What is a TCall? FAQ


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In Crisis? Text "SOS" to 741741 up to 160 characters

Secrets No More - We would like you to check this out and participate if you can.
Latest News - "CTL is the largest mental health data set that's ever been collected, stored and analyized."

R U There? - New Yorker
Why Aren’t More Crisis Hotlines Offering Chat-Based Help? - The Atlantic
This text line is helping teens talk about mental health without saying a word
This text-message hotline can predict your risk of depression or stress - Business Insider
Tech’s Biggest Names Are Giving Millions to Crisis Text Line - Wired
Crisis Help Lines Have Been Inundated Following The Election - The Huffington Post
Pride in Mental Health: An Interview With The Trevor Project And Crisis Text Line
For Teens in Crisis, the Next Text Could Be a Lifesaver
Crisis Text Line: Saving Lives Through Data
Crisis Texters Data by State
Flash - Monthy news up-dates from Crisis Text Line. Latest 6/30/17
Crisis Text Line Brings Help to Troubled Teens Where They Live — Their Phones
In the world’s hub of innovation, crisis support catches up with the times
SOS via SMS: Help for suicidal teens is a text message away
What Bay Area leaders are saying

What is a TCall?
What does "SOS" mean?
What is it?
What is its origin?
How does it work?
Who should text in?
How are we serving the Hispanic population
About us
Our principles
SOS via SMS: Help for suicidal teens is a text message away
Crisis Text Line Topics
Day of Week, Time of Day and topic coverage reports
R U There?  The New Yorker
Related Issues: 
Emergency Numbers, Teen Suicide, Suicide, Semicolon Campaign, Zero Attempts Campaign, 741741, Depression, How to talk with your kids about suicide, Need to Talk?

Statistics show that.."Only 5% of teens are willing to call phone crisis lines, but they'll text a hotline." TCall 741741 (not 741-741) and text "SOS" to connect with a crisis counselor anonymously 24/7/366.

Must See
TED Talks - Crisis Next Line - Founder
Strangers helping strangers via Text
Mostly Human
Silicon Valley's secret
Help Is Just A Text Away - Hopeline PSA
If You Only Knew What You Left Behind
Crisis Text Line helps reach teens in trouble
Crisis Text Line: Strangers Helping Strangers via Tex
Crisis Help: Just a Text Away
Crisis Text Line - A free, 24/7 text line for people in crisis

What is a TCall?

It is a six digit cell phone number, used by people in crisis, fo text message emergency services

What does "SOS" mean?

S O S became the international signal of extreme distress (particularly in maritime use) on 1 July 1908, having first been adopted by the German government three years earlier. SOS is the only nine-element signal in Morse code, making it more easily recognizable, as no other symbol uses more than eight elements. It has since entered the awareness of those who are unlikely ever to summon help at sea – appearing in contexts as varied as the title of songs by ABBA, Rihanna, and the Jonas Brothers, and the home renovation TV programme DIY SOS.
Source; blog.oxforddictionaries.com/2014/07/sos-mayday/ Also en.wikipedia.org/wiki/SOS

Why are we using it beyond the obvious point of being a cry for help?
It has taken on at least two meanings in the Suicide Prevention movement. Signs of Suicide and Survivors of Suicide and is used by the American Association of Suicidology. Or, pick the one that works for you or come up with your own. Here are some starters.
Save Our Selves, Source Of Strength, Save Our Souls, Sign Of Strength, Science Of Survival, Save Our Society, Save Our Survivors, and Signals Of Silence. I'm somewhat drawn to this last one because texting can be a silent cry for help and nobody knows you're doing it..

What is the Crisis Text Line?

Crisis Text Line is a service that troubled teens can use to find help with suicidal thoughts, depression, anxiety, and other issues via text messaging. The long-term hope was to anonymize and encode these text messages so that researchers and policy-makers could better understand something typically kept private to the individuals.

Following through, the organization recently released a look into their data and a sample of encoded messages.

The visual part of the release shows when text messages typically come in, and you can subset by issue, state, and days. It could use some work, but it’s a good start. Hopefully they keep working on it and release more data as the set grows. It could potentially do a lot of good.

When a young woman texted DoSomething.org with a heartbreaking cry for help, the organization responded by opening a nationwide Crisis Text Line for people in pain. Over 20 million text messages later, the organization is using the privacy and power of text messaging to help people handle addiction, suicidal thoughts, eating disorders, sexual abuse and more. But there's an even bigger win: The anonymous data collected by text is teaching us when crises are most likely to happen — and helping schools and law enforcement to prepare for them by using technology and data to help save lives.

Statistics show that.."Only 5% of teens are willing to call phone crisis lines, but they're
more willing to text. Texting 741741 is a way to text anonymously with a crisis counselor."

What is its origin?

The Crisis Text Line was begun in August, 2013. In September 2015, an image began circulating via social media web sites, stating that teens can text 741741 in order to speak with a crisis counselor. However, many viewers were skeptical about the putative program since the organization behind it was not identified in the image.

But 741741 is indeed the number for the Crisis Text Hotline. While the meme specified "teens," the number is available to anyone in crisis which includes deaf or the hard of hearing. It is especially effective who are in the presense of dnger and a phone call to 911 might draw the activity to them when the perpetrator hears them talking. This wouldn't happen with Text Messaging.

Some Recent History

In December 2015, Crisis Text Line made headlines by releasing data that implied that bullying and harassment against Muslims was on the rise. "These political scare tactics have real implications on everyday Americans."

Crisis Text Line experienced a noteworthy increase in volume immediately after Donald Trump's election as President of the United States. Specifically, the data revealed that "election" and "scared" were the words that overindexed most in the days after the election, and that the word "scared" was most frequently associated with LGBTQ texters.

How does the Crises Text Line work?

You text 741741 when in crisis. Anywhere, anytime.

A live, trained crisis counselor receives the text and responds quickly.

The crisis counselor helps you move from a hot moment to a cool calm to stay safe and healthy using effective active listening and suggested referrals – all through text message using CTL’s secure platform.

Who should text in?

A: We exist to help anyone in crisis any time.

The Crisis Text Hotline also notes in its FAQ section that all text messages are anonymous and free, although charges may apply with carriers other than AT&T, T-Mobile, Sprint, or Verizon.

In a June 2015 article published by the Chicago Tribune, Nancy Lublin, the CEO of DoSomething.org, explained why she founded the Crisis Text Line:

The text message to a DoSomething.org staffer read: "He won't stop raping me. He told me not to tell anyone."

Those words quickly made their way to Nancy Lublin, the CEO of the New York City-based youth empowerment group, which runs do-good campaigns by text, like initiatives for gender-neutral bathrooms and sharing tips to prevent texting while driving.

Lublin's staff had received a few messages — concerns about bullying and the like — unrelated to their campaigns, but "that one message stopped me in my tracks," Lublin said. "It was like being punched in the stomach. The first rule of marketing and sales is: Go where demand is. People want this by text. We should be supplying crisis counseling by text."

That week, Lublin started building Crisis Text Line, a national 24/7 text number — 741741 — available to everyone but mostly used by teens. It went live two years later in 2013 in Chicago and El Paso, Texas. Chicago was chosen because of the influence of an early funder, the Chicago-based MacArthur Foundation. El Paso was a data-driven decision based on its large Latino population.

Within four months, the line had been contacted by cellphones from every area code in America. The organization is expected to surpass 7 million messages by July, and Lublin is now in need of more counselors.

About Us

Your best friend. Your dad. That lady down the street. That quiet kid in school. That loud kid in school. That dude in accounting. Your cousin in Alaska. That hipster in the flannel in Brooklyn. That rando who might lurk online. Crisis Text Line is for everyone.

Crisis Text Line is free, 24/7 support for those in crisis. Text SOS to 741741 from anywhere in the USA to text with a trained Crisis Counselor.

Crisis Text Line trains volunteers (like you!) to support people in crisis. With 20,070,473 messages processed to date, we’re growing quickly, but so is the need. Apply to be a crisis counselor now.

Our principles

We fight for the texter. Our first priority is helping people move from a hot moment to a cool calm, guiding you to create a plan to stay safe and healthy. YOU = our priority.

We believe data science and technology make us faster and more accurate. See our Founder’s TED talk for more scoop on how we’re using this stuff. While we love data science and technology, we don’t think robots make great Crisis Counselors. Instead, we use this stuff to make us faster and more accurate–but every text is viewed by a human.

We believe in open collaboration. We share our learnings in newsletters, at conferences and on social media. And, we’ve opened our data to help fuel other people’s work.  


Q: How does the Crisis Text Line work?

A: You text SOS to 741741 when in crisis. Available 24/7 in the USA. A live, trained crisis counselor receives the text and responds quickly.

The crisis counselor helps you move from a hot moment to a cool calm to stay safe and healthy using effective active listening and suggested referrals – all through text message using Crisis Text Line’s secure platform.

Q: Who should text in?

A: We exist to help anyone in crisis at any time.

Q: Who answers the text messages?

A: Crisis Text Line crisis counselors are both rigorously trained volunteers and employees of our crisis center partners.

Q: What can I expect when I text in?

A: You’ll receive an automated text asking you what your crisis is. Within minutes, a live trained crisis counselor will answer your text. They will help you out of your moment of crisis and work with you to create a plan to continue to feel better.

Q: Is the Crisis Text Line actually anonymous?

A: Yes. Crisis counselors only know what texters share with them, and that information stays confidential. We take your anonymity seriously. Check out our terms of service here .

Q: How much does the Crisis Text Line cost?

A: We do not charge texters. If your cell phone plan is with AT&T, T-Mobile, Sprint, or Verizon, texts to our short code, 741741 are free of charge. If you have a plan with a different carrier, standard text message rates apply.

Q: Will the Crisis Text Line show up on my cell phone bill?

A: Nothing will appear on your bill if your cell phone plan is with AT&T, T-Mobile, Sprint, or Verizon. If your plan is with another carrier our short code, 741741 will appear on your billing statement. Read about how this happened here.

Q: Will the Crisis Text Line work with my phone?

A: The Crisis Text Line works on all major US carriers, and most minor regional carriers. However, shortcodes (like 741741) are not allowed on many prepaid plans like T-Mobile’s.

Q: I had a great experience when I texted in. Can I text in again?

A: You can text in again, if you are experiencing a crisis. However, you should not feel dependent on us. The Crisis Text Line is not a replacement for long-term counseling, in-person therapy, or a friend.

Q: How long do I have to wait to text with a crisis counselor?

A: Our goal is to respond to every texter in under 5 minutes. During high volume times, such as at night or when people are talking about us on social media, wait times may be longer.

Q: Is there a character limit when texting the Crisis Text Line?

A: Yes, our system is only able to process 140 characters in one message.

Q: Why am I receiving an error message or no response at all?

Sadly, there are some carriers who have not adopted the use of shortcodes–and the small percentage of people with these phones, can’t use the Crisis Text Line. (We hear that sometimes you get an auto-error response. Sometimes nothing at all. We know this is shitty and we wish those carriers would enable us). If your phone carrier doesn’t enable shortcodes, here is a list of hotlines you can call.

Q: Is there any other way to reach the Crisis Text Line besides text?

A: Yes, you can reach us through Facebook Messenger. Access to message Crisis Text Line is located through Facebook’s Safety checkpoint. This is accessible by flagging a user’s post.

Q: Is I reach out via Facebook Messenger, does anonymity apply?

A: Yes. We do not have access to your Facebook profile. The only information about you that we’ll know is what you share with us.

Q: Is I reach out via Facebook Messenger, who has access to the data?

A: Three parties: you (in your Messenger thread), the Crisis Text Line, and Facebook.

Q: If I reach out via Facebook Messenger and I want my data deleted, what do I do?

A: Message us back with the word ‘LOOFAH’. We’ll scrub your data from our system, and make a request to Facebook to do the same.

Q: If I reach out via Facebook Messenger, which terms of service apply to me?

A: By contacting the Crisis Text Line through Facebook Messenger, users agree to Facebook Messenger’s Terms of Service, as well as the Crisis Text Line’s Terms of Service.

Q: Is Crisis Text Line counseling?

A: No, our specialists do not counsel, but rather practice active listening to help texters move from a hot moment to a cool calm.

Q: What is active listening?

A: Active listening is when someone communicates in a way that is empathetic, understanding, and respectful. It includes focus on the texter and thoughtful answers.

Q: What's the difference between Crisis Text Line and therapy?

A: Crisis Text Line is not a replacement for therapy. Therapy includes a diagnosis made by a doctor, a treatment plan of action, and a patient/therapist relationship. Crisis Text Line helps people in moments of crisis. Our crisis counselors practice active listening to help our texters find calm and create an action plan for themselves to continue to feel better. Crisis Text Line’s crisis counselors are not therapists.

Q: What are all of the crisis issues you track? Can you add more?

A: See the issues we track at www.crisistrends.org . If you’re a researcher or practitioner with interest in another issue, submit your suggestion in the form at the bottom of www.crisistrends.org

Q: Who can apply for access to the Crisis Text Line's data?

A: Data access is available to approved academic researchers. Please visit www.crisistrends.org to see the latest trends in how texters are experiencing crisis.

How are we serving the Hispanic population, particularly because we don’t (yet) offer the service in Spanish? While we only receive a handful of conversations in Spanish, we do receive a lot of volume from Hispanic texters: they make up ~15% of our texter population. Here are some quick facts about Crisis Text Line texters who identify as Hispanic:


Gender. (No difference.) Hispanic texters are slightly more likely to identify as female (74% vs. 73%) AND male (17% vs. 15%). More interestingly, Hispanic texters are less likely to identify as another gender such as Agender or Genderqueer, vs. other texters (9% vs. 12%, or ¼ lower).

Age. (Wow!) 55% of our Hispanic texters identify as 17 or younger, vs. 46% of other texters.


Hispanic texters love us. Conversation quality is 2.5% higher for conversations with Hispanic texters vs. other texters. So, even though we’re English-only, our Hispanic texters are digging our service!

Hispanic texters really share with us! 72% of Hispanic texters share something for the first time, vs. 66% of other texters.

Need to talk?

Find a therapist that's a good fit for you with this health tool.
Source: therapists.psychologytoday.com/webmd

SOS via SMS: Help for suicidal teens is a text message away

With younger generations using cellphones less for actual conversation and more for text messaging, suicide prevention organizations are setting up ways that let distraught youths seek help that way.

Suicide is the second leading cause of death among teenagers and college-age adults, making a text messaging initiative — started this month by Samaritans Inc. of Massachusetts to supplement the more traditional phone help line — a natural, Executive Director Steve Mongeau said.

Nearly 5,300 U.S. residents younger than 24 took their own lives in 2013, the most recent year for which data are available, according to the Washington, D.C.-based American Association of Suicidology. The latest suicide report by the Massachusetts Department of Public Health indicates that 90 state residents ages 5 to 24 killed themselves in 2012.

"We want you, as a person in need, to be able to use the communication platform you feel most comfortable with," Mongeau said, adding that Samaritans is the first suicide prevention organization in Massachusetts to offer the texting option.

