The week that ITBusiness.ca spoke with Crisis Services Canada (CSC) CTO Roberta Fox about the non-profit winning an ITWC Digital Transformation Award in the SME public category, there were a couple of high-profile suicides – and the increase in crisis service centre calls that went with them.
“During the week of June 9th and the weekend we first saw the news about fashion designer Kate Spade and celebrity chef Anthony Bourdain taking their lives by suicide within days of each other, we got a 1600 per cent increase in traffic on our website and a 450 per cent increase in traffic in our virtual contact centre,” she explained.
Yet thanks to its DTA-winning national suicide prevention and crisis hotline, designed by Fox with infrastructure support from Rogers Communications Inc., contact centre solutions provider Genesys, CRM provider iCarol, SMS provider Impact Mobile, integrator QuovimC3 and telecom dispatch vendor Northern911, CSC was able to answer the various calls, chats, or instant messaging requests it received between March 2017 and July 7, 2018, when it was forced to suspend its text and chat service due to a lack of funding.
Fox was quick to note that funding ran out because the hotline received a higher than anticipated volume of contacts, and that the organization is still providing direct voice support and lists other organizations that provide text and chat services on its website.
Callers who reached out to the hotline, which could accommodate voice, online chat, and text-based requests, were given a range of numbered options to choose from, which helped the system identify an appropriate volunteer for them to connect with. Then, regardless of where the caller was from or the volunteer’s location (CSC operates seven centres across Canada, is adding more locations across the country, and many volunteers work from home), the system automatically linked the two.
Though she estimated a cost of $60 for each call, Fox positioned the system’s primary benefit as not money, but lives, since according to the World Health Organization and the American Foundation of Suicide Prevention, for every suicide more than 115 people are directly affected.
And since more than 270 of the 16,000-plus Canadians who reached out to CSC after Fox finished installing the new system have indicated their conversations with volunteers made a difference, that means it helped more than 300,000 Canadians (316,250 to be exact, based on the WHO statistic) in fewer than eight months.
There was, of course, a financial benefit too: During the initial eight months of the project the CSC helped keep 74 Canadians from entering the hospital via EMS or police, which Fox estimates saved Canada’s healthcare system $336,000 per person, or $24.9 million total.
She also noted that there was a call to action embedded in CSC’s DTA win: “The government gave us the funding to build the national VCC solution; but unfortunately they did not give us the money to cover the responders or ongoing amounts to sustain the infrastructure,” she said. “So we risk having to turn it off totally if we don’t get the support we need for the short term to cover an adequate volume of responders, as well as for the ongoing long term.”
Mapping out the project’s Genesys – literally
Building what Fox called “the first integrated multimedia virtual voice text and chat suicide prevention service” wasn’t easy, of course.
“We have seven locations, with four different, distinct distress centre organizations, each with their own IT, telecom and legacy network technology elements,” she explained.
Instead of implementing one solution, Fox and her team – which comprised more than 1000 volunteers, vendors and CSC resources – decided to address the challenges presented one at a time.
For the hotline’s primary engine, Fox chose the Rogers’ hosted Genesys solution, their VPN security solution, and enterprise Internet services, emphasizing that it was important to her that all of the hotline’s technical elements be housed in Canadian infrastructure. She also noted that every system component had redundancies in place in case of emergencies.
For the hotline’s texting component, which Canadians could reach out to via internet or SMS, the organization relied on the Canadian-designed iCarol distress centre clinical CRM platform, which is integrated with Genesys and could easily be overlaid on CSC volunteers’ distress centre environment or home computing systems.
“If the person has chat, they come in via iCarol through the public internet. If the person has text, they are routed through the SMS aggregator Impact Mobile, and through the magic of the Genesys virtual contact centre are routed to the closest available responder,” Fox explained, noting that one benefit of the text-based system is that users can identify their age, gender, and current mood if they wish, which enables the trained responders to provide appropriate support.
“We integrated the Rogers Genesys solution with the iCarol CRM solution so the responders don’t have to fill in as many fields in the case management information,” Fox said. “Multiple fields are automatically populated with information about the phone number they’re calling or texting from, so that the next time they contact us, if they want to, we have all that information and don’t have to spend the first five minutes figuring out who they are, because all that CRM and VCC intelligence is underneath the CSC umbrella.”
