Charity’s emergency counselling service cut need for ambulance call-outs by half - report

An emergency counselling and suicide-prevention service for homeless people has reduced ambulance call-outs to hostels and rough-sleepers by half, a report on its operation finds.

The report, led by independent health and social researcher Kevin Cullen, says one of the challenges faced by the Sure Steps counselling service, is "maintaining service responsivity in the light of substantially increasing demand".

Sure Steps, operated by Dublin Simon, expanded its operating hours in autumn 2018 to provide cover from 8am to 10pm Monday to Friday and 4pm to 10pm at weekends. The move was made on foot of a recommendation from the national office for suicide prevention (NOSP).

It operates such that when a ‘client’ - a resident in emergency accommodation or on the streets - expresses suicidal ideation or self-harms, frontline staff can request an urgent call-out by a counsellor to assess the person - either immediately or within 24 hours.

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In all, 655 client interventions/sessions were provided during 2019 according to the report.

“Ambulance call-outs were lower by almost one-half during the period since introduction of the out of hours service (September 2018 - December 2019) compared with the eight-month period before this for which data was available,” it says.

A sample log of incidents, noting their nature and whether ambulances were called, shows that in 44 per cent of incidents - including self-harm, suicide attempt, suicidal ideation - ambulances were called between January and August 2018. This fell to 24 per cent between September 2018 and the end of 2019.

“The activity logs also show the volatility and vulnerability of the client population served, and the major efforts made by the counsellors to connect with at-risk clients and establish/maintain their engagement with the service.

“Keeping track of clients moving between accommodation and the street and keeping in touch with them requires considerable time and tenacity (but) the extension of the service is clearly making a strong contribution as part of the overall Sure Steps suicide prevention response service and helps provide an alternative to ambulance call-outs for incidents where this is appropriate and feasible,” says the report.

Psychological specialist manager at Dublin Simon, Derek Dempsey, said: "The dramatic reduction in ambulance callouts also highlights a stark need for the expansion of this type of service, which aligns with the levels of suicidality we are seeing in the clients who present to us."