The U.S. Department of Veterans Affairs has offered text help for suicidal veterans for several years.

The National Suicide Prevention Lifeline also offers text messaging help at many of its more than 160 crisis centers nationwide. That organization found that nearly 40 percent of people reaching out for help using its online chat option indicated they would not feel comfortable seeking help by phone.

Young people may not be able to articulate their feelings in a phone conversation, said Dr. Jill Harkavy-Friedman, vice president of research at the America Foundation for Suicide Prevention, yet their emotions became crystal clear in a text conversation.

"What we found is that parents would look at their children's phones after a suicide and see all the distress their children were experiencing," she said.

The same Samaritans telephone number often seen posted near bridges — 877-870-4673 — can be used for text messages, Mongeau said.

People texting the organization are connected with a volunteer trained in the use of text messaging, and familiar with the grammatical quirks, abbreviations and emoticons used in text messaging. In fact, most of the organization's volunteers are under 30, with some as young as 16, and are already well-versed in text messaging, Mongeau said.

Text messages are also more private, he notes.

"Say you're in a public place, or on a school bus, you can text back and forth without being overheard," he said.

The Samaritans texting service is so far available daily only from 3 p.m. until 11 p.m., the period after school when young people tend to have more time on their hands, Mongeau said. But the goal is to make the program available 24/7.

And of course, anyone who wants to can text, regardless of age.

A few people have already taken advantage of the texting option, Mongeau said, even though the organization is still trying to get the word out. Eventually he expects to engage in as many 300 text conversations per day, or about the same as the number of phone calls the organization receives daily.

"People just want someone to confide in without judgment," he said.

Editor's note: See Crisis Text Line (741741) for a national service established in 2013 that has processed over 32,000,000 texts as of March 13, 2017.

Crisis Text Line Brings Help to Troubled Teens Where They Live — Their Cell Phones

Your teen is in trouble and won’t talk to you. But she’ll text a friend or a counselor. Enter @CrisisTextLine

“I want to die or run away. I can't take my family.”

“I just feel awful... im in the bathroom at my school crying.”

“I have no one to talk to about it. I would like to stop cutting myself.”

An incoming text message that a volunteer mental health counselor at Crisis Text Line responds to during a typical shift might look like this.

Between August 2013, when the free, nonprofit text-messaging-based counseling service launched, and June 30, 2017, counselors have exchanged more than 41.6 million messages with people nationwide struggling with depression, bullying, eating disorders, sexual abuse, self-harm, suicidal thoughts and other crises.

Seventy percent of those texting in are teens and young adults, ages 13 to 25, according to the organization — and that number could grow as educators become more aware of the service and the possibilities it holds, especially for cash-strapped schools struggling to keep guidance counselors and social workers on the payroll. (A recent 74 investigation found that four of the top 10 school districts in the country currently employ more security officers than counselors)

It’s simple enough to use the service — just text “SOS” to 741741, and a live, trained counselor, perhaps located thousands of miles away, responds within a few minutes.

Robert Nikc, an assistant principal at Intermediate School 145 in Queens, said a text counseling service like Crisis Text Line could be a tremendous resource for his students, who are more prone to vent about a problem via a text or social media post than they are to initiate a conversation in person.

“(Texting) is something that they are very comfortable using and they don’t have concerns, if you will, about disclosing personal information over that forum to their friends,” Nikc said.

Nikc said he recently learned about the service and plans to present it to his administrative team, which could consider offering it as a resource to students and their families.

The school has nearly 2,000 students in grades six to eight and five full-time school counselors — or one for every 400 students. (The American School Counselor Association recommends a ratio of one counselor for every 250 students.) That a text message conversation is readily available during the hours when teachers, counselors and deans are not (nights are high-volume times for Crisis Text Line) makes the service more appealing, Nikc said, although he cautioned it shouldn’t be considered a replacement for one-on-one conversation with an adult.

Starting this year, Crisis Text Line is embarking on a partnership with the popular teen messaging app After School, which has millions of users at more than 20,000 high schools around the country. The app is designed to be inaccessible to the prying eyes of adults — students can post anonymously and they sign up for a school-specific newsfeed by verifying their identity and their school via their Facebook account.

If students post specific words or phrases that alert After School’s human moderators to a potential crisis, the app will send a message asking if the user would like to speak confidentially with a Crisis Text Line counselor. In other cases, threats are flagged by a moderator or the app’s automatic language detection filters, triggering After School to contact local authorities to intervene.

Since the app began offering a counseling service in April 2015, more than 60,000 students have used it, a spokesman said. (The app first partnered with a different service, Instawell, from April to December last year and switched to Crisis Text Line in early 2016.)

Text-based services that cater to children and teens (and their parents) are nothing new. A school in Los Angeles, for one, sends texts to parents with updates on students’ assignments, which boosted homework completion rates by 25 percent, according to The Hechinger Report.

Researchers at the University of Virginia found that when high school seniors were sent text reminders to finish financial aid forms, they were more likely to enroll in a two-year college than those not sent text messages.

But the idea that an app or a text service could end up as the first line of defense for kids who may be at risk for suicide or depression? That has yet to fully catch on with parents and educators.

Executives at both organizations believe that by working together they can speed up that process and improve outreach to youth in crisis and prevent tragedies.

“We know that teenagers don’t want to go talk to their parents, or they don’t want to go to the school counselor and watch everyone watch them walk into the office, so where teens feel most comfortable is on their phones,” said Cory Levy, After School’s co-founder and chief operating officer.

And they will pour their hearts out in 140 characters or less — the per message limit set by Crisis Text — in conversations the service says last 45 minutes to an hour on average. The texter in crisis is using a phone but the counselor is on a computer that allows quick access to helpful information or referrals.

The goal is for the counselor to provide a temporary intervention, guiding the texter from what the organization calls a “hot” moment to a “cool calm” using active listening. Most conversations end with a referral to other services, said Crisis Text Line’s Director of Communications Liz Eddy.

In order to become counselors, volunteers must be 18 years old, complete 34 hours of training, undergo a background check and make it through the interview process. The organization has about 1,500 counselors.

Eventually the organization plans to create an online referral database of mental health services, shelters and counseling centers that can be regularly updated, Eddy said.

Crisis Text Line has made a trove of data available to approved researchers in an effort to better inform public policy and improve mental health care services. (The organization has headquarters in New York City and was founded by Nancy Lublin, who previously spent 12 years as the chief executive of DoSomething.org.)

Among the data that is publicly available on its site right now:

— States where texters most often seek help for “school problems,” a category used by Crisis Text Line, are South Carolina, Virginia, Illinois and Connecticut.

— Vermont, South Dakota and Mississippi are the top three states for messages exchanged about “bullying.” (This data includes all texters, not just young adults).

— LGBT issues are more prevalent among all texters in Alaska, Oklahoma and Nebraska.

Note: See http://bit.ly/2lKrtYA for more recent data for Oregon

At After School, Levy, 24, and his co-founder, CEO Michael Callahan, 33, hope to draw from that data pool and serve a greater purpose in schools. Their app launched a beta version in 2014 and was quickly downloaded by students at thousands of high schools across the U.S. Just as quickly, it seemed, the app became a magnet for bullying, harassment and even threats of violent attacks at schools, despite its stated intention to be a safe space for positive messaging between teens. It was temporarily removed from the Apple store because of inappropriate content.

The updated version of the app — once again available for download in the Apple store — includes new security features designed to protect its young users. The emergency notification system is part of that, along with 24/7 moderators and enforcement of a zero-tolerance policy toward cyberbullying and threats, the app-makers say.

Levy said they ultimately want to use the data to advise state and local education policymakers about how students in a particular region or district are faring mentally and emotionally

To that end, they’ve talked with educators and administrators in cities like Houston, Dallas, San Francisco, Los Angeles, Chicago and Miami.

“If we know that in Colorado, we get a lot more requests (for the counseling service) than we do in Texas, then maybe we should go talk to the Board of Education in Colorado and tell them that ‘Hey, we’re seeing a problem in your state,’” he said.

Maria Tavella, a middle school counselor at I.S. 141, “The Steinway” school in Queens, said she tacked the 741741 number to her bulletin board at the beginning of the year and is now going from class to class to explain how Crisis Text Line works.

The school has 1,200 students in sixth to eighth grade and only two counselors, she said.

Tavella said she often encounters students who have plenty of friends but tell her it’s not always safe or reliable to confide in them. The anonymous nature of the service and the understanding that a trained adult is on the other side of the iPhone makes it attractive, she believes.

“Come a weekend, if they can’t reach out to their friends, if they can’t tell their parents about something, it’s nice to know, ‘OK, here’s something else I can trust, here’s someone else I can go to.’”

If you or someone you know needs help, use the Crisis Text Line, 741741 or call the National Suicide Prevention Lifeline at 1-800-273-8255.
Source: www.the74million.org/article/crisis-text-line-brings-help-to-troubled-teens-where-they-live-their-phones

In the world’s hub of innovation, crisis support catches up with the times

Whether you’re a local student, a commuter taking the train into work, or a concerned parent, many have been touched by suicides at Caltrain in the Bay Area. Today, Crisis Text Line, the national not-for-profit that provides free, 24/7 crisis support via SMS, launches an array of local partnerships in the Bay Area – including Caltrain.

Caltrain will be adding signage and information to stations urging people to text 741741 for crisis support. Sally Longyear, a Palo Alto parent whose daughter, Sarah Longyear, died by suicide at Caltrain in April, supports Crisis Text Line. “If my daughter had known about Crisis Text Line she might be here today,” said Sally Longyear. “If just one life is saved by adding these signs, it will be worth it.”

In 2013, serial social entrepreneur Nancy Lublin founded Crisis Text Line. Since then, they’ve exchanged over 26 million messages with people in crisis, creating the largest real-time mental health data set. The organization has garnered support from tech giants like Reid Hoffman, Steve Ballmer, Melinda Gates, and the Omidyar Network.


To date, Crisis Text Line has already handled over 25,000 conversations with people in crisis in the Bay Area. Our Bay Area data shows 75% of texters are under 25 years old, and “school” is the #1 location mentioned by suicidal texters. “Mental health stigma continues to be a barrier for individuals and families to seek needed care. As we all know, millions of people use social media, and text message can be a private, accessible way to receive support,” said Barbara Garcia, Director of the San Francisco Department of Public Health. “Crisis Text Line will improve access to care in times of extreme stress and also help identify trends to enrich our understanding of the population that uses this new intervention.”


Many beloved San Francisco icons are banding together in support of Crisis Text Line’s Bay Area launch. The San Francisco Giants will raise awareness with their fans throughout the 2017 season for Crisis Text Line both in park and through their large social media following to ensure that all fans know where to turn in crisis: 741741. Bay Area based Peet’s Coffee will promote the number in local Peet’s locations and provide free coffee for Crisis Counselor volunteers.

Crisis Text Line Bay Area partners include:

  • City of San Francisco
  • Caltrain
  • Golden Gate Bridge District
  • San Francisco Giants
  • Peet’s Coffee
  • Sunnyvale Department of Public Safety
  • Los Gatos Monte Sereno Police Department
  • Project Safety Net
  • Children’s Health Council
  • Adolescent Counseling Services
  • SafeSpace

These partners are in addition to Crisis Text Line’s national corporate partners based in the Bay Area, including YouTube, Facebook, After School, Twilio, and Speck Products.


Crisis Text Line’s Bay Area efforts are supported by a grant from The Battery’s philanthropic branch, Battery Powered. “Crisis Text Line is a fast-moving, innovative organization that is disrupting the mental health sector,” said Michael Birch, Founder of The Battery. “We were blown away by their data and how it can inform Bay Area policy, parents and schools.”

Crisis Text Line has hired Palo Alto native Libby Craig to lead these efforts. Craig attended Gunn High School during its first suicide cluster in 2009. “I’m honored to grow Crisis Text Line in my home town, where I saw peers die by suicide,” said Craig. “We all know 911 for crime and emergency. I’m hoping 741741 will be known across the Bay Area for mental health crises.”


  • If you’re in crisis, text BAY to 741741 for crisis support in the Bay Area.
  • Become a volunteer Crisis Counselor at crisistextline.org/volunteer.
  • To learn how your organization, company, or school can get involved, reach out to Bay Area Director Libby Craig at libby@crisistextline.org.

About Crisis Text Line

Crisis Text Line is free, 24/7, confidential crisis support via text. Learn more at crisistextline.org


What Bay Area leaders are saying:

“Caltrain highly supports suicide prevention and mental health initiatives in this community.” said Tasha Bartholomew, Caltrain Communications Officer. “We believe working with Crisis Text Line will be instrumental in reaching more people in crisis who might be more comfortable using text message.”

“Crisis Text Line fills a need that our teens have been asking for, a safe anonymous text support line designed for teens and young adults.” said Pat Burt, Mayor of Palo Alto. “Having access to the collected data is an additional bonus that will help inform our decisions about how we allocate resources to keep our young people healthy and safe.”

“Crisis Text Line is a powerful tool to help us reach people in crisis, and we’ve added 30 signs on the bridge and in the parking lots with their number,” Priya Clemens, Communications Manager of the Golden Gate Bridge and Transit District. “We’ve already seen the benefits of this partnership, with Crisis Text Line alerting bridge patrol of people considering suicide on their way to or at the bridge.”

“By using an increasingly popular means of communication, this organization is revolutionizing crisis support and providing a needed public service to the Bay Area,” said Michael Spath, Communications Manager, Sunnyvale Department of Public Safety. “Every 911 Public Safety Answering Point (PSAP) should know about the 24/7, free availability of Crisis Text Line. As public safety agencies nationwide are currently implementing our own ability to process emergency text messages sent to 911, having additional resources available for the texting community will become even more important.”

“Police response to mental health issues and the ability to quickly and appropriately support those in need is an ongoing priority of our department,” said Matt Frisby, Chief of Los Gatos Monte Sereno Police Department. “Our partnership with Crisis Text Line provides yet another avenue to connect with persons in crisis and provide them with the care they deserve.”

“Every student should know about this important resource,” said Jessica Colvin, Wellness Director of Tam Unified School District. “There should be stickers in every bathroom and flyers in every classroom. Students need to enter 741741 into their phones.”

Source: www.crisistextline.org/media/baypress/

R U There?

A new counselling service harnesses the power of the text message.

In 2011, a young woman named Stephanie Shih was working in New York City at DoSomething.org, a nonprofit that helps young people start volunteer campaigns. Shih was responsible for sending out text messages to teen-agers across the country, alerting them to various altruistic opportunities and encouraging them to become involved in their local communities: running food drives, organizing support groups, getting their cafeterias to recycle more. Silly, prankish responses were not uncommon, but neither were messages of enthusiasm and thanks. Then, in August, after six months on the job, Shih received a message that left her close to tears for the rest of the day. “He won’t stop raping me,” it said. “He told me not to tell anyone.” A few hours later, another message came: “R u there?” Shih wrote back, asking who was doing this. The next day, a response came in: “It’s my dad.”

