Skip to main content Skip to our phone number

National Suicide Prevention Lifeline

Best Practices

Best Practices

The Lifeline Network strives to create and uphold best practices in assessing suicide risk and imminent risk. All Lifeline centers follow these high standards for helping suicidal callers.

Suicide Risk Assessment Standards

Following SAMHSA-funded evaluations that indicated the need for more consistent, uniform suicide risk assessment practices for crisis call centers, Lifeline assembled its Standards, Training & Practices Subcommittee (STPS) of nationally and internationally recognized experts in suicide prevention and tasked this group with developing policies, standards, guidelines and recommended practices for its network of crisis centers. The STPS developed evidence-informed Suicide Risk Assessment Standards in 2006 (Joiner et al., 2007). Lifeline adopted these standards as policy, and verified full network membership adherence with these standards in September 2007.

The Suicide Risk Assessment Standards focus on four core principles: Suicidal Desire, Suicidal Capability, Suicidal Intent and Buffers along with the subcomponents for each. Click here for a review of the suicide risk assessment standards and three example prompt questions with rationale for incorporating them into a call. 

Imminent Risk Policy

In February 2011, the Lifeline released a new Policy for Helping Callers at Imminent Risk of Suicide. This policy, developed over the course of several years, is a result of extensive work by the Lifeline to provide network centers with unified parameters for assisting our highest risk callers. It contains significant contributions from participating centers, researchers and trainers in the field of suicide prevention and represents consensus expert opinion in this central domain of crisis hotline work. Since April 1, 2012, all Lifeline centers have successfully incorporated this policy into ongoing practice.

The Lifeline Policy for Helping Callers at Imminent Risk of Suicide is a logical sequel to the Lifeline Risk Assessment Standards. The Imminent Risk Policy essentially focuses on three core areas:

  • The use of Active Engagement, which requires that hotline staff make reasonable efforts to collaborate with callers at imminent risk to better secure their safety.
  • The use of Active Rescue, which requires that staff take all action necessary to secure the safety of a caller and initiate emergency response with or without the caller’s consent if they are unwilling or unable to take action on their own behalf.
  • A focus on Collaboration with other community crisis and emergency services towards better assuring the continuous care and safety of Lifeline callers determined to be at imminent risk of suicide.

Click here to read the full policy [PDF]