Text Hotline Makes "Talking" About Complex Emotional Issues Easier

Many crisis centers, hotlines and help lines are finding that people of all ages, demographics are reaching out by text to ask for help.  And several agencies are now providing text hotline services in an effort to take advantage of this social dynamic.  Their logic is simple.  Increase access to their services through an innovative web-based service, PreventionPays Text, and grow your user-base by that same number.

Every hotline/helpline that has added texting has seen an instant boost in their traffic.  And now there's a tremendous amount of data that shows quantitatively and qualitatively that teens prefer using texting to talk about their issues.  The preference is strong.  Early adopters tried to convert text conversations to voice calls which turned out to be ineffective.  In fact, in most cases, when asked to move to a call, the texter would refuse, or worse, opt out. Hotline staff realized the mere suggestion would result in premature termination of the encounter. 

New research supports this.  Studies on text out of Michigan and UC Berkeley report that text is preferred when individuals are required to talk about emotional issues or reflect on their personal health.

PreventionPays Text was evaluated during a 3-year SAMHSA GLS Grant. "Someone To Listen: Help-Seeking Behavior Through a Text-Based Crisis Line for Youth" Dr. William Evans, researcher at University of Nevada, Reno and Research Assistants Laura Davidson and Lorie Sicafuse used a multi-method evaluation to assess the efficacy and use rates of the youth text hotline, which is fully operational today and receiving statewide texts in Nevada as well as national texts from youth and young adults who have found their text line through the Internet. 

The research team used program data on use rates and feedback from middle school and high school students in focus groups. The team also conducted focus groups with Crisis Call Center's staff regarding their personal experiences using text instead of the standard model, telephone voice call.  This research is published in the "Journal of Community Psychology" and included as a link on this post.

Today, the collection of hotlines/helplines using PreventionPays text for crisis support have logged well over 1 million text encounters since the service officially launched in 2010, a staggering statistic when considering the nature of the conversations. They are contacting the hotlines because they are in crisis. Many of the youth reaching out through text are facing very serious issues like bullying, self-harm, eating disorders, abuse, domestic violence, and thoughts of suicide.  They are using the text hotlines as a lifeline. While it may be difficult for some to imagine suicide prevention is happening in 160 characters or less, those who use the service, the hundreds of teens and young adults texting these hotlines every day, couldn't imagine it any other way.

If you are in crisis and need help, you can text ANSWER to 839863

A new resource https://www.yourlifeyourvoice.org/Pages/home.aspx that came out of a partnership from the award-winning film BULLY, is also providing text help to teens.

Text VOICE to 20121 to find help now 

(Boys Town hotline provides 24/7 hotline support to youth in crisis and those that love them. All help offered through their website is confidential and free)

Colorado WIC Deploys WIC Text Program with Low Income Moms

Colorado WIC will test the effectiveness of the WIC text program with one of their regional WIC offices in Pueblo Colorado.  They plan to use the program to provide breastfeeding education and two-way Peer Support as many other WIC are now doing nationwide.  However, they have also stated that they plan to use the system in their outreach efforts as a way to attract more residents to their program. They feel young Gen-Y moms will feel more confident reaching out and asking questions about WIC through the sms channel.  It's a medium they already use on a daily basis with friends and family.  State officials are following the same logic behind recent research (that has shown texting to be a useful tool in eliminating barriers and eliciting more candid responses from participants); at year's end, they will determine whether this is a method they want to deploy statewide as a way to increase awareness and participation among all target groups. 

Moms and families in Pueblo CO will be able to text their local WIC office and engage in a secure texting conversation with the hopes that this will help shift their perception about WIC and make these terrific services more accessible to those who need them the most. 

In fact, this is precisely why we built the text platform. Projects like Pueblo are representative of how public health is pushing the limits of sms to make their texting more meaningful to their constituents. 

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Hotline in New Jersey Expanding its Reach to Teens With a Text Hotline

Since introducing a texting service in late March of 2012, the suicide prevention and crisis intervention hotline CONTACT We Care has received more than 2000 texts from people in distress, the majority coming from teenagers, the nonprofit reported today.

Texters reach the hotline by texting “CWC” to 839863 Monday, Wednesday or Friday 4:00-10:00 p.m.  All texts are anonymous and confidential.