DoSomething.org had no protocol for anything like this, so Shih texted back with the contact information for rainn (Rape, Abuse & Incest National Network*)*, the country’s largest anti-sexual-assault organization. But the texter indicated that she was too scared to make a phone call. “This is the right thing to do,” Shih insisted. There was no reply. “Not knowing if she was safe or had gotten help or would ever get help consumed my thoughts,” Shih told me last fall. She printed out the text messages and handed them to her boss, Nancy Lublin, DoSomething.org’s C.E.O.

“I’ll never forget the day,” Lublin said. “It was like I’d been punched in the stomach.”

That week, Lublin and Shih started work on what two years later became Crisis Text Line, the first and only national, 24/7 crisis-intervention hotline to conduct its conversations (the majority of which are with teen-agers) exclusively by text message.

Depression is common among teens, and its consequences are volatile: suicide is the third leading cause of death for Americans between the ages of ten and twenty-four. In that same age group, the use of text messaging is near-universal. The average adolescent sends almost two thousand text messages a month. They contact their friends more by text than by phone or e-mail or instant-message or even face-to-face conversations. A. T. & T. offers parents a tutorial in deciphering acronyms used by children (pir stands for “parent in room”). For teens, texting isn’t a novel form of communication; it’s the default.

People who spent their high-school years chatting with friends on landlines are often dismissive of texting, as if it might be a phase one outgrows, but the form is unparalleled in its ability to relay information concisely. The act of writing, even if the product consists of only a hundred and forty characters composed with one’s thumbs, forces a kind of real-time distillation of emotional chaos. A substantial body of research confirms the efficacy of writing as a therapeutic intervention, and although tapping out a text message isn’t the same as keeping a diary, it can act as a behavioral buffer, providing distance between a person and intense, immediate, and often impulsive feelings. Communication by text message is halting and asynchronous, which can be frustrating when you’re waiting for a reply but liberating when you don’t want to respond. The young people who contact Crisis Text Line might be doing so between classes, while waiting in line for the bus, or before soccer practice. In addition, more than ninety-eight per cent of text messages are opened; they are four times more likely to be read by the recipient than e-mails. If you’re a parent, you know that, even if your son does not text you back about where he is, he has read your message. If you are a distressed teen or a counsellor, you know that what you say will be read.

A person can contact Crisis Text Line without even looking at her phone. The number—741741—traces a simple, muscle-memory-friendly path down the left column of the keypad. Anyone who texts in receives an automatic response welcoming her to the service. Another provides a link to the organization’s privacy policy and explains that she can text “stop” to end a conversation at any time. Meanwhile, the incoming message appears on the screen of Crisis Text Line’s proprietary computer system. The interface looks remarkably like a Facebook feed—pale background, blue banner at the top, pop-up messages in the lower right corner—a design that is intended to feel familiar and frictionless. The system, which receives an average of fifteen thousand texts a day, highlights messages containing words that might indicate imminent danger, such as “suicide,” “kill,” and “hopeless.”

Within five minutes, one of the counsellors on duty will write back. (Up to fifty people, most of them in their late twenties, are available at any given time, depending upon demand, and they can work wherever there’s an Internet connection.) An introductory message from a counsellor includes a casual greeting and a question about why the texter is writing in. If the texter’s first message is substantive (“My so-called boyfriend is drunk and won’t stop yelling at me”), the counsellor echoes the language in order to elicit additional details (“I’m so sorry to hear that. Can you tell me a little more about what your so-called boyfriend is saying?”). If the incoming message is vague (“Life sucks. I’m freaking out”), the reply will be more open-ended, while gently pressing for greater specificity (“So what’s going on tonight?”). An average exchange takes place over a little more than an hour, longer if there is the risk of suicide.

Counsellors are trained to put texters at ease and not to jump too quickly into a problem-solving mode. Open-ended questions are good; “why” questions are bad. Also bad: making assumptions about the texter’s gender or sexual orientation, sounding like a robot, using language that a young person might not know. Techniques that are encouraged include validation (“What a tough situation”); “tentafiers” (“Do you mind if I ask you . . . ”); strength identification (“You’re a great brother for being so worried about him”); and empathetic responses (“It sounds like you’re feeling anxious because of all these rumors”). The implicit theory is that in a conversation people are naturally inclined to fill silences.

It is important to type carefully. In text messages sent to friends, typos can be an indication of intimacy. But a typo appearing on the cell-phone screen of a distressed teen-ager can undermine the sense of authority he’s looking for. “You have to train yourself not to hit that return button automatically,” a sixty-year-old counsellor from California told me. (Crisis Text Line counsellors are free to give a real or assumed first name to people who text in.) It is also regarded as a mistake to embrace teen-age patois too enthusiastically. One volunteer told me that she tries not to use acronyms. “I sometimes worry that it would come across as too ‘Oh, I got you!’ ” she said. Neutral language allows the texter to feel anonymous. These people have contacted a stranger for a reason. They aren’t looking for friendship.

Often, the conversations are about minor-seeming problems—fights with friends, academic pressure from parents—and the bar for helpfulness is quite low. “A lot of times, when chatting with young people, it’s clear that they just need someone to listen to them,” one counsellor told me. “Sometimes it’s obvious. They’ll say, ‘Thanks for listening. Nobody ever does that,’ and at other times it’s less explicit; they just want to get everything out, and they provide you with a very, very detailed account.”

The etiquette encouraged for counsellors can be surprising. When an agitated friend texts me bad news (a breakup, a layoff, a sudden rent increase), my instinct is to find a positive response to the predicament (“But you didn’t even like him!” “Now you can finally go freelance!” “move!”). But this is precisely what one is not supposed to do when communicating with a teen-ager in crisis. Instead, counsellors are trained to deploy language that at first seems inflammatory: “You must be devastated” is a common refrain; so is “That sounds like torture.” The idea is to validate texters’ feelings and respond in a way that doesn’t belittle them.

Thomas Joiner, a psychology professor at Florida State University and one of the country’s leading suicide experts, pointed out another way in which conversational norms can be counterproductive. “From a clinical standpoint, one common misstep is tiptoeing around issues and treating them like taboos,” he said. “It sends the implicit message that it’s really not O.K. to talk about it, and if the counsellor doesn’t feel comfortable talking about it why would the teen-ager?” It takes practice to tell someone who is suffering that he has a real problem, and that, though things may get better, it may not be anytime soon.

Each day, on average, Crisis Text Line instigates at least one active rescue of a texter who’s thought to be in immediate danger of suicide. During active rescues, the counsellor asks questions as casually as possible—Are you alone? Do you have someone you trust whom you want us to contact? Is your door locked?—and feeds the answers to a trained supervisor, who, in turn, contacts the police. One counsellor, a twenty-eight-year-old former Division 1 basketball player who began volunteering last May, told me that the very first conversation he took was with a teen-ager who was contemplating jumping off a roof. The exchange lasted for an hour, and, by the end of it, the teen was in the car with a parent, driving to the hospital.

In 1906, a woman staying at a Manhattan hotel asked the manager if she could speak to a minister. The manager tried calling Harry Marsh Warren, a minister at a Baptist church, but was unable to get through. The following morning, the woman was found unconscious beside a bottle of poison and was rushed to Bellevue. Warren visited her as she lay dying, and she told him, “I think maybe if I had talked to someone like you I wouldn’t have done it.” Soon after, Warren started the Save-A-Life League, the country’s first suicide-prevention organization. He placed an ad in a local paper, encouraging anyone contemplating suicide to contact him. News spread quickly, as did the organization’s reach. By the time Warren died, in 1940, there were branches across the United States, as well as in London and Paris, and the league was helping around a hundred people each week—providing counselling, free hospital beds, and legal services. It also raised summer-camp tuition for the children of suicides.

In the nineteen-forties, a Boston-based psychiatrist named Erich Lindemann attempted to make the field of crisis intervention more empirical. He conducted his research in the wake of the Cocoanut Grove disaster, of 1942, a fire at a Boston night club that killed nearly five hundred people. Lindemann interviewed dozens of survivors and published a paper based on his findings. He determined that people in crisis are open to help, and that appropriate and expedient treatment could avert the need for long-term psychotherapy, which was the leading method of mental-health treatment at the time.

A decade later, in London, Chad Varah, an Anglican priest, founded a suicide hotline in the crypt of his church: the Samaritans took its first call on November 2, 1953. The idea for the service had come to Varah when he held a funeral for a fourteen-year-old girl who had killed herself on getting her first period, which she thought was symptomatic of a sexually transmitted disease. In 1958, the Los Angeles Suicide Prevention Center was founded, the first in America. It formulated a set of protocols that were adopted by other centers in the United States and abroad. Volunteers establish rapport, define the problems, and assess the risk of self-harm. They aim to reduce anxiety, discussing how callers have coped with similar problems in the past. Finally, they develop a specific plan of action.

In 1963, President Kennedy signed the Community Mental Health Act into law. Among other things, this legislation provided federal funding for community-based mental-health-care centers. Crisis-intervention hotlines soon proliferated, with separate lines for those experiencing suicidal thoughts, drug addiction, sexual abuse, eating disorders, and so on. This arrangement insured that callers would talk to someone who had a reasonable degree of expertise in what was troubling them. Crisis Text Line departs from this practice; there’s just one number to text, whatever ails you. The medium makes it easy for volunteers to look up information, and the C.T.L. interface enables them to enlist the help of colleagues who have training in a particular area. Nancy Lublin often explains the system by saying, “People don’t experience life in an issue-specific way.”

Texting has other advantages. The fact that counsellors can work from home while eating Chinese takeout—and can even trade shifts with one another—makes it easier to attract volunteers. More important, from an adult perspective teen-agers can often seem willfully uncommunicative in speech but are forthcoming, even garrulous, when texting. “On the phone, you have to ask a few more questions, sort of explore a little bit more to find out what’s really going on,” Jen James, who works for C.T.L. in Michigan, told me. “With the text line, they are pretty open. They just come out and tell you and want to talk about it.” Research bears out this observation. According to Fred Conrad, a cognitive psychologist and the director of the Program in Survey Methodology at the University of Michigan Institute for Social Research, people are “more likely to disclose sensitive information via text messages than in voice interviews.” To those who didn’t grow up texting, this seems counterintuitive. Texts are a written record, after all, and what if the wrong person saw them? But, in practical terms, text messaging affords a level of privacy that the human voice makes impossible. If you’re hiding from an abusive relative or you just don’t want your classmates to know how overwhelmed you feel about applying to college, a text message, even one sent in public, is safer than a phone call. What’s more, tears go undetected by the person you’ve reached out to, and you don’t have to hear yourself say aloud your most shameful secrets.

It’s difficult not to notice the merriness of the place in which these dismal matters are analyzed. DoSomething.org’s headquarters, where the employees of Crisis Text Line also work, is situated just north of Union Square, in New York City. Stray balloons cling to the ceiling; there’s an aquarium and a disco ball. Many of the staff members—eighty people, of whom only fourteen are over thirty—seem to spend much of the day without shoes. Under the bright lights and amid the cheerful buzz of people born after the Gulf War, one has a sense of observing kids collaborating on a group project at a school in a county with high property taxes.

DoSomething.org and Crisis Text Line are separate entities, but Nancy Lublin is the C.E.O. of both. She is forty-three, and likes to refer to herself as the C.O.P. (Chief Old Person). She speaks quickly, in a frank but friendly tone, and is unafraid to contort her face into goofy, sometimes even self-consciously grotesque expressions. Lublin brags on behalf of her employees, often in their presence, and has the air of a beloved social-studies teacher who swears. When we first met, last October, she was wearing a cotton scarf printed with the face of Hello Kitty.

Lublin grew up in Hartford, Connecticut, a city that she disdainfully identifies as “the insurance capital of the world.” She attended Brown University and then Oxford, where she was a Marshall Scholar studying political theory—or, as she puts it, “a lot of dead white guys.” Upon returning to the States, Lublin enrolled in law school at N.Y.U. “My whole life people were, like, ‘Oh, you have a lot to say! You’re going to be a lawyer,’ ” she told me. But Lublin hated “everything from nine-point font in thick textbooks to the Socratic method to classmates who were really just fighting for the right to be on law review, which was looking up your professor’s footnotes for an article that was going to appear in a journal that maybe twelve people would read.” She dropped out after her fourth term.

While still at N.Y.U., Lublin recalled something that her father, a lawyer, once told her about his method of hiring new secretaries for the firm. Looking out his window, he would watch the women walk from their car to the front of the building and know before they reached the door whether he would hire them. “I remember being horrified by this story,” Lublin said. “ ‘You never even met her! How could you know that you’d hire her or not? Just based on what she looked like?’ And he’d say, ‘Yes, and that’s why you need to go comb your hair.’ ” Lublin chose to respond with a kind of benevolent pragmatism: in 1996, at the age of twenty-four, and with the help of three nuns in Spanish Harlem, she founded Dress for Success, a nonprofit that provides interview suits to underprivileged women looking for jobs. The budget came from five thousand dollars that she had recently inherited from her great-grandfather and her occasional winnings at poker. The nuns found space in a church, rented for a few hundred dollars a month, but it flooded a week before the launch, and Lublin was forced to transplant all the garments to her apartment, a one-bedroom in Greenwich Village. Dress for Success’s inaugural client was Charline Brundidge, who had been granted clemency after a conviction for fatally shooting her physically abusive husband. As reported in the Times, “Gov. George E. Pataki gave Mrs. Brundidge a pardon. Dress for Success gave her a suit.”

Within two years, Dress for Success had expanded nationally and was operating out of thirty cities across the country. (There are now affiliates in sixteen countries worldwide, and the Home Shopping Network produces clothing for the organization.) But by 2002 Lublin was bored. She cashed in the bonds given to her for her bat mitzvah and left Dress for Success. She spent a year writing and fielding calls from headhunters intent on recruiting her for C.E.O. positions at large nonprofits. She had just turned thirty and knew that the companies approaching her saw her as a token young person. Then she got a call from the actor Andrew Shue, of “Melrose Place” fame, who had co-founded DoSomething.org ten years earlier. The organization, seriously in debt, had just lost its headquarters and almost all its staff. Lublin thought this would be the perfect place to start up again from scratch. This was 2003, a year before Facebook was launched, and Lublin knew that if the organization was to have a future it would have to live online. She closed five of DoSomething’s offices; reconfigured its board of directors; and began polling its teen-age members about their habits, preferences, and passions. The organization now operates on a healthy budget of more than nine million dollars, attracts corporate sponsorship from companies like JetBlue and H & M, and hosts benefits that raise up to a million dollars.

In the fall of 2011, Lublin began raising funds for Crisis Text Line. To date, she has raised about five million dollars. Promotion is solely by word of mouth, and within four months the organization was receiving texts from all two hundred and ninety-five area codes in the United States. Lublin, who is friends with many Silicon Valley entrepreneurs and sees herself as an iconoclast, has built Crisis Text Line more along the lines of a tech company than a nonprofit. She told me, “We think of ourselves a lot more like Airbnb or Uber or Lyft.”

