Telephone helplines emerged more than 50 years ago as part of a community mental health movement worldwide and are now a feature of mental health promotion and suicide prevention in many countries. Their conceptualisation around crisis theory (Kaplan; Rudd; Hoff) reinforces the importance of accessible responses to people seeking help. These services also create pathways to mental health supports (Gould).

In the past decade, research and evaluation has considerably improved understanding of best practice in telephone helplines and the emergence of online crisis support services.

Quality in service has been considered beyond the hallmark values of compassion and empathy to examine processes, models of theory, and consistency of service delivery (Lester, Kalafat, Mishara). Consumer profiles and service outcomes are becoming better understood and measured (Gould, Pirkis, Watson).

Research has also reinforced the need to address the mental health and wellbeing of helplines workers - paid and volunteer. This has informed improvements in supervision and models of self care for those working in this challenging environment.

This paper will examine recent studies in Australia and overseas to demonstrate how research knowledge can inform service practice and improvement. The paper will also canvass how helplines and online services can improve consumer outcomes.

Improving the physical health of people living with mental illness is a priority[1]. Our team developed Better Health Choices, a telephone delivered intervention that incorporates motivational interviewing and cognitive behavioural strategies. It consists of eight-telephone delivered sessions targeting fruit and vegetable (F&V) consumption and leisure screen time, as well as smoking and alcohol use (as appropriate). The presentation will provide an overview of the ongoing research focused on Better Health Choices. It will include presenting results from our first pilot trial, where psychologists delivered Better Health Choices. Twenty people diagnosed with a non-acute psychotic disorder were recruited [2]. Nineteen participants (95%) completed all intervention sessions, and 17 (85%) completed follow-up assessments. Significant pre-post increases were seen in fruit, vegetable and overall diet quality. Significant reductions in leisure screen time and sitting time were also seen. Our second pilot, funded by the Schizophrenia Fellowship NSW, has focused on the delivery of Better Health Choices by peer workers with people who are accessing Neami services. Results suggest that telephone delivered healthy lifestyle interventions, targeting cardiovascular disease risk behaviours, are feasible and effective in the short-term, and that peer workers could play an important role in disseminating these types of approaches.