Characteristics and Risk of Adverse Mental Health Events Amongst Users of the National Overdose Response Service (NORS) Telephone Hotline

Abstract The National Overdose Response Service (NORS) is a Canadian mobile or virtual overdose response hotline intended to prevent drug overdose deaths but has unexpectedly received mental health related calls, including adverse mental health events. Our study aimed to examine these occurrences and caller characteristics predictive of adverse mental health outcomes. Using the NORS call dataset, we conducted a descriptive representation of mental health occurrences and mental health emergencies along with correlative statistics. We found that NORS had received 2518 mental health calls, with 28 (1.1%) being adverse events. Men, rural callers, polyroute substance consumption and history of overdosing were found to have increased odds of having an adverse mental health event, while being from Quebec, using non-standard consumption routes and using the line between 50 and 99 times were found to decrease odds. This supports the utility of overdose prevention hotlines to also support people experiencing adverse mental health situations and reduce harm for individuals with mental health and/or substance use disorders.