Like a tech company, C.T.L. analyzes feedback from users, performs A/B testing, and is quick to make changes on the basis of what it finds. Although other data-driven philanthropic missions exist—Kiva, the microfinance site, and the public-school donation service Donors Choose are among the more well known—nonprofits have generally been reluctant to embrace methods of quantification that big corporations increasingly take for granted. But at C.T.L. the chief data scientist, Bob Filbin, was Lublin’s second hire. He co-wrote the data algorithms for C.T.L.’s system after travelling to crisis centers across the country and interviewing hundreds of volunteers about how their work could be made more effective. The communication techniques employed by C.T.L. counsellors are largely modelled on standard crisis-counselling practices, but C.T.L. has made modifications based on its data. It turns out that, for instance, statements couched in the first person (“I’m worried about how upset you seem”) are associated with positive responses.

The organization’s quantified approach, based on five million texts, has already produced a unique collection of mental-health data. C.T.L. has found that depression peaks at 8 p.m., anxiety at 11 p.m., self-harm at 4 a.m., and substance abuse at 5 a.m. The organization is working on predictive analysis, which would allow counsellors to determine with a high degree of accuracy whether a texter from a particular area, writing in at a particular time, using particular words, was, say, high on methamphetamine or the victim of sex trafficking. A texter who uses the word “Mormon” tends to be reaching out about L.G.B.T.Q. issues.

Out of consideration for texters’ anonymity, Crisis Text Line displays its findings only by state. (Arkansas ranks highest for eating disorders, Vermont for depression; suicidal thoughts are most common in Montana and least common in New Hampshire.) But eventually there will be enough data to allow the organization to confidently reveal Zip codes and area codes without the risk of making any single texter identifiable. Such a wealth of data is new in the field of mental health. Isaac Kohane, a pediatrician who also has a Ph.D. in computer science and is the co-director of the Center for Biomedical Informatics at Harvard Medical School, told me, “You cannot have accountable care—financially or morally accountable care—if you cannot count, and until recently we literally could not count with any degree of acceptable accuracy.” He added, “It’s been mind-boggling, to those of us who knew what was available, that Amazon and Netflix were creating a far more customized, data-driven, evidence-based experience for their consumers than medicine has.”

Lublin hopes that the data will eventually be useful to school districts and police departments. “The corpus of data has the volume, velocity, and variety to really draw meaningful conclusions,” she told me. Lublin also mentioned that many people have told her that she is “crazy” for not wanting to sell the data that have been collected. A hedge-fund manager said that he would happily pay for a subscription that allowed him access to crisis trends. “I was basically, like, You’re a jerk,” she recalled thinking.

One Sunday evening in early December, I embarked on a training course as a Crisis Text Line counsellor. I was out of the country, but, as befits an organization in which the person who saves your life may be thousands of miles away, training takes place online. You learn by watching videos, reading PDFs, taking online quizzes, role-playing with fellow-counsellors, and observing conversations live. Volunteers, who must be older than eighteen, have to pass a preliminary interview and a background check. The course runs for thirty-four hours, over a period of seven weeks, and concludes with a final one-on-one video interview lasting twenty-five minutes. New counsellors commit to one four-hour weekend or evening shift per week for a year.

At the start of the first session, the faces of twenty-one participants, on Webcam, appeared along the top of my screen, some small and framed by the rooms around them, others so close that I could see their pores. We smiled and waved at one another; we all looked to be in our twenties or thirties. Our supervisor, who was wearing a pink plush hat, introduced herself and, in a crackling voice, let us know that we were welcome to wear pajamas next time. Like the sessions that followed in the coming weeks, this one was ninety minutes long but felt more like thirty. The training combines two pleasures largely lacking in adult life: structured incremental learning and make-believe. In an instant-message box, we practiced replying to various imaginary texts. The recommended formula for replies is tentafier + feeling adjective + source of feeling (“It sounds like you’re feeling ashamed because your friend didn’t invite you to her party”). We also practiced paraphrased reflections (“You must be really upset with your friend”). We learned to ask open-ended questions and to actively identify a texter’s strengths: pointing out his bravery in reaching out, complimenting his self-awareness. Then we were paired up in order to practice these skills in a role-play, one of us pretending to be an upset teen-ager and the other acting as a C.T.L. volunteer. Afterward, we annotated the transcript with “pluses” and “wishes,” the organization’s preferred language for “good” and “bad.” Intermittently, the supervisor’s cursor appeared in the document to offer advice.

The thing I found most difficult was employing Crisis Text Line’s teachings while still coming across like myself. The maxim “Don’t sound like a robot” is often repeated, and eventually it was possible to achieve this effect by imagining my words being read by a teen-ager. Using as many contractions as possible came to seem surprisingly important, because formality gets in the way of affirmation. It was hard to fend off vague and echoey therapist-speak, and I wasted a lot of time trying to rephrase the question “And how does that make you feel?” before realizing that I didn’t have to. There is something humbling about Crisis Text Line, and, indeed, about help lines in general: a person in pain will say what she wants to say, and it probably doesn’t matter much who does the asking.

The weekly practice sessions are the core of the training. Volunteers also participate in two Observation Shifts (each three hours long), in which they have the opportunity to see actual conversations occur between texters and a counsellor. Crisis Text Line goes to great lengths to insure that texters’ identity remains secret, and trainees sign a stringent agreement to protect confidentiality. (I agreed not to divulge personal details.) During my first shift, I witnessed a halting conversation between a counsellor and a young girl with body dysmorphia. The conversation lasted for an hour and a half. The counsellor provided links to resources for people struggling with eating disorders, and the girl eventually agreed to distract herself with a bath and a movie. Simultaneously, that counsellor was texting with a girl who wanted to cut herself and was having suicidal thoughts, and with a third texter whose grades were plummeting because of depression. This last texter was much less engaged in the process than the others were. “This isn’t making me feel much better,” he or she wrote. Soon after, the communication fizzled out entirely.

A week later, I shadowed another counsellor. Her first conversation was with a girl who was fighting with her cousin and struggling against the urge to hurt herself. The next was with a college-aged young man who was confused about the romantic feelings he harbored for his ex-boyfriend, who had sexually assaulted him. The counsellor’s last conversation of the night was with the daughter of an abusive father. She wrote that she avoided him by spending lots of time locked in her bedroom. The counsellor reassured her and asked about her plans for the rest of the evening. She said that she was going shopping with her family, and that afterward she’d be alone. She typed, “Thats the part im scared for.” Source: www.newyorker.com/magazine/2015/02/09/r-u

Why Aren’t More Crisis Hotlines Offering Chat-Based Help?

Many organizations know that text-based service is the future—but upgrading from phone-based systems costs time and money.

We are now living in a chat-based society and traditional crisis hotlines are struggling to adapt.

The volume of text messages has surpassed voice calls in the United States since 2008. Which means, with every passing year and new messaging app, the telephone becomes more irrelevant. According to Experian, U.S. smartphone owners between the ages of 18 and 24 send an average of 2,022 texts per month on average—the equivalent of 67 texts a day. Meanwhile, telephone conversation is in the midst of a “serious decline.” People (especially Millennials) just don’t call each other like they used to, and this has serious implications for the institutions designed to help them through crises. The telephone hotline has dominated crisis support for over 40 years, and now the tide is slowly turning.

As a volunteer for the Rape Abuse Incest National Network, or RAINN, I know first hand about the organization’s efforts to adapt. I went through 60 hours of training and supervision to become an online volunteer on RAINN’s National Sexual Assault Hotline, where I talk to victims of rape and sexual assault through an anonymous, Instant Messenger-style chat service. I let visitors know that the chat is anonymous and they do not have to share anything with me they do not want to. I ask if they are safe and if they have any privacy or safety concerns. Then I ask what brought them to the hotline. Sometimes, visitors share what is on their mind right away, while others take longer to open up. The chats usually last at least an hour.

RAINN was one of the first victim-support organizations to launch an online hotline back in 2007. Since then, it has served almost 250,000 visitors and demand for the service grows every year. Two hundred volunteers and 45 paid staff members work around the clock—24 hours a day, every day of the year—to provide continuous support for the online hotline. Earlier this year, RAINN added a Spanish-language service, and between the two, RAINN conducts an average of 113 sessions a day.

RAINN also operates the Department of Defense Safe Helpline services through a contract with the agency’s Sexual Assault Prevention and Response Office (SAPRO) and has partnered with the Peace Corps to provide chat-based support to its volunteers.

RAINN offers these chat services in addition to its telephone hotline: 1-800-656-HOPE (4673). Operating the online hotline requires a substantial amount of financial and human resources, and money for initiatives like this is in short supply. However, as with businesses across all sectors, nonprofits are not impervious to shifts in the way people communicate. In order to “stay relevant,” they have to modernize.

The interface of the chat system looks ambiguous, so it can be used in public spaces without screaming “crisis hotline.”

“We get people who are talking about what happened to them for the first time, and if it wasn't for an online service like this, they wouldn't have reached out in another way,” said Jennifer Marsh, RAINN’s vice president of victims services. “We are catching young survivors and people who say they could never talk about this out loud. Online communication gives them the space to control the conversation and put down their own narrative about what happened.”

Marsh said that a vast majority of the online hotline visitors are between 13 and 24 years old. More than half are talking about abuse or assault that took place five or more years ago. RAINN has also found that the chat system appeals to people who have been through particularly violent trauma or experienced a type of assault or abuse with a higher stigma, such as incest—40 percent discuss an attack that was perpetrated by a family member. (The RAINN chats that I have had reflect these findings as well.)

The interface of the chat system is stripped of “branding” and looks ambiguous, so it can be used in public spaces like school libraries, home computers, and mobile devices on a bus without screaming “crisis hotline.” RAINN does not ask for any personally identifiable information or track IP addresses. It records no transcripts of the session and all data are encrypted. There is nothing that could be subject to subpoena. From a volunteer’s perspective, all I see is that “anonymous” is typing.

According to Marsh, and in my own experience, most visitors don’t come with quick questions. They want to discuss layers of complex issues and the online chats are generally longer than the phone chats. “I was raped when I was 15. I was very young and scared, and worried that no one would believe me,” said Toby Wagner Klein, a member of RAINN’s Speakers Bureau who agreed to talk with me about her experience with the online hotline. “The idea of taking up a phone and speaking to a complete stranger about things I wasn’t even entirely sure of myself seemed daunting. The online chat helped me express what I wasn’t able to vocalize with my therapist or family and friends. I probably would not have gone to RAINN if it did not have an online chat.”

In addition to appealing to a younger demographic, online hotlines also enable conversations that can’t be overheard, which is critical when immediate safety is at risk. Brian Pinero is the Chief Programs Officer at the National Domestic Violence Hotline, which launched an online chat service called The Hotline in 2013. The Hotline now sees 1,000 to 1,500 chats a month, half of which come from mobile devices. Pinero said the ability to communicate silently is key, since visitors often cannot discuss sexual coercion and assault on the phone when their husband or kids are in the house, or in public.

“It is hard to have a discussion about how your husband makes you have sex in ways you don’t want to,” he said. “On chat, people reveal way more than they do on the phone, and that is a huge opportunity for us to start exploring topics surrounding assault and coercion without making the visitor feel completely vulnerable.”

Conversely, the greater anonymity of the chat system makes it more difficult to gather information that can help provide the best support. Volunteers have far fewer contextual clues about the visitor’s gender, age, or current state of mind, and you cannot make assumptions. With so little personal and contextual information, saying the “right” thing or recommending relevant resources can be a challenge. You have to focus completely on and respond to what the visitor has felt comfortable sharing.

“Our entire approach was phone-based and we had to change our advocacy style, because in chats you don’t have the ability to hear environmental things,” Pinero said. “On the phone, I can hear if children are crying. With chats, you need to follow up, clarify you understand what is going on, and check in. You can't hear the inflection in someone’s voice that this is a difficult moment. Conveying empathy is much more difficult.”

Chat-based conversations require more time to build trust and rapport. While it might seem that online chats would be more “scalable” than phone hotlines, this is not the case, at least not yet. Longer sessions demand more volunteers, and volunteers take a long time to find and train. A shortage of volunteers means longer wait times. On RAINN, peak wait times can be up to an hour, and I’ve had sessions where 10 people are in the waiting room at a time. It’s sad, but demand significantly outstrips supply.

The National Suicide Prevention Lifeline just made its chat service available 24/7 in January across a network of 28 (out of 165) centers, but the wait times are still significantly longer than on the phone. As a result of limited capacity, John Draper, the project director, said that the chat remains a secondary service. However, he hopes to continue expanding it into a robust and fully-integrated option.

“You can’t schedule a crisis, and our goal is to open as many doors and windows as possible to get people help in the moment when they are in crisis,” he said. “97 percent of calls to the phone hotline are answered within 90 seconds, while only about half of chats can be responded to at all. But we do know from early data that an overwhelming majority of people who access the service feel better after the chat. Typically, they are feeling less sad and more hopeful.”

"Our goal is to open as many doors and windows as possible to get people help in the moment when they are in crisis."

Draper said that the Lifeline Crisis Chat service is overwhelmingly visited by young women. The phone hotline is around a 50-50 split between the genders, whereas 78 to 80 percent of the chat visitors are women, and 70 percent are women under 25. Draper said this is not just an American phenomenon, and that similar international services have found the same.

Like the National Suicide Prevention Lifeline, RAINN and the National Domestic Violence Hotline also aspire to scale up their chat services and acknowledge that they are the way of the future. However, scaling up requires funding, and funding requires evidence.

In May 2013, the Department of Justice’s Office for Victims of Crime published a report titled “Vision 21: Transforming Victim Services” that represented the “first comprehensive assessment of the victim assistance field in nearly 15 years.” This initiative received $12.5 million in the congressional Consolidated Appropriations Act, 2014, to address the recommendations in the report by providing grants to organizations that are working to address gaps in capacity and infrastructure, including making victim services more accessible through technology. While any funding amount helps—RAINN’s Spanish language online hotline was made possible through a Vision 21 grant—$12.5 million is a drop in the bucket.

“The funding infrastructure to support chat hotlines is just not there yet,” Draper said. “We’d like to expand, but we can only stick our toes in because we don’t have the funding to jump all the way in. Once we have scientifically-based data that says, ‘X number of people want chats, this is how effective they are, and this is how much they cost,’ then we will see crisis chats become increasingly ubiquitous, but it could take 15 to 20 years.”

That’s a long time, especially when you consider that hotlines can dramatically expand the reach of crisis organizations, not just in terms of numbers, but also in terms of the populations they reach and when.

“When you look at short and long term effects of sexual violence—whether substance abuse, depression, self harm, unhealthy relationships, or intimacy problems—the fact is that we are getting to people earlier with chats,” Marsh said. “There are public-health ramifications to getting people plugged into support systems earlier, by allowing them to avoid or lessen long term effects. This is really powerful. I think it is one of the greatest things about the online service.”

