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How Crisis Text Line is Taking Crisis Intervention to the Next Generation

April 18, 2017

~ Morning Zen Guest Blog Post – Jared Wolf ~

At this moment, people in all kinds of crisis are talking to trained volunteers, whose job it is to listen, seek understanding, and guide the other person as they form their next steps. They never see each other’s faces. In fact, they don’t even hear each other’s voices: this is all happening over text. And with 35 million text messages exchanged in under 4 years, it’s happening at a massive scale.

Crisis Text Line was born out of a clear need for a crisis intervention service via an accessible medium young people were already using and comfortable with: text. The need became apparent to Nancy Lublin, then-CEO of DoSomething.org, when she learned that the organization’s young members, not knowing where else to turn, were replying to SMS messages sent from DoSomething.org with cries for help. One series of texts in particular haunted her: “He won’t stop raping me… It’s my dad…R U there?”

This moment, which Lublin describes in her first TED Talk, was when she realized that if young people in serious crisis were already reaching out to whoever they could, via text message, for support, then there needed to be a text-based resource out there for them. So, she created Crisis Text Line: the first free, nationwide, 24/7 text message service for people in crisis.

Today, Crisis Text Line’s 3,100-strong community of volunteer Crisis Counselors support people dealing with a variety of crises: suicidal ideation and depression account for about ⅓ of conversations, with the rest including abuse, self-harm, addiction, eating disorders, anxiety, and relationship troubles.

By using text as its medium, Crisis Text Line is able to innovate in ways that wouldn’t be possible on a phone line. For example, conversations are taken by severity, rather than chronologically. Analysis of the conversations in which an active rescue (calling emergency services for a texter at imminent risk of suicide – this happens in 1% of conversations) were triggered led to an improved stack-ranking system for conversations. People more likely to be at imminent risk are connected to a Crisis Counselor first.

Machine learning will continue to bring Crisis Text Line into the future. One of many possible applications is an algorithm that identifies the issue that a texter is dealing with based on the language they use, and provides Crisis Counselors with advice specific to that issue, or with the external referrals most correlated to positive outcomes for similar texters.

While it can be argued that text limits a user’s ability to convey tone, there are certain advantages to the medium, as well. Text is straightforward: a text message lacks the hemming and hawing of spoken communication, so texters in crisis are able to convey how they’re feeling with clarity. For a generation raised on texting, Crisis Text Line offers a unique opportunity to discuss difficult feelings without the discomfort that can come from expressing them aloud.

From the start, the mission of Crisis Text Line has been two-fold. In addition to providing in-the-moment crisis intervention, we’re using our massive dataset as a force for good. The tens of millions of messages exchanged are the largest real-time mental health dataset in the United States, and contain countless insights about trends and best practices in the crisis intervention space.

The organization uses this data to improve not only our own work, but the mental health space itself.

Looking to the space as a whole, Crisis Text Line is making our message-level data, stripped of personally-identifiable information, available to select researchers seeking to use it to aid suicide prevention and related efforts. On our website, we list the three ways these partnerships will benefit people in crisis:

  • “(1) we’ll make all research papers available on our website

  • (2) we’ll incorporate findings into our training for Crisis Counselors

  • (3) this research should lead to more funding for good things, better journalism, less stigma, and other stuff that should help people. That’s kinda the whole point.”

Non-research partners can also access aggregate data to learn more about the mental health needs of the populations they serve. These partners market a keyword (such as the “HELLO” in “Text HELLO to 741741”), and receive anonymized data about the issues their populations are facing. Keyword partners have included geographic areas like the state of Ohio, colleges and universities like University of Alabama, and issue-focused groups like the National Eating Disorders Association. By understanding the mental health needs of their populations, these organizations can be empowered to make informed policy decisions that promote well-being. You can email liz@crisistextline.org if you’re interested in this type of partnership.

Anyone can be involved in Crisis Text Line’s work, either by spreading the word about the service or helping to recruit volunteers. Introducing Crisis Text Line to people of any age could save a life.

In crisis? Text HELLO to 741741 for free, 24/7 support in the US from a trained Crisis Counselor.

Interested in volunteering? We’ll give you the skills – You’ll never even have to leave your couch! Apply here.

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jaredJared Wolf is the Media Manager at Crisis Text Line, and previously worked as a Trainer & User Support Specialist at the organization. In his current role, he oversees social media, digital advertising, and content production. As a Crisis Counselor, he’s supported nearly 300 people in crisis over two years.

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