Table A3. Characteristics of frequent callers and differences between frequent callers and other users in studies defining frequent callers as persons calling eight or more times in a month.

Study (sample description)	A: Demographic variables	B: Differences in usage patterns of callers (days/week and frequency)	C: Helpline services delivery	D: Presenting problems	E: Psychosocial variables
Burgess et al. (2008) Minimal frequency over 4 weeks for very frequent users ≥ 10 (N = 39); frequent users ≥ 3–9 (N = 77), less frequent users = 1/2 (N = 151). Of 1,404 calls, 439 met the inclusion criteria (i.e., not crisis and not short referral calls), 270 callers agreed to participate. Note: significant findings were between all 3 groups only.	Since statistical tests compared all 3 groups, only visual inspection of mean data could be used to estimate which group(s) had more/less or scored higher/lower. More frequent callers appeared to be older. Very frequent callers were more likely to be never married.			Frequent and more frequent callers seemed to be more likely to report concerns with loneliness, physical illness, and anxiety.	Goldberg Anxiety Scale very frequent callers have higher anxiety scores, more panic attacks. Social and simple phobias. Less likely to not drink alcohol. More likely to have seen psychiatrists in past month. Perhaps less likely to have seen other mental health professionals.
De Carli (1988) Selected “chronic” callers who called twice a week for at least 1 month, excluding contacts “of an improbable sexual nature”; 9 chronic callers were rated by 18 volunteers and paid staff, who also rated “typical callers” who were the third call they received on their shift.	Lack of comparison to other callers.	Identified 2 patterns of “chronic” caller: “regulars” who continue to call repeatedly and people who call often for a limited period of time. This study included only “regulars.”			Chronic callers were rated higher than “typical callers” on dominant, hostile, and exhibitionistic of the Kiesler scales. Typical callers were higher in agreeable scale. Volunteers rated chronic callers as more controlling, self-focused, and angry, and they rated typical callers as more tactful and accepting.
Johnson and Barry (1978) Collected using a caller frequency category system on 100 calls to a telephone crisis intervention center.		Only 1 caller in their sample called 10 or more times; however, calls from center personnel to callers constituted 44% of calls, leading a staff member to state, “We are the chronic callers around here.”		Calls categorized by number of calls and having either the same problem for each call or multiple problems in 6 categories.
Middleton, Gunn et al. (2016) Minimum ≥ 20 calls/month (N = 19) (subsample who participated in phone interview). Middleton et al. (2017) Minimal frequency over a month = ≥20 calls/month. Of 328 survey respondents, 69 were frequent callers. See also Pirkis et al. (2016), which includes data on the same study.	Overall, 45% of frequent users were male compared to 31% of episodic and 37% of one-off users. Over half of the frequent users (55%) reported being unable to work due to sickness or disability, compared to 35% of episodic and 19% of one-off users.			Interviews found they call for someone to talk to, for help with mental health problems and dealing with negative life events. In survey results: More frequent use was associated with regularly calling to talk about their feelings. This was the only reason that was significantly associated with crisis helpline user category in both the univariate and multivariate analysis.
Mishara and Daigle (1997) Minimal frequency over a month, probably over 8 calls: N = 617 calls from 263 callers, of which 25% of callers repeatedly called and had a dossier as a “chronic caller” at the center, which generally requires “frequent” calls over a period of several weeks (generally well over 10 per month, although no exact calculations of call numbers are reported).			There was no significant relationship between use of Rogerian categories during calls and changes in urgency (immediate risk) among chronic callers; however, a high level of use of Rogerian categories was related to significantly greater reductions in urgency among nonchronic callers.
Pirkis et al. (2016) Summarized literature review and data from 4 empirical studies.	Frequent callers are more isolated with less social support.			Have major health and mental health problems, are frequently in crisis.
Spittal et al., (2015) Records audit of the 2,584 callers who made 667 calls per day in any period from 1 week to 549 days (7.7 in 7 days, 20 in 30 days, etc.) compared to 95,580 nonfrequent callers.	Frequent callers when compared to infrequent callers are more often male or transgender, older, never married.	Longer call durations was associated with odds of being a frequent caller.		Frequent callers more often had suicide identified as a safety issue by telephone crisis workers. Safety assessments for self-harm were more frequent. Frequent callers, more often had mental health issues.