Victim services organizations aren’t the only ones faced with the need to update their infrastructure, and with the challenges inherent in doing so. Just 5 percent of the 6,500 emergency dispatch centers across the U.S. accept 911 text messages, but last year, the FCC voted to require all cell service providers to universally support 911 texts by the year’s end, including those from third-party messaging apps. Progress, albeit slow progress, is being made. In the meantime, it seems the best way to get immediate help remains to call. Otherwise, there may be a wait.
Source: https://www.theatlantic.com/health/archive/2015/07/online-crisis-hotlines-chat-prevention/398312/

This text line is helping teens talk about mental health without saying a word

"He won't stop raping me. He told me not to tell anyone."

In August 2011, teen-focused social change organization DoSomething.org received this startling text message. It wasn't rare for the nonprofit to receive replies unrelated to the social causes it highlighted through its mobile platform — teens often looked to talk about issues such as bullying, questioning sexuality and substance abuse. But this text's raw honesty was particularly jarring.

After one of DoSomething's digital engagement managers hesitated to answer, another message came through from the same number about an hour later: "R U there?"

The manager then texted back, asking the texter who was assaulting her. She responded the following day: "It's my dad."

It's been almost five years since that text, and former DoSomething.org CEO Nancy Lublin still hasn't heard from the girl, though she's tried several times to contact her. But the message created a sense of urgency in Lublin, calling her to act.

"We realized with that message that it was time to create counseling based around texting," Lublin said. "So we built it."

That text was the catalyst for Crisis Text Line, a mental health-based text messaging support line geared toward teens in the U.S., founded in August 2013. Over the past three years, users of the text line have exchanged nearly 7.5 million text messages with volunteer Crisis Text Line counselors.

Now independent from DoSomething (though Lublin calls the two organizations the "best of friends") the line has started a mental health movement based around a medium of communication teens can get comfortable with — text.

"We get a lot of people in the heat of the moment, when they are about to get really angry, or they're about to have a panic attack, or they're about to have a bulimic episode," Lublin says.

A Crisis Text Line counselor's goal is to move a texter from that "hot moment" to a "cool moment." And every day the stakes are high. Lublin says the line performs an estimated eight "live rescues" per day, in which counselors call EMTs or police to intervene in a potentially life-threatening situation, such as suicide ideation.

It's these intimate conversations and demanding moments that make for a different type of volunteering experience for counselors.

"This is not like painting the side of a school. This is contact with another person who is in pain," Lublin says.

When a texter messages Crisis Text Line, they're greeted with a simple prompt from an automated algorithmic system: "We're here for you. Tell me more about what's going on..."

"We want to try to get the texter to tell us what's happening so the algorithm can read the severity," Lublin says. "If a texter says something like, 'I want to die' or 'I want to kill myself,' we make them No. 1 in the queue."

The algorithm makes the line operate like a hospital: The most critical patients are seen first by a crisis counselor. Crisis Text Line volunteers "text" via an encrypted, secure site on their personal computers — so secure, in fact, that counselors don't even see the mobile numbers of those they're helping.

And there are even more intensive privacy measures in place for texters concerned about their anonymity.

"Anyone can be scrubbed from our system just by texting in the word 'loofah' — and then we scrub you," Lublin says. She admits "loofah" can be a difficult words for teens to spell correctly, so variations — like "lufah" — work, too.

But "loofah"-ing yourself is more of a technicality than a necessity when using Crisis Text Line. Even with phone numbers saved in the depths of the Crisis Text Line system, there's no other identifying information connected to those numbers or made available to counselors.

“This is not like painting the side of a school. This is contact with another person who is in pain.”

“We have a special relationship with all the major mobile carriers, where you aren't charged a fee, we aren't charged a fee and it doesn't even show up on your bill," Lublin said. "It's like you never even texted us."

Lublin says texting is the perfect medium for anonymity, despite popular opinion that tech can never afford true privacy. The main reason? It's a way of communication that doesn't require speech. You can confess your deepest secrets while sitting in a room full of people — and they'd have no clue.

"We tend to get a lot of texts every day around lunchtime," Lublin says. "People are sitting in a cafeteria or a Starbucks and you think they are texting their mom. But they are actually texting us."

The history of on-demand crisis counseling is tied to the evolution of tech. First, it was solely telephone-based hotlines, through which those in crisis could call in for help. With the popularization of instant messaging, mental health organizations started adding chat features to their websites with live support.

The next logical step for a connected generation of teens is text. Nearly 75% of U.S. teens own or have access to a smartphone, with only 12% of 13- to 17-year-old teens reporting they don't have access to a phone of any type. Of those teens who are connected, about 90% text.

Finally decided to check out @CrisisTextLine , it's honestly very helpful and the counselors are amazing.

Even with Crisis Text Line's success by capitalizing on texting, Lublin says older models aren't losing their staying power.

"I don't think [hotlines or instant messaging support] are ever going away — and they shouldn't," she says. "When it's possible to do crisis intervention by Tupac hologram or crisis intervention by Oculus Rift, it should all be made available. People are very divergent in their needs, and there should be a plethora of options to get help."

But, for Lublin, there's something special about texting. It's familiar, she says — people know they have limited space and already expect a delay in response.

"People are sitting in a cafeteria or a Starbucks and you think they are texting their mom. But they are actually texting us."

"What's really great about this is that, unlike phones, we don’t get the word 'um,'" she says. "We don't get repetition. We don't get hyperventilating or crying. There are no interruptions. It's incredibly effective for counseling because what we do get is facts."

And those facts help to create a "juicy corpus," Lublin adds. Anonymous data collected through text conversations is available to the public through a sister effort called Crisis Trends, which tracks mental health trends that help inform the public, policy leaders and the nonprofit itself.

"We use the data in two ways: to make us faster and more accurate, and to, hopefully, make the country better," Lublin says.

Because of this data, Crisis Text Line knows that text counseling appeals to teens and young adults. About 65% of Crisis Text Line texters mention "school" as their location. While that’s not entirely surprising, an unexpected 35% of texters are estimated to be older than the line's target teen audience. In fact, 10% of Crisis Text Line texters are middle-aged men.

"That's really exciting, because [middle-aged men] are most at risk for depression and suicide,” Lublin says. "But they are least likely to seek out help."

Although mental health is the main focus, Lublin hesitates to make it the sole aspect of Crisis Text Line's story. First and foremost, she says, Crisis Text Line is about innovation — with data and startup roots taking center stage.

"We think of ourselves as a tech startup first and a mental health organization second," she says. "When it comes to volunteers, we love people who think of themselves as tech innovators first and volunteers second."

Right now, the line has 1,500 volunteer counselors across the country. Crisis counselors complete 35 hours of intensive mental health training — created and facilitated by Crisis Text Line trainers — including online modules, quizzes and role plays. Lublin says about 39% of those who apply to be a counselor are accepted and complete the training.

"If you're introverted, this is a really great way to volunteer," she says. "This doesn't require your voice. You can do it at home in your jammies. And you're going to save lives."

Allen Wang, a 19-year-old counselor who just completed his sophomore year at Iowa State University, has been a volunteer with Crisis Text Line since August 2015. As a student, Wang isn't pursuing mental health as a career path. His studies, to Lublin's point, are more tech-based — aerospace engineering and economics.

"That's how I know I'm doing this because it matters to me, not because I want to push forward a career or whatever," Wang tells Mashable.

Not only is Wang a counselor, but he also knows what it's like to be on the other end of the conversation. His first interaction with Crisis Text Line was when he was in crisis himself. In May 2015, he was fighting through a period of depression; after finding Crisis Text Line's number on Reddit, he decided to reach out.

"There was this girl I was really into, but it wasn’t going to happen," he says. "I was feeling really bummed out after a really hard semester. It was just me sharing what was going on. It felt good to be able to do that."

“If you're introverted, this is a really great way to volunteer ... And you're going to save lives.”

Now as a counselor, Wang has about five or six conversations with texters in crisis per every four-hour shift, each one lasting about 45 minutes to an hour. Most days, he's talking to texters who are being bullied or having difficulty with self-image. But, once in a while, he does talk to an actively suicidal texter.

Out of 160 conversations in his time with Crisis Text Line, he estimates three or four have ended in police involvement due to suicidal ideation.

A few months ago, Wang was connected to a girl who was actively cutting herself while texting the line. She told Wang she didn’t want any help. What she wanted, she said, was to die.

Wang told his supervisor, who ended up contacting the police. Using the signal from her cellphone, the authorities were able to pinpoint her location.

"When they got there, she texted me back saying, 'What the...?!'" Wang says, trailing off. "She cursed me out, asking why the police were there, and just shot me texts of quite a few obscenities."

He sighs heavily, his voice quiet. "I knew we did the right thing, but that one really sticks with me," he says.

The emotional weight of being a counselor is one of the biggest obstacles of the job. Burnout from high stress and pressure is something Wang has struggled with, along with the obligation to stop communicating with a person in crisis after a single, intense conversation.

"In some cases, you are the only person they have ever told these things to. It was really hard when I first started to just walk away from that."

"You heard from the very depths of these individuals," he says. "Their deepest, darkest secrets — hopes, dreams, fears, terrible things that have happened to them. In some cases, you are the only person they have ever told these things to. It was really hard when I first started to just walk away from that — to just let go and move on.”

But being a crisis counselor has given him a "crash course in letting go." If he couldn’t, he says, it would be too much of a burden.

"It's a really good skill to have in life — to just move on from something,” he says.

Lublin, however, can’t move on from the text that started it all.

The girl who texted DoSomething about her sexually abusive father is still on Lublin’s mind — and she has been for five years.

Lublin talks about her a lot — in speeches, interviews, daily life — hoping that even if she never speaks directly to her, the girl will find out what her bravery and honesty helped to create.

"I want her to know that her courage inspired this whole thing. Thanks to her, we are saving a lot of other people," Lublin says.

"She started all of this."

To learn more about Crisis Text Line or to apply to be a crisis counselor, visit here.

If you want to talk to someone or are experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255. For international resources, this list is a good place to start.
Source: mashable.com/2016/05/28/crisis-text-line/#02u3QOLFHEqQ

This text-message hotline can predict your risk of depression or stress

When counselors are helping someone in the midst of an emotional crisis, they must not only know how to talk — they also must be willing to text.

Crisis Text Line, a non-profit text-message–based counseling service, operates a hotline for people who find it safer or easier to text about their problems than make a phone call or send an instant message. Over 1,500 volunteers are on hand 24/7 to lend support about problems including bullying, isolation, suicidal thoughts, bereavement, self-harm, or even just stress.

But in addition to providing a new outlet for those who prefer to communicate by text, the service is gathering a wellspring of anonymized data.

"We look for patterns in historical conversations that end up being higher risk for self harm and suicide attempts," Liz Eddy, a Crisis Text Line spokesperson, tells Tech Insider. "By grounding in historical data, we can predict the risk of new texters coming in."crisis-text-line-sms

According to Fortune, the organization is using machine learning to prioritize higher-risk individuals for quicker and more effective responses. But Crisis Text Line is also wielding the data it gathers in other ways — the company has published a page of trends that tells the public which hours or days people are more likely to be affected by certain issues, as well as which US states are most affected by specific crises or psychological states.

According to the data, residents of Alaska reach out to the Text Line for LGBTQ issues more than those in other states, and Maine is one of the most stressed out states. Physical abuse is most commonly reported in North Dakota and Wyoming, while depression is more prevalent in texters from Kentucky and West Virginia.

The research comes at an especially critical time. According to studies from the National Center for Health Statistics, US suicide rates have surged to a 30-year high. The study noted a rise in suicide rates for all demographics except black men over the age of 75. Alarmingly, the suicide rate among 10- to 14-year-old girls has tripled since 1999.

Crisis Text Line's goal to use data in order to tackle these challenges made headlines in 2014, and the attention brought a wave of investment. Shripriya Mahesh, a partner at the philanthropic investment firm Omidyar Network (which was started by eBay founder Pierre Omidyar), says the firm has given the service two grants. Last week, Crisis Text Line received $23.8 million in grants from a squadron of Silicon Valley investors, including Melinda Gates, Steve Ballmer of Microsoft fame, and many more. This round brings its total up to $35 million in funding.

Mahesh says the Line has been raising money the same way a startup does, and this current wave of grants can be thought of as a "Series B" — a secondary funding round in which investors are confident the company is going in the right direction.

"[Crisis Text Line] not only does good but it's really efficiently and is conscious of how effective they are," she said.

To further that effectiveness, Crisis Text Line is partnering with other services to move beyond text messages. The company now provides counseling to users of Kik, Facebook Messenger, and After School, a safe discussion space for students. And Liz Eddy says company is still expanding.

"We're working with social media apps, search engines, messaging apps and other tech companies to help them provide support and resources to their users who are in crisis," Eddy says.

She declined to name any specific apps the service plans to partner with going forward, but it wouldn't be a stretch to imagine contacting the Crisis Text Line through Twitter, WhatsApp or Gmail in the near future.
Source: www.businessinsider.com/crisis-text-line-is-gathering-data-about-depression-stress-2023-6

Tech’s Biggest Names Are Giving Millions to Crisis Text Line

Crisis Text Line, a nonprofit that offers free, 24/7 text-message counseling for people in need, is getting millions from some of tech’s most recognizable names.

On stage at the WIRED Business Conference in New York, founder and CEO Nancy Lublin said the company raised nearly $24 million. LinkedIn founder Reid Hoffman led the funding, with additional participation from tech philanthropists Melinda Gates and Pierre Omidyar, as well as former Microsoft CEO Steve Ballmer. Altogether Crisis Text Line has raised $35 million.

Of course, these “investors” aren’t looking for an exit in the conventional sense. (“There is no equity; no possibility of a liquidity moment,” Lublin said.) But the venture-style approach makes sense in the context of the Crisis Text Line’s startup sensibility.

“We have the bones and minds of a tech startup,” Lublin said. “We solve problems with products.”

Eighty percent of Crisis Text Line’s texters are under 25, Lublin said. For people that age, messaging likely feels much more natural than making a phone call to a crisis hotline. Crisis Text Line also makes use of algorithms and machine learning to prioritize the most urgent queries—for instance, if someone texts that they’re considering suicide.

Since launching in August 2013, Crisis Text Line has processed nearly 19 million messages. Right now more than 1,500 volunteer crisis counselors man the lines for Crisis Text Line; over the next couple of years, it’s seeking to expand to more than 4,000. It’s also in the process of moving beyond texting alone as it integrates with popular messaging apps like Facebook Messenger and Kik, as well as Facebook itself via its Safety Check Point feature, Lublin said today.
Source: www.wired.com/2016/06/techs-biggest-names-giving-millions-crisis-text-line/

Crisis Help Lines Have Been Inundated Following The Election

If you need help, it’s out there.

Some crisis intervention resources saw an uptick in users following the election.

Many people felt a deep need to reach out for mental health help following Tuesday night’s election results.

Crisis Text Line, a mental health service that allows people to chat with a counselor via messaging, experienced twice the average volume in the last 24 hours, according to the organization.

