Clinical predictors of high-risk triage categorisation and in-patient admission in Qatar’s National Mental Health Helpline

Abstract

Suicide remains a major global public health concern, and crisis helplines are increasingly recognised as important components of suicide prevention. The National Mental Health Helpline (NMHH) in Qatar was established in 2020 as a confidential, multilingual service designed to provide rapid assessment and intervention for individuals experiencing mental health crisis, including suicidality. To identify independent factors associated with high-risk triage categorisation and in-patient admission among callers to Qatar’s NMHH over a 3-year period and to describe their sociodemographic and clinical profiles. A 3-year cross-sectional chart review using stratified random sampling analysed 698 cases representing low-, moderate- and high-priority categories. Assessments were conducted using the Australian State of Victoria’s Statewide Mental Health Triage Scale, supported by clinical assessment, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 scale, and the Situation, Background, Assessment and Recommendation (SBAR) framework. Logistic regression analyses were performed to identify predictors of high-risk categorisation and in-patient admission. During the study period, 50 803 calls were received. The analytic sample was evenly distributed by gender (50.1% female), with a median age of 29 years, and 75.9% were non-Qatari. Common symptoms included disturbed sleep (47%), anxiety (43%) and depressed mood (36%). Female gender, severe mental illness, impulsivity and suicidal ideation independently predicted high-risk triage categorisation; emotional instability, disturbed appetite, impulsivity, suicidal ideation and social isolation predicted in-patient admission. Structured crisis lines/helplines can effectively deliver suicide risk assessment and intervention within national health systems. The NMHH model demonstrates the potential of integrated helpline services to identify high-risk individuals, facilitate timely intervention and support community-based management.