Another advantage of the Genesys/iCarol platform is it can match users with local, specialized support, thanks to its 211-entry-strong database of mental health experts and organizations that CSC has assembled and maintains.
“So if you called in and I want to follow up with help related to, say, elder abuse, we know our responders have access to that information coast to coast,” Fox said. “Even if, say, somebody in Calgary is taking the call they can give a referral for Toronto or Nunavut or Vancouver Island.”
Fox credited the Genesys/iCarol platform as a major reason for the hotline’s success: 62 per cent of its users indicated they preferred discussing their feelings through text and chat versus voice, she said.
Finally, to ensure users have speedy access to emergency services when necessary, Fox collaborated with Northern911, a Canadian telecommunications firm that gives the hotline easy access to 209 emergency services providers across the country.
“This enables us to have fast access to the right police department and the right EMS when required, so no matter where you’re calling from there’s no delays,” she said.
She was quick to note that the CSC’s hotline didn’t immediately connect callers to 911, because not everyone who calls in requires emergency attention.
“Sometimes people are under extreme distress and may not be having thoughts about taking their life,” Fox said. “They may just need help coping. Our experienced suicide prevention responders are trained and able to help the service user deal with their distress and only engage 911 when absolutely necessary.”
A priceless benefit – and a call to action
On the very first night it was officially up and running – Nov. 28, 2017 – the CSC Calgary hotline’s staff used chat to help a responder prevent an 11-year-old girl in Toronto from taking her life through suicide.
On Dec. 30, before embarking on a vacation, Fox herself ended up having a conversation with the close friend of a 45-year-old father of three who felt disconnected from his family. The friend was worried there could have been a suicide in progress. Fox was able to connect with a responder who helped prevent the father from taking his life, and also helped him secure the ongoing mental health support he needed.
Then there was the gentleman in his 60s who had lost his wife and told CSC he felt alone and didn’t know how to cope. With help from CSC’s outbound follow-up support service, he reached out to his family, which was surprised to learn about his thoughts, and through them is now getting the support he needs.
But for all of the lives helped by the hotline, (188 as of Aug. 14), Fox emphasized during her discussion with ITBusiness.ca that the program is still in the initial development stage, and that CSC’s reaction to user surges and the volume of contacts coming in has often been “Oh my gosh, we don’t have enough capacity!”
And that was before the service was suspended.
“There was no benchmark we could use to plan the volume for these new text and chat incoming contacts as there has not been a national multi-media suicide prevention service of this type anywhere in the world,” she said.
“We need to grow capacity fast in order to meet the higher than anticipated volume of contacts from the people of Canada,” she continued. “We can’t go past the initial program stage until we get additional funding to cover the responder costs, which were not provided in the current government funding program. We need help from the business community and from Canadians.”
Fox said that in a recent survey of the hotline’s seven pilot sites, responders and administrators told her the CSC’s new tools represented a challenge, but a worthwhile one.
“They had never used traditional contact centre applications like the Genesys platform,” she said. “These are not traditional contact centre workers or supervisors. Our resources are distress centre staff, plus trained volunteers who are social workers, police, retirees, students, etc. But they’re working through learning how to use the integrated CSC solution, and they’re also benefiting from learning from each other how to be better crisis centre responders – acting as one national organization, ensuring that the suicide prevention training, practices, and support are all the same.”
The speed afforded by the organization’s transformation also helped the actual service users.
“When people are in an distressed place, contemplating suicide, the longer they have to think about it or are in progress, the more likely they are to actually take action,” Fox explained. “If they can get access to real-time support our responders, on average, can take a person from an unhappy place to a happy place where they realize they have reasons to live in 20 to 30 minutes with voice, or 60 minutes on average with text or chat. So giving our responders the tools and capacity to help these people is a major victory.”
The aspect of the project that Fox said she was proudest of was its “‘Made in Canada’ culture: the way we do more with less, the dedication, collaboration and commitment of the 11 technology vendors, and the way more than 1000 people worked as a team on the most complex project I’ve ever designed and led – and I’ve led hundreds,” she said. “But it’s all working, enabling conversations about suicide and, most importantly to the people of Canada, it’s saving lives!”