In an analysis of the messages Crisis Text Line received, data researchers at the organization found the words “election” and “scared” were the top two phrases being mentioned by texters. The most common association with the word “scared” in texts was the phrase “LGBTQ.”

The National Suicide Prevention Lifeline, a 24-hour hotline for people who are at risk for self harm, also saw a rise following the results. The number of calls between the hours of 1 a.m. and 2 a.m. Eastern Time increased by 140 percent, according to John Draper, the project director for the Lifeline.

While we may not know if this particular election that caused psychological distress (it’s possible call volumes increase after any election), it’s also no secret that this divisive and negative race has taken a toll on citizens’ mental health. A survey conducted by the American Psychological Association last month found that the majority of Americans felt significant stress over the election.

“Election stress becomes exacerbated by arguments, stories, images and video on social media that can heighten concern and frustration, particularly with thousands of comments that can range from factual to hostile or even inflammatory,” Lynn Bufka, APA’s associate executive director for practice research and policy, said in a statement following the survey.

That, according to Draper, is what the Lifeline saw firsthand. While the calls into the hotline peaked in the few hours following the results, the stress started to take hold long before. The Lifeline saw a 30 percent rise in calls starting this pas Monday, the day before the election, compared with their average Monday traffic.

“We know during times of great change and uncertainty there are fears, anxieties and, for some, even a large sense of loss,” Draper said. “That’s why the Lifeline is there.”

Exercising self-care can work

The Crisis Text Line analysis found that 88 percent of people who used the service felt connecting with the counselors was useful, which was an increase from their normal rate. Bottom line: These resources do help.

Immediately, it’s important to exercise self care during contentious periods where your mental well-being may be threatened. Experts stress that finding techniques that work for you is crucial.

“Think of three things that make you feel strong: A person, an activity and an online resource,” Nancy Lublin, chief executive officer and founder of Crisis Text Line told HuffPost. “Prioritize these things.”

And, most importantly, both Lublin and Draper hope anyone struggling with a mental health issue ? no matter if it’s election-related or not ? knows that they’re not alone in their experience. Below are a few other ways you can take care of your mental health following the election:

Spend time with loved ones.

There’s power in human connection and social support. Research shows hanging out with close friends can beat stress.

Keep up a routine.

”Going about your day can help during difficult times,” Draper said. That may include going to work, heading to the gym or even just making your weekly grocery store trip. “It’s nice to do things that are familiar because it reminds yourself that you’re not out of control,” he stressed.

Write down your emotions.

Put pen to paper to sort out what’s going on with your psychological wellness. Then it might be worth chucking it: Studies have found that writing down negative feelings and physically throwing them away can help clear your mind.

Allow yourself to feel sad...

We experience a spectrum of emotions, including negative ones. “Once you fully accept that you are affected by this loss then you can begin to move forward and eventually heal,” grief therapist Claire Bidwell Smith wrote in HuffPost.

...but seek help if it becomes overwhelming.

There’s nothing wrong with talking to someone. Reach out to crisis hotlines or a mental health professional if your sadness ? for any reason ? is interfering with your every day life.

If you’re in crisis, you can text HELLO to 741741 for free, 24-hour support from the Crisis Text Line.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources
Source: www.huffingtonpost.com/entry/crisis-help-lines-election_us_582344fde4b0d9ce6fc03fef

Pride in Mental Health: An Interview With The Trevor Project And Crisis Text Line

The experts I spoke to all fight tirelessly to connect people to the safe, loving, and supportive relationships they need and deserve.

This week I had the privilege of speaking with experts, activists, and advocates about the various mental health needs we have in the LGBTQ communities, at an event hosted by Crisis Text Line. We all agreed that a supportive and continuous, therapeutic relationship is key, for everyone really. But for those of us who face constant discrimination it can be a matter of life and death. The trouble is that psychotherapy is stigmatized; not enough clinicians are competent, curious, or empathetic enough to make a connection with LGBTQ clients; and too many people simply can’t afford therapy, or their insurance won’t cover it (if they even have insurance). The experts I spoke to all fight tirelessly against these obstacles, in order to connect people to the safe, loving, and supportive relationships they need and deserve.

For this segment of my Pride in Mental Health Series, I talk with David Bond, Vice President of Programs at The Trevor Project, (the leading national organization providing crisis intervention and suicide prevention services to LGBTQ+ youth), and Shoko Morikawa, Crisis Counselor Supervisor at Crisis Text Line (which provides 24/7 text support to those in crisis, text 741741 for free).

What are the mental health needs of the LGBTQ people who contact your crisis counselors?

David Bond: This is a huge huge question. They are so wide and varied. On one spectrum, we need to stop pretending that sexual minorities and gender minorities are the same population. We come together for advocacy and support and allyship of each other, but for research purposes and intervention purposes those things are really distinct because the stressors are very, very different, and the trauma can be very, very different. So, education and advocacy are immensely important [in identifying the specific mental health needs of the people who contact The Trevor Lifeline, Trevor Chat, or Trevor Text]. If you look at the National Institute for Mental Health, and all the funding they provide for research, less than one half of 1 percent of all NIH funding goes to LGBT issues and 80 percent of that goes to HIV/ AIDS, there’s a tiny sliver of funding that goes toward research of any LGBT healthcare issue whatsoever, and almost none of that goes to minors. So there’s this population of people who are completely not understood. Closeted youth never get studied because...no closeted youth is going to sign up for a research study, since they’d need to have parental consent. So we need to have a better understanding of the funding sources and avenues to research these communities to really understand their resiliency, what they’re going through, and how to intervene in the most effective kinds of ways.

Shoko Morikawa: I know that at Crisis Text Line, roughly half of the people who text in [44 percent] are LGBTQ+. It’s great that we can reach that many people from those communities. They mostly talk about family, depression, suicide. Compared to people who text in who do not identify as LGBTQ+, they are more likely to talk about bullying, [4.7 times the rate of CTL’s general population], school [4.3 times the rate], and emotional abuse [3.6 times the rate]. Those who identify this way also tend to be a lot younger, under the age of 25. And the majority of these texters tend to talk about issues that are more generally about bullying, or family rejection, and less about being LGBT or Q, directly. They don’t tend to text about issues like coming out or gender identity. [It’s more to do with not fitting in and/or being abused, emotionally and/or physically, at home and/or at school]

In addition to the crisis counseling your organizations provide for those who text and call into your hotlines, what types of long term services do you connect them to?

Shoko Morikawa: We’re a short term service: conversations will last about an hour. Which is generally enough time for our trained crisis counselors to listen and validate whatever that person texting in is going through. And then helping them calm down, identifying their strengths, and helping them brainstorm next steps, and more ways to cope with what’s going on. Our goal is to bring them from a “hot moment” to a “cool calm” [i.e., use techniques in empathetic listening to build rapport and trust, and explore the texter’s issues and goal, so that they can collaboratively problem-solve to develop a plan to stay safe.]

Since we are a national organization, we don’t always have specific referrals [for therapists and other mental health professionals] though we are growing those lists, state by state. But we do refer people to organizations like The Trevor Project, The Trans Lifeline, GLSEN.

David Bond: Crisis services are meant to be episodic. Even if someone calls six times, they’re not necessarily seen as our client at the organization. It’s framed as, that person had six episodes of a moment of care. Although we will follow people over time. But what’s complicated for many people is to identify where those local resources are, depending on where they are in the country, they may have to travel two states away to find an LGBT center. So we do work very hard to try to find mental health resources, and if we can’t identify them, we work with people especially young people to think about all the people in their lives and who is the most supportive, who cares about them the most. Really try and help them to realize that there might be alternative ways of thinking about the people who are in their life. Because some of them may be much more supportive than you would assume.

David, you brought up a crucial point earlier, which is that a great deal of LGBT youth are not out. So how do we prepare teachers, guidance counselors, parents, and other adults, to at least provide a safe environment for those who are closeted and too afraid to seek help?

David Bond: The Trevor Project has these resource posters that are meant for classrooms and healthcare organizations, as part of the crisis intervention and peer support resources that we provide for free. There’s this little tiny rainbow sliver that goes through the middle of it. And I say to educators all the time,”If you have something like this in your classroom, it sends a tacit communication to the person in your classroom who might be struggling, that you might be a safe person to have a conversation with about all these things.” I used to tell, teasingly would tell other mental health practitioners, “In your office you need a great big book that says ‘LGBT’ on it, or ‘Gay’ or ‘Trans.’ And you don’t even have to read the book. You just need to have it on the shelf, so that a client could come in and see your office might be a safe place to talk about it.” Because doing a safety assessment of, I mean doing a coming out safety assessment is incredibly important. You hear these messages all the time that, “Everyone just needs to come out.” But the truth is if you’ve done a strong safety assessment, then it’s not necessarily a protective factor at all.

The youth who reach out to the Trevor Project, only about 50 percent are out to at least one parent. But 90 percent of them are out online. So it’s also important to create safe online spaces that are non-sexualized, that provide opportunity for young people to meet each other and build systems of support. If you think about that Trans girl of color in rural Arkansas, who doesn’t feel that there’s any one around her who understands. And she needs to find an online space, for example, that will give her access to other people like her so she doesn’t feel so isolated.

How do you get the word out about your service?

Shoko Morikawa: We use a lot of press at the schools all across the nation. With high schools, grade schools, and colleges as well. We also have partnerships with various city-based organizations, such as The Golden Gate Bridge and the CalTrain System in San Francisco. They help us get the word out by having billboards, especially at places like train stations, where we know that suicide attempts take place.

At the schools we have our Crisis Text Line posters, or our cards with our number on it, that school counselors can hand out to kids. We also have a lot of social media and national press coverage.

What would help to make mental health services more available, accessible, and appealing for people in need?

Shoko Morikawa: More discussions about mental health for sure. With our text line we have exchange 40 million messages the past 3 ½ years. So we’re also reaching a lot of people. And

the great thing about being a texting service is that it’s private and for that reason it is a great way to increase conversations about mental health awareness. We always “fight” [for the texter] during lunch times, because many young people who may seem to their peers like they’re texting their friends or something like that at the lunch table, are actually texting about an eating disorder, or about a family conflict. And especially for LGBTQ+ texters, it’s a great way for them to get help if they’re not out. They don’t want to be overheard. And by text it’s safe, silent, private, and accessible. And we’re 24/7 so you can text during your lunch break. When you get up in the morning. At 2am when you get up and go back to sleep. We’re always there. I think we’re making steps toward having those conversations more and having [mental health] become more accessible.

David Bond: Suicide is the second leading cause of death for all young people, between the ages of 10 and 24. And I always get the question, “What’s number 1?” It’s motor vehicle accidents. So since the year 2000, we’ve been able to decrease motor vehicle fatalities in this country between 35- 40 percent. And that’s because of policy change. We have bicycle helmet laws and seat belt laws and zero tolerance for drinking and driving, and texting and driving and we have enhanced crosswalks, and we have car seat laws for infants. Fatalities have been reduced by 35-40 percent, in just 17 years. Yet we’re not engaging in massive large scale public education about suicide prevention. Even though it’s number 2. And the big problem around this is the stigma. Because if someone has an accident or if someone has a physical health disease, people can blame the disease. But when people have mental health struggles. Or people are struggling with depression or thoughts of suicide, it’s not a disease model of blame. People are blaming the people who are feeling that way, who are suffering, saying, “Why don’t you snap out of it?” And, we need to have a real shift in the public health conversation in this country about mental health issues so you respect them in the same way that health care issues are respected.

You also have to identify the problem. So the other major problem that the LGBT community is suffering from is that we’re not being counted. So there’s a national violent death recording system that records all violent death in most states throughout the country. So they’ll know how somebody died. If they don’t collect the information about sexual orientation or gender identity, death investigators. Death certificates don’t say...they will say veteran status. So we know how veterans die. They’ll say male or female. So we get, “Well men die from some of these things, women die from some of these things.” But the whole country has absolutely no concept of how LGBT people die. So when we talk about research that we need to protect ourselves, to protect the community from death by suicide and mental health issues, we have to be counted. So it’s census. It’s death investigators. It’s a number of other ways.

At Trevor we do quite a bit of advocacy around this. We work on trying to change that scenario for the science. We work on bans for conversion therapy on a state by state basis. Successful in five states that ban conversion therapy for minors, as well as other municipalities. We also work on having states implement legislation that requires all of their schools to have suicide prevention policies. And those are LGBT inclusive, as well as other vulnerable populations. So we need policy interaction, but we also need more research. I mentioned earlier the NIH funding? Leukemia 30 years ago had a 90 percent mortality rate. It now has a 90 percent survival rate. The change was every leukemia patient participated in research and their doctors submitted it. Research led to treatment which led to cures, which created a huge shift in life. Because of research and advocacy.
Source: www.crisistextline.org/who-we-are/

The Trevor Project www.thetrevorproject.org/

Psychology Today Therapist Finder https://therapists.psychologytoday.com/rms/?tr=Hdr_SubBrand Refine your search based on therapists’ experience with people who are LGBTQ+

For Teens in Crisis, the Next Text Could Be a Lifesaver

The message to the Crisis Text Line was answered by Aaron Amrich, a volunteer crisis counselor based in California. It was sent by a 19-year-old woman who wrote that she was feeling hopeless and beginning to give up on life. Amrich, a veteran who served in Afghanistan and Iraq, has himself suffered from post-traumatic stress disorder and depression. He understood the feeling.

Crisis Text Line counselors have already exchanged more than eight million messages (42 million as of July 8, 2017) with individuals in distress.

For the past year, he has been able to draw upon his experiences to assist this woman and others by volunteering with the Crisis Text Line — a free, confidential 24-hour service accessible via the number 741741. The text line currently has more than 600 volunteer counselors around the country. To date, Amrich has assisted more than 400 people. His text conversations indicate that he consistently helps them get through crisis moments. In the process, he has also helped himself. “It’s one of the best things that ever happened to me,” said Amrich. “It’s made me a lot happier than all the therapy I was doing with the Veterans Administration.”

To qualify as a counselor, Amrich had to undergo six weeks of training, pass tests, and commit to offer at least four hours of volunteer service per week for a year. As he had been instructed, Amrich “listened” openly and nonjudgmentally to the young woman. He didn’t offer advice; he didn’t try to help her solve her problems. Mostly, he said, his messages mirrored back what he heard from her, occasionally emphasizing a strength that he noticed — like the fact that she’d taken this step to help herself even in the midst of her depression.

“A lot of people have an overwhelming loneliness,” he told me. “They feel unworthy and they don’t talk to people they care about because they don’t want to be a burden. Sometimes it takes a stranger to say, ‘Hey, you’ve been through hell and I want to emphasize that you’ve done a lot. You’ve been helping yourself without any training. Good job. If you can do that on your own, you can do more.’ Many people reply: ‘I’ve never thought about it that way before.’”

