A multi-method evaluation was conducted to assess the TextToday pilot program (aka PreventionPaysText) the nation’s first crisis line with the capacity to accept text messages. The program is 24/7 and available to anyone with a mobile phone equipped with a texting plan. Objectives of the evaluation included how successful the system was in meeting the needs of underserved youth and how effectively the social marketing campaign reached the target population with information about the texting crisis service. The service was found to increase youth help-seeking behaviors among our pilot study population. Implications for replication, integrating texting into community crisis services, and future research are discussed.
Evaluation findings from the TextToday (PreventionPays Text) program reveal that this text-based crisis line has increased help-seeking behaviors of adolescents and young adults. Although 172 individuals texted into the system during this pilot study, by the spring of 2012 over 300 youth per month were accessing the system for support, representing a sharp monthly increase in youth contacts to the Center over the previous 5-year period. More than half of all texts into the system during the pilot were by “repeat texters,” those who texted in more than one time, with some youth texting in as many as nine times within a 2–3-month period. In schools in which administrative support for the program was particularly high, between 6.3%-12.3% of the student body later texted into the program.
Focus groups with Crisis Line counselors and data on texters suggest that many youth text the system when they are bored, just want to talk, or to discuss an issue they do not feel comfortable discussing with parents, friends, or other support networks. In fact, interpersonal conflicts, and particularly those with romantic partners emerged as the primary issue youth wanted to discuss with counselors. This coheres with research suggesting that interpersonal conflicts are the single greatest stressors reported by youth (Seiffge-Krenke, Aunola, & Nurmi, 2009). Adolescents in romantic relationships tend to report more conflict than those without romantic partners (Laursen, 1995) and manifest more symptoms of depression (Joyner & Udry, 2000). That said, 29 acute crisis texts were received during the pilot and were successfully de-escalated from a suicidal state. Further,
counselors successfully initiated follow up text conversations with many suicidal texters, suggesting that a text-based platform is effective for both crisis and noncrisis texters. Overall, students who participated in focus groups about the text messaging system believed that a text-based crisis line offered many advantages over other resources available to them. Students expressed concern that counselors, teachers, and other school-based resources would discuss issues students brought to them amongst each other and even with other students. Further, although many youth felt they could discuss their problems
with their parents or friends, many others did not feel comfortable talking to their parents about issues, particularly when the topic was sensitive, might cause their parents to involve school officials or other parents, or might get them in trouble. Thus, most students perceived the TextToday system as more confidential, more convenient, and more accessible than other resources available to them. Although some youth expressed concerns that Crisis counselors could “track” their phone numbers and involve their parents or school officials, the majority of youth believed that the line was confidential, and would recommend the service to a friend in crisis.
As texting is increasingly adopted across all age groups and research accumulates about the potential benefits this technology has to increase users’ disclosure, reach previously underserved populations, and improve crisis services overall, texting platforms have the potential to emerge as a central component of community crisis services.