Patterns and characteristics of 'calls of despair': a service evaluation using Yorkshire Ambulance Service data.

Introduction: 'Deaths of despair' (DoD) - encompassing fatalities from suicide, drug overdoses and alcohol-related causes - represent a growing public health crisis. Socioeconomic vulnerability and healthcare disparities are well-documented drivers of DoD. While healthcare contacts preceding despair-related deaths have been studied extensively, the role of ambulance services is underexplored. This study aimed to address this gap by utilising ambulance service data to provide insights into 'calls of despair' received by a UK ambulance service over a 12-month period. Methods: This exploratory, retrospective study analysed data collected during 2023 by Yorkshire Ambulance Service (YAS), which serves urban and rural areas with varying levels of deprivation. Calls were included if they involved suicidal ideation and/or drug or alcohol misuse. Data were sourced from computer-aided dispatch and electronic patient records and were analysed to describe call characteristics, demographic profiles, geographical distribution, temporal trends and repeat caller patterns. Results: In 2023 YAS received 40,870 calls of despair. Nearly half of those calls originated from the most deprived quintile. Urban areas had more than double the rate of calls compared to rural areas. More than half (54%) of the calls involved drug and alcohol misuse, while 43% were related to suicidal ideation. Females were more likely to call for substance misuse (58%) than suicide (46%), and young females (<25 years) represented a disproportionate share of calls. Only 43% of calls resulted in hospital conveyance, suggesting ambulance services capture crises that are not reflected in hospital datasets. Repeat callers were common, with 119 individuals making more than 10 calls each. Conclusion: The findings highlight the utility of ambulance service data in understanding despair-related crises, particularly among socioeconomically disadvantaged and young populations. Ambulance data offers a valuable lens for public health monitoring, capturing acute needs often absent in traditional healthcare datasets. These insights emphasise the need for targeted interventions and cross-sectoral approaches to address the underlying drivers of despair.