The opportunity to share her feelings with an empathetic person appeared to help this woman. “She said she couldn’t remember the last time anyone had told her they believed in her,” he recalled. She ended the conversation the way people often do, by texting: ‘Thanks for listening,’ Amrich said. (The Crisis Text Line follows up after conversations with an automatic message asking texters if they feel better — a data point that is closely tracked.)

The Crisis Text Line has been in operation for two years. Although it has received little publicity, its counselors have already exchanged more than eight million messages with individuals in distress. The service is filling a critical need and is likely to grow considerably in the coming years. Across the country, there is widespread concern about the social, academic and economic pressures that young people are facing and the alarming prevalence of anxiety, loneliness and suicidal ideation among teenagers and young adults. (Note: Sept. 10 is World Suicide Prevention Day, an initiative of the International Association for Suicide Prevention.)

We may not be able to change the things that make teenagers depressed and anxious, but we can make it easier for them to get help.

While the environments that produce these pressures are tough to change in the short run, it’s possible to make it easier for young people to get help. When young people are in distress, the single most beneficial step they can take is to confide in and seek help from a trusted and capable adult. But only 15 percent of high school students who seriously consider suicide do so. Only about half speak with friends. And only 2 percent use telephone crisis hotlines.

That’s why researchers are excited about the Crisis Text Line. “Young people have been reluctant to use crisis services,” observes Anthony Pisani, a suicide prevention researcher at the University of Rochester. “The top two barriers are the sense of shame and self reliance. I think the Crisis Text Line has cracked the code on both of them. It offers a layer of protection from the shame of expressing your vulnerabilities. And it lowers the barrier of entry for the proud and self reliant because it’s so easy to experiment with a conversation.”

The Crisis Text Line emerged from the work of DoSomething.org, a youth social change organization with over four million registered members that uses text messaging to communicate with them.

Today, the Crisis Text Line’s counselors exchange 20,000 messages a day with people seeking help. Nancy Lublin, who spent 12 years as the chief executive of DoSomething.org and is now heading the Crisis Text Line, which she founded, hopes to have 2,000 counselors in place by the end of the year, more than tripling its current reach.

Everything hinges on the quality of counseling. The training program was designed by mental health experts. Only a quarter of applicants complete it. “We try to instill in trainees that when you start a conversation, all of your suppositions have to be put aside,” explains Kaley Leshem, who trains counselors. “It’s not about giving advice. You have to be completely nonjudgmental.” It’s essential to establish trust. One of the most effective messages is simply: ‘I’m hearing that you’re feeling X because of Y.’ It gives the texter the opportunity to correct you and to clarify,” Leshem says. “And by being very specific, it shows that you’re paying attention and that you care.”

If a young woman says that she is cutting herself, the counselor might ask: “How does it feel when you self-harm?” After rapport is established, she might follow up with: “It’s understandable that you would like to feel relief from the stress you’re under, but can we think of other ways to do that?”

The goal of a crisis line, explains Lublin, is narrow. It’s not therapy; it’s meant to bring people from “a moment of hot to a moment of cool,” so counselors can suggest ways the texter can move to a place of increased safety.

The counselors are scattered far and wide, but the conversations are monitored on a central platform by supervisors who are trained mental health professionals. Counselors can ask for assistance in real time. If a texter says that he or she is thinking about suicide, the conversation is prioritized and a supervisor is brought on to oversee it. Together, they will assess if the texter has a plan, the means, and a time frame — the key indicators of serious risk. If so, the supervisor will lead an active rescue, asking the user their location and contacting 911. In rare cases, when the texter does not provide an address, they work with mobile carriers to determine the location and send help through 911.

The millions of messages that the Crisis Text Line has amassed have become a treasure trove for researchers. “Beyond the C.D.C. and the N.I.H., it’s the largest database on real-time crisis in the country,” says Lublin.

For now, the data is primarily used to prioritize conversations and improve training for counselors. “When counselors express sympathy, as opposed to empathy, texters give lower ratings to the conversations,” says Bob Filbin, the service’s chief data scientist. “Counselors who focus on problem solving, as opposed to listening, also get lower ratings.” Research indicates that the optimum conversation contains 40 to 60 messages and lasts an average of 45 minutes. Lublin says that veterans, young gay women, and people who are deaf or hard of hearing, have proved to be excellent counselors.

Moving forward, the Crisis Text Line is making its anonymized data broadly available. Researchers and government agencies are interested in using it to better design and target prevention services. (See its Crisis Trends website.) The information can be mined to identify broad patterns. For instance, depression or suicide are currently mentioned in 35 percent of conversations, anxiety comes up in 16 percent, family issues in 14 percent, and self-harm in 9 percent.

Or it can be used for deeper explorations. Messages for eating disorders currently peak on Sunday night; for sexual abuse this summer they spiked between 6 a.m. and 9 a.m.; for substance abuse they peak at 5 a.m. “If you run an intake facility, knowing that is super important,” says Lublin.

“You can look at the data from so many angles,” she adds. “What happens on Christmas Day? What are the triggers for eating disorders? How many times do people mention social media as a source of depression or anxiety?”

John MacPhee, the executive director of the Jed Foundation, a leading organization working to promote emotional health and prevent suicide among college and university students, says: “Being a teenager and transitioning into adulthood can be a difficult period and it’s not unusual for a young person to find themselves feeling uncertain, concerned and in distress. Having a 24/7 service there for someone who is afraid to speak up to have an exchange on a safe, anonymous basis in a medium they’re comfortable with is a tremendous advance. Every older adult should give every younger adult that number and make sure it’s in their phones.”

The big problem adults have in trying to help young people is getting them to open up. “Many programs seek to make adults aware of signs that teenagers are in distress and increase their willingness to talk with youth,” said Anthony Pisani. “But research has shown that unless they have established trusted connections the youth aren’t going to talk with them. Kids worry that adults might overreact and not understand their challenges.”

Can we increase the willingness among youth to seek help from adults? Yes. The program Sources of Strength, for example, has demonstrated success in training peer leaders. Pisani hopes that the text line will also help with this challenge. “Kids who text to Crisis Text Line are likely to be those who don’t perceive themselves as having trusted adults in their own natural support system,” he says. “If a positive interaction with the text line can begin to shift their attitudes about the role that adults could play in providing guidance and support, we have the potential to strengthen a key protective factor against suicidal behavior.”

“If kids tell stories about successful experiences with adults who are capable and available, it could shape social norms,” he adds. “If that’s the case, they may be on to something even bigger than they know.” These are the kinds of stories that youth-oriented groups like To Write Love On Her Arms are well suited to share.

For Aaron Amrich, the stories he has heard have touched a deep chord. “Talking through problems with other people has given me an outside perspective on things I’ve been through but didn’t know how to process or deal with,” he said. “And working with the other crisis counselors has given me a sense of belonging that I haven’t had for a long time.”

“We’re all people, and people can help,” he added. “You don’t need to have a Ph.D. to help people feel that they can be pushing forward in their lives. I think that’s a beautiful thing.”

Join Fixes on Facebook and follow updates on twitter.com/nytimesfixes. To receive e-mail alerts for Fixes columns, sign up here.
Source: opinionator.blogs.nytimes.com/2015/09/04/for-teens-in-crisis-this-text-could-be-a-lifesaver/

Crisis Text Line: Saving Lives Through Data

Non-profits aren’t known for being particularly data-driven. Crisis Text Line, however, views itself as a tech company first, helping folks with mental health challenges; it just so happens to be a non-profit. It has now amassed the most comprehensive real-time mental health data set to date.[1]

Crisis Text Line is a non-profit organization that offers free support 24/7 via text message to people facing a crisis. Founded in 2013, the organization was birthed out of DoSomething.org, a text-based non-profit organization that connects teens with volunteer opportunities. The catalyst for the organization’s creation was that some teens were responding to calls for volunteers with messages crying out for help. In particular, a respondent asserted that she was being regularly raped by a family member and didn’t know what to do. DoSomething.org staff felt like they had to truly do something.

The victim could have called one of many crisis hotlines; however, there wasn’t a way to text one. Teens, in particular, significantly favor texting over calling as a means of communication and texting provides a different level of privacy than calling. Additionally, “people are more likely to disclose sensitive information via text message than in voice interviews.” [2] Accordingly, it was then obvious that there was a real opportunity to address mental health issues facing teens in a new fashion.

Since Crisis Text Line was established, over 34 million text messages have been exchanged, and it only took four months for the line to receive text messages from all 295 area codes in America.[3, 4] Consequently, the organization has amassed a huge amount of real-time, mid-crisis data – an unparalleled data set in the mental health field.[5] In contrast, other data are typically captured post-crisis, when memories can be biased or tarnished. The text based nature of the service is also advantageous as it allows for easy data capture (e.g. time, geography, language). The data is completely anonymized upon collection and counselors don’t have access to the texter’s contact information. Neither party is billed for the correspondence (as a result of an agreement with national cellphone carriers like Verizon and AT&T), and the conversation isn’t even noted on the texter’s phone bills.

Harnessing and analyzing the data has been a key focus for the organization from its inception: the second hire was a Chief Data Scientist.[6] Data helps to modify and optimize crisis-counseling practices and enables the organization to more efficiently and effectively help those in crisis. For instance, Crisis Text Line has found that first-person responses are more effective in helping people “cool down” from a “hot moment.”[7] Also, based on a text’s language, Crisis Text Line’s algorithm can help predict the crisis’ severity level and place that person in the number one slot in the queue, similar to how triage works in hospitals. Lastly, because there’s only one number to text (versus crisis-specific hotlines), people in crisis don’t have to overthink which number to text. The organization and algorithm also benefit by being able to centrally aggregate and, in turn leverage, a variety of data.

Crisis Trends is Crisis Text Line’s sister effort, which helps to educate the public about mental health trends. Researchers, who want to delve deeper into more granular data, can gain access to it by affiliating with a university or research organization and having proper IRB (Institutional Review Board) approval. There are three types of data available: conversation level, actor level, and message level.[8] The aim is that this data set will help the public and policy leaders better address mental health challenges and improve people’s lives. Learn More Here.

Although Crisis Text Line and Crisis Trends don’t capture value in a traditional manner (i.e. monetization), the data helps to drive the organization’s operational efforts. For instance, knowing that “depression peaks at 8 p.m., anxiety at 11 p.m., self-harm at 4 a.m., and substance abuse at 5 a.m.” can help the organization appropriately staff employees and volunteers, which in turns helps to streamline costs.[9] Since data can help control costs, the burden of fundraising is lessened. Lastly, value is captured via social impact (i.e. lives saved and bettered as a result of the service). Crisis Text Line serves hundreds of folks daily and, on average, has eight “live rescues” a day.[10] The service also is more accessible to the hearing impaired and deaf, relative to other crisis services available.

Future Opportunities

Looking to the future, the organization hopes to generate greater awareness, onboard more highly trained volunteers, and grow to international markets.

[1] https://blogs.microsoft.com/bayarea/2016/11/30/how-crisis-text-line-is-harnessing-data-to-improve-mental-health-support-in-the-bay-area

[2] http://www.newyorker.com/magazine/2015/02/09/r-u

[3] http://crisistrends.org

[4] http://www.newyorker.com/magazine/2015/02/09/r-u

[5] Ibid.

[6] Ibid.

[7] Ibid.

[8] http://www.mobihealthnews.com/content/crisis-text-line-opens-its-mental-health-texting-data-set-researchers

[9] http://www.newyorker.com/magazine/2015/02/09/r-u

[10] http://mashable.com/2016/05/28/crisis-text-line/#Bgua4OBg4Eq2

Crisis Text Line, Crisis Trends, DoSomethingorg, mental health, non-profit, policy, social impact 0
Source: digit.hbs.org/submission/crisis-text-line-saving-lives-through-data/


I. Ask Bob. 11/24/17

What were texters telling us this Thanksgiving?

Overall traffic was down. This is typical: we tend to see traffic rise leading up to a major holiday, then drop on the actual date.

Some trends from last year held: for the second year in a row, family was the #1 issue for Thanksgiving texters, and eating disorders were the issue that over-indexed the most - we had over twice the typical volume of ED conversations.

Other trends have changed year-over-year: bereavement/grief, a top issue on Thanksgiving 2016, was not significantly different from average yesterday. Sexual assault has been over-indexing for over a month as allegations against public figures continue to make news, and yesterday’s holiday was no different.

(And more generally on the theme of “thanks…”)

How do our texters “give thanks?”

62% of texters explicitly thank their Crisis Counselor in their conversations.

Of the those who don’t, about half go on to do so in the post-conversation survey, and even more rate the conversation positively in that survey.

Four themes stand out among these expressions of gratitude:

  • Listening: “Thank you for being there for me and listening.”
  • Validation: “You made me feel valuable and worthy.”
  • Hope: “You really made me feel hopeful for the first time in a few months.”
  • Authenticity: “Your words were so genuine and kind.”

So, what stands out in these conversations?

The Crisis Counselor responses are about 10% longer than average, at 110 characters. Texters value “meaty messages” that show we’re listening!

More strength IDs. These “thank you” convos have 2x the number of strength IDs (a technique by which the Crisis Counselor compared to other conversations.

I. Ask Bob - 6/30/17

In honor of Pride month, we took a look at LGBTQ+ texter trends. LGBTQ+ teens are two to three times more likely than other teens to attempt suicide.

More than half our texters do not identify as heterosexual.

They talk most about family, depression, and suicide…

Family = 39% of conversations (2.9X the rate of our general population)
Depression = 25% of conversations (1.4X the rate of our general population)
Suicide = 23% of conversations (1.5X the rate of our general population)… and over-index in discussion of bullying, school, and emotional abuse.

Bullying = 10% of conversations (4.7X the rate of our general population)
School = 12% of conversations (4.3X the rate of our general population)
Emotional Abuse = 4% of conversations (3.6X the rate of our general population)

Our LGBTQ texters skew young. 83% of our LGBTQ+ texters are under the age of 25 (compared with 78% of straight texters).

II. Org News

In the press.

We hosted our first LGBTQ Media Day on 6/19. It was like speed dating, but for journalists and experts to do mini interviews (10 minutes each). The goal? To get more media coverage on LGBTQ mental health during Pride as one step towards combating stigma. Check out the first of many articles to come out of the event in Psychology Today and Greatist.

Check out this release on our partnership with California Community Colleges.

Youtuber Jess Conte gives a sweet shout-out to Crisis Text Line in her video on bullying and high school advice 16:49(towards the end, at the 14:45 mark!)

Reid Hoffman’s podcast Master’s of Scale featuring our CEO, Nancy, on grit and building three epic orgs.


We are gearing up for the Shred Hate activation at the XGames in partnership with ESPN. Shred Hate hopes to help end bullying in schools while spreading a culture of kindness. Have a partnership idea? Email Liz: liz@crisistextline.org

Bob Filbin

I. Ask Bob - 4/21/17

Have a data question? Email our Chief Data Scientist: bob@crisistextline.org

Two weeks ago, Netflix launched a new show: 13 Reasons Why. It’s about the experience of a teenage girl who dies by suicide. And, it’s now Netflix biggest series ever. Yep. Wayyyyy bigger than Orange is the New Black and House of Cards...combined!

