Administration, which has in turn agreed to continue to operate it.

Mental health advocates also are taking steps to disseminate widely information about the 2-year-old National Suicide Prevention Lifeline. This number, 800-273-TALK, routes callers to a similar network of crisis centers.

"The most important thing for anybody to know is that there is a number that they can call 24 hours a day, seven days a week," said John Draper, PhD, director of the Lifeline program.

The 800-SUICIDE line came close to being disconnected Aug. 25 because organizers failed to raise the more than $60,000 needed to pay its outstanding phone bill.

The reasons for the funding shortfall are murky. Officials from the Kristin Brooks Hope Center maintained that SAMHSA owed thousands of dollars from a grant that ended in 2004. The agency denies this.

Experts suggest, however, that the outcome -- that resources continue to exist to help people in crisis -- is the key message in this story.

"There's no doubt in my mind that having a well-known, widely recognized national hotline has saved lives," said David Fassler, MD, clinical professor of psychiatry at the University of Vermont College of Medicine in Burlington. "Hopefully, the various organizations will find a way to ensure that the service continues to operate with as much continuity as possible."

The antidepressant-suicidality link?

Meanwhile, a team of researchers at Carnegie Mellon University in Pittsburgh and Ohio State University in Columbus have received a $1.2-million grant from the National Institute of Mental Health to determine the extent to which there is a link between the use of antidepressants and suicidality.

This research team previously questioned the Food and Drug Administration's conclusions that these drugs could be linked to an increased risk of suicidality in those younger than 18.

In April, they published a paper in Clinical Trials suggesting that the risk was increased only in adolescents with major depressive disorder who took selective serotonin reuptake inhibitors and that these conclusions were not necessarily generalizable to those taking other antidepressants for other conditions.

"Our concern was that by mixing together different diagnostic groups as well as different formulations of antidepressants, the FDA was underestimating important sources of variability that would make their results look more significant than they were," said Joel Greenhouse, PhD, one of the study's authors and professor of statistics at Carnegie Mellon.

The team will investigate the use of data from clinical trials that were not designed to evaluate suicide. Researchers also intend to dig through large observational studies such as those that use health administrative data that have failed to find a link and were not used by the agency to reach its conclusions.