We are featured on 13RW’s website and cast members have been spreading the word about us as a resource. So, what’s been the impact 13 Reasons Why?


  • About 3.0% of our conversations have directly mentioned the show since the release on March 31st.
  • 67% of these texters are messaging into Crisis Text Line for the first time.

Bottomline: thanks to this show, we are helping a lot more new people.


65% of 13 Reasons Why texters shared something with us that they have never shared with anyone else..

The top three issues they mention are depression, suicidal ideation, and family/friend issues.

II. Org News

In the press.

We hosted our first LGBTQ Media Day on 6/19. It was like speed dating, but for journalists and experts to do mini interviews (10 minutes each). The goal? To get more media coverage on LGBTQ mental health during Pride as one step towards combating stigma. Check out the first of many articles to come out of the event in Psychology Today and Greatist.

Check out this release on our partnership with California Community Colleges.

Youtuber Jess Conte gives a sweet shout-out to Crisis Text Line in her video on bullying and high school advice 16:49 (towards the end, at the 14:45 mark!)

Reid Hoffman’s podcast Master’s of Scale featuring our CEO, Nancy, on grit and building three epic orgs.

C. Meet our team! Crisis Text Line staff is often out talking about data, tech and all things mental health.

4/22-23: Data Scientist, Nitya Kanuri, will be speaking at the Unite for Sight Global Health and Innovation conference in New Haven, CT.

4/27: CEO and Founder, Nancy Lublin, will be speaking at PitchLab in NYC. Tickets available here. Use our ticket promo code: "pitchlabfriends" for 20% off.

4/27-28: AAS 50th Annual Conference in Phoenix, AZ. Chief Data Scientist, Bob Filbin and Supervisor, Jen James, will be presenting

5/2-3: Data Scientist, Nitya Kanuri, is speaking at Health Data Exploration Project's Third Annual Health Data Exploration Network Meeting & Data Dive: Promoting Social Justice in the Use of Personal Health Data at UCSD.

5/6: Data Scientist, Nitya Kanuri, is speaking at Computing and Mental Health, Computer Human Interaction in Denver, CO.

D. Partnerships!

We’re psyched to be working with A Voice for the Innocent and Vans Warped Tour! Crisis Text Line will be featured at each show during the two month long summer tour. Think you might be a good potential partner? Email Liz: liz@crisistextline.org

Our partners, the San Francisco Giants, featured Crisis Text Line at their game vs. the San Diego Padres on Sunday, April 30! Check out the beautiful SF AT&T park and stop by the Community Clubhouse to learn more about Crisis Text Line. You can buy tickets here.

Bob Filbin

Chief Data Scientist

Random fact about me: Last weekend, I went to NH to see my family. My parents informed me that the hot topic of conversation with their neighbors was, when will the ice melt off the nearby lake? And thus, I had an opportunity to discuss predictive modeling with my family. (Since then, the results are in: we did predict correctly to the day.)

I. Ask Bob 2/24/17

Next week, our partners at NEDA are leading National Eating Disorders Awareness Week. Our data team took a look at some of the trends we see around eating disorders:

Texters who mention eating disorders also tend to talk about (in order of relevance):

  • Depression
  • Stress
  • Self-harm
  • Anxiety
  • Suicide

Nationally, talk about eating disorders peaks on Tuesdays and Sundays 8PM - 10PM

On a state level, texters in AR, NJ, and ME mention eating disorders at the highest rates

III. Org News

C. Some big partnerships! We’ve recently partnered with AFSP (American Foundation for Suicide Prevention). AFSP will be using Crisis Text Line as their preferred crisis text service, promoting it through both digital and on the ground events. Are you a part of a school system, city/state government or national organization? Are you a content creator or part of a media outlet? Partner with us! Email Liz: liz@crisistextline.org

1. Ask Bob - 3/27/17

Immigration. Has all the talk in the media and the political climate affected everyday Americans?

Talk of immigration has been slowly increasing over the past 12 months, taking a BIG jump around the election.

Over the last year, 1.2% of our conversations contained some mention of immigration; this number doubled to 2.2% of all conversations around the November election.

“Hurt,” “hate,” and “scared” are the top three emotions mentioned in these conversations.

Immigration related conversations contain a higher prevalence of family issues (12% higher than average), isolation (9% higher than average), anxiety (7% higher than average), and depression (7% higher than average).

II. Heroes

Rainy Roth has been a volunteer for over a year and just became a Level 5 Crisis Counselor--which means she’s handled over 1,000 conversations!

How did you learn about Crisis Text Line?

I first learned about Crisis Text Line from a Facebook post. I thought it would be an incredible volunteer activity I could do from my teeny, tiny town (population 943).

What is your favorite thing about being a Crisis Counselor?

My favorite thing about being a Crisis Counselor, oddly enough, are the active rescues. The moment the texter responds with, "they're here" is the time you realize that you helped someone get the help they need. It's not only about saving their life for me; it's about letting them know that people care.

What is the best thing you've learned as a Crisis Counselor?

I think the best thing I have learned from being a Crisis Counselor is to never make assumptions. Someone who starts the conversation with "my mom made me eat broccoli today" will usually start to open up and reply with, "oh, and I self harmed and I can't stop." It is usually those openings that lead to deeper conversations.

III. Org News

Facebook Messenger. Facebook users can now connect with a live, trained Crisis Counselor right through Facebook Messenger! Full announcement here. And, check out these awesome posts from Mark Zuckerberg and Sheryl Sandberg.

In the press.

Mashable wrote an article about how we used machine learning to predict high risk texters.

Libby Craig (our Bay Area Director) was included in a great CNN piece on depression in Silicon Valley.

D. Meet our team! Crisis Text Line staff is often out talking about data, tech and all things mental health.

3/31-4/8: (y)ourstory with the Francesca Harper Project at Harlem Stage. Coach Coe Bethea will be performing a piece inspired by Crisis Text Line.

4/20: Vanity Fair Founders Fair in NYC. Founder and CEO, Nancy Lublin, will join Jessi Hempel (Wired) and Caterina Fake (Founder, Flickr, Findery, and seed funder of Etsy) on a panel titled, “Re-Start Me Up: Confessions of Serial Entrepreneurs”.

4/27-28: AAS 50th Annual Conference in Phoenix, AZ. Chief Data Scientist, Bob Filbin and Supervisor, Jen James, will be presenting (and making an exciting announcement!)

III. How You Can Help

Perks. We love giving nice things to our volunteers! Gift certificates, samples, tickets, etc. Got leads? Email Elif@crisistextline.org

West Coast is the best coast. We need Crisis Counselors in those time zones (especially Hawaii and Alaska) to help with overnight texters. Got friends or family out there? Nudge them to apply to volunteer with us.

Spread the word. This video created by Dose and posted on Facebook is pretty terrific. Please share it widely.

I. Ask Bob 1/27/17

77% of our texters are under the age of 25. What do we know about them?


Gender. 76% of texters under 25 identify as female, 14% as male, and 10% as other. Texters over 25 are more likely to identify as male (18%) and less likely to identify as other (6%).

Sexual Orientation. Texters under 25 are less likely to identify as heterosexual (52% vs. 69%) and are more likely to identify as bisexual (24% vs. 16%) and pansexual (12% vs. 5%).

Race. Young texters are more likely to identify as being of Hispanic, Latino, or Spanish origin (16% vs. 11%) and less likely to identify as white (66% vs. 73%).


Severity. Nearly 25% of our conversations with young texters contain suicidal thoughts.

Sharing something for the first time. A whopping 67% of texters under 25 are more likely to share something with us that they’ve never told anyone else.

II. Org News

Follow us! We’re using six social media platforms for news, updates, and insights:

  • facebook.com/crisistextline
  • twitter.com/crisistextline
  • instagram.com/crisistextline
  • linkedin.com/company/crisistextline
  • Crisistextline.tumblr.com
  • open.spotify.com/user/crisistextline

C. Some big partnerships!

Keyword Partners. We’ve recently partnered with the Mayor's Office in Los Angeles, PennState University, and Lookout Mountain Community Services in Georgia.

Content Partners. We’ve launched content partnerships with The Mighty, Thrive Global, and SoulPancake, helping them to better support their communities.

Are you a part of a school system, city/state government or national organization? Are you a content creator or part of a media outlet? Partner with us! Email Liz: liz@crisistextline.org

D. Crisis Trends V2. Crisis Trends V2 is live! This version allows you to view (on your phone!) the location, day of week, time of day, accompanying issues, and words most associated with specific issues, by state. Whoa! Check it out at CrisisTrends.org


I. Ask Bob - 1/27/17

Have a data question? Email our Chief Data Scientist: bob@crisistextline.org

77% of our texters are under the age of 25. What do we know about them?


  • Gender. 76% of texters under 25 identify as female, 14% as male, and 10% as other. Texters over 25 are more likely to identify as male (18%) and less likely to identify as other (6%).
  • Sexual Orientation. Texters under 25 are less likely to identify as heterosexual (52% vs. 69%) and are more likely to identify as bisexual (24% vs. 16%) and pansexual (12% vs. 5%).
  • Race. Young texters are more likely to identify as being of Hispanic, Latino, or Spanish origin (16% vs. 11%) and less likely to identify as white (66% vs. 73%).


  • Severity. Nearly 25% of our conversations with young texters contain suicidal thoughts.
  • Sharing something for the first time. A whopping 67% of texters under 25 are more likely to share something with us that they’ve never told anyone else.

II. Heroes

Scott Wentworth is a Crisis Counselor and a Youth Advisory Council member.

How did you learn about Crisis Text Line?

I found out about Crisis Text Line during my first year in college about three years ago. I had a lot going on in my life at the time, and I was in a rather dark place. I searched online for something and found Crisis Text Line. When I later found out they were accepting applications for volunteers, I applied, and here I am.

What is your favorite thing about being a Crisis Counselor?

Things like suicide and mental illness have had an immense, and profound affect on my life and the lives of those around me. My favorite thing about being a Crisis Counselor is having the ability to help people in their darkest moments.

What is the best thing you've learned as a Crisis Counselor?

Simply listening can really help. I now see that many people just want somebody to listen, instead of giving advice.

III. Org News

Follow us! We’re using six social media platforms for news, updates, and insights:

  • facebook.com/crisistextline
  • twitter.com/crisistextline
  • instagram.com/crisistextline
  • linkedin.com/company/crisistextline
  • Crisistextline.tumblr.com
  • open.spotify.com/user/crisistextline

C. Some big partnerships!

Keyword Partners. We’ve recently partnered with the Mayor's Office in Los Angeles, PennState University, and Lookout Mountain Community Services in Georgia.

Content Partners. We’ve launched content partnerships with The Mighty, Thrive Global, and SoulPancake, helping them to better support their communities.

Are you a part of a school system, city/state government or national organization? Are you a content creator or part of a media outlet? Partner with us! Email Liz: liz@crisistextline.org

D. Crisis Trends V2. Crisis Trends V2 is live! This version allows you to view (on your phone!) the location, day of week, time of day, accompanying issues, and words most associated with specific issues, by state. Whoa! Check it out at CrisisTrends.org


I. Ask Bob. 11/25/16

One in six of our texters (17%) is of college age. Some more scoop:


Gender. 73% identify as female, 17% as male, 10% other.

Sexual orientation. 55% identify as heterosexual, 20% as bi-sexual, 7% gay or lesbian, 18% other.

Race. 71% identify as White, 15% as Hispanic, Latino, or Spanish Origin, 11% identify as Black or African American, 6% Asian, 4% American Indian.


Here are the top issues texters in college face, according to the % of conversations in which the issue is mentioned:

  • Depression: 39%
  • Anxiety: 38%
  • Suicidal Ideation: 24%
  • Family Issues: 24%
  • Romantic Relationships: 17%
  • Isolation: 12%
  • Friend Issues: 11%
  • Self Harm: 11%


Day of Week. Volume for texters mentioning college peaks on Monday, and tails off over the week.

Time of Day. The peak time of day for conversations is night time, 9pm - 2am.

III. Org News

A. Post Election. The entire country was feeling a lot of feels. We saw a 4x increase in volume in the days following the election. The words “election” and “scared” were the top two things being mentioned by texters. The most common association with “scared” was “LGBTQ.”

How did we handle it? We rallied! Our community of trained volunteer Crisis Counselors are incredible. Despite the increase in volume, we actually saw a 2 percentage point increase in satisfaction ratings (a whopping 88% of texters said that connecting with us was helpful.) And, we actually saw a 3 percentage point increase in speed. We were able to help 91% of texters in under 5 five minutes--including “high severity” texters connecting with a human in an average 39 seconds.


I. Ask Bob. 7/29/16

Have a data question? Email our Chief Data Scientist: bob@crisistextline.org

On July 15th, Crisis Text Line passed 20 million messages exchanged with texters in crisis. That’s less than three years since our launch. AMAZING. What else do we know about these 20 million messages???

Top 5 Issues:

Depression: 25% of conversations
Anxiety: 20%
Family Issues: 16%
Romantic Relationships: 15%
Suicidal Ideation: 20% (this used to be #3; it just became #2)

Active Rescues: 3,171

% Texters by Time of Day (EST):

12am - 04am: 22% (Almost 1/4 of our texters are in crisis late night!)
04am - 08am: 6%
08am - 12pm: 9%
12pm - 04pm: 15%
04pm - 08pm: 18%
08pm - 12am: 30%

What was our 20 millionth message? “Hello” (no period). From a first time texter.

In the office, on July 15th, it was our version of a New Year’s countdown:

3:39p - So close
4:02p - The last thousand
4:09p - 840
4:28p - 443
4:46p - Boom! 20,000.060

II. Heroes

Nancy Denburg is a Crisis Counselor on Thursday nights. Nancy shared her experience as a 78 year old Crisis Counselor with CNN this week discussing her initial concerns about her age and the technology and how she overcame.

"How could I, at 77, begin to understand the psyche of teenagers and younger people? I felt that [Crisis Text Line] probably would not be interested in someone as old as me," said Denburg. "Then, I had this epiphany: They don't really know how old I am."

III. Org News

Wow, 3!

We’re turning 3 on Monday! (8/1/16) For our birthday, we’re asking our friends to celebrate by recruiting 3 friends. Our volunteers provide free, 24/7 crisis support--- all from their couch! Apply here!

The Crisis Text Line Blog

There’s so much happening here. So, we launched a blog!

More new hires!

Elizabeth Sweezey Morrell, Crisis Counselor Advocate
Rachel Stephens, Director, Community
Max Kamowski, Supervision

Interested in applying or know someone who might be? Learn more and apply here.

Bob Filbin
Chief Data Scientist

Random fact about me: I went to Harry Potter World at Universal Studios, Florida last weekend. Highlights include drinking butterbeer, eating strawberry peanut butter ice cream (a Harry Potter speciality), and riding 17 rides in 10 hours. Here’s when my sugar craze reached it’s peak and me loitering outside Zonkos Joke Shop:
Source: Email alert

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