This significant use of the texting service followed CONTACT’s promotion of the option in several Union County schools as part of its roll out of the program, as well as through general publicity, according to Joanne Oppelt, the agency’s executive director.  In 2013 CONTACT plans to add up to four additional schools in an effort to make more teenagers aware of the service. 

There are other frightening numbers driving that expansion.  Suicide is the third leading cause of death among youth aged 15-24, the fourth leading cause of death for youth aged 10-14 and the second leading cause of death among college students, Oppelt said.

Each year approximately 5,000 young people aged 10-24 commit suicide, according to national statistics.  In addition, the National Institute of Mental Health believes as many as 25 suicides are attempted for each one that is completed.  According to the National Conference of State Legislatures, 19.3 percent of high school students have seriously considered suicide and 14.5 percent have made plans to kill themselves. 

Causes for teen suicide include: stress over school; feelings of being misunderstood by parents or teachers; struggles with friendships or romantic relationships; social isolation; low self-esteem; developmental issues; recent loss; bullying; eating disorders; and mental disorders.

“Add to that list the tragedy of Newton, Connecticut, and the rising level of violence young people are being exposed to,” Oppelt said.  “Being a teenager in the 21st century can bring untold pressures, angst and disappointment.  Yet this age also gives us technology we’ve never had before and that technology gives these young people in crisis one more important avenue for getting help, and one they are comfortable with.”

More than 60 percent of teenagers prefer texting to other forms of communication, according to the Pew Internet Research Center.  Seventy-five percent of teenagers text and the average American teen sends more than 60 texts each day, with older teenage girls averaging 100, Pew revealed.

After introducing texting in late March CONTACT worked with Cranford, Roselle Park and Scotch Plains high schools to promote the service and raise awareness of options for teenagers in distress within those schools.  Promotion included posters, take-home cards, presentations and morning broadcasts and emails to parents.

Materials featured messages such as “RU hrtn?,” “UR not alone” and “I was too scared to tell my friends.  My parents would never understand.  It seemed too horrible for words.  Then I texted about it I got answers.”

In 2013 CONTACT hopes to begin similar promotional campaigns in Westfield, Union County College, Summit and Elizabeth, according to Oppelt.

CONTACT We Care is staffed by more than 100 listeners and text consultants who are trained to be empathetic and help callers and texters come to their own conclusions that they have options and that, if they are feeling suicidal, taking their life is not the answer.  CONTACT handles more than 12,000 calls and texts each year.

CONTACT We Care serves Central and Northern New Jersey and a primary responder to calls to the national suicide prevention line (1-800-273-TALK or 1-800-SUICIDE) that originate in New Jersey.  Callers also reach CONTACT by dialing 908-232-2880 or texting “CWC” to 839863.

About CONTACT We Care

CONTACT We Care is Central and Northern New Jersey’s crisis listening line, receiving more than 12,000 calls per year.  CONTACT brings comfort and hope to people in emotional distress through active, empathetic and nonjudgmental listening.  All calls are free, anonymous and confidential.  If you are in crisis and need someone to listen, call our hotline at 908-232-2880.  We are affiliated with CONTACT USA, the National Suicide Prevention Lifeline, and the American Association of Suicidology.  For general information about CONTACT We Care or to become a volunteer, call us at 908-301-1899 or visit our website at www.contactwecare.org.

Story and excerpts from clark.patch.com

For Teens, Texting Offers a More Intimate Form of Communication

I read recently several blog posts that were criticizing teen texting behavior referring to it as "alienating" and "detached". However the crisis lines and helplines that use PreventionPays are reporting data that suggests the opposite is true.  Teens use texting to connect with others. In the hotline industry if you can find the courage to ask for help it doesn't matter whether you speak it or write it.  What matters is that you take that incredibly difficult first step.

I grew up in the 80s when every teenager had to have their own personal landline. My sister and her friends would literally get on the phone the moment they got home from school and not hang up until they passed out. My dad would try all sorts of tricks to get her off the phone to no avail. He even disconnected the line from time to time as a form of punishment because if he grounded her, she'd just be on the phone racking up a massive bill. Talking on the phone does not teach teens how to read people's emotions.  So the argument that writing rather than speaking is any less intimate is inherently flawed.  I suspect the telephone dependent teens of the 80s and 90s had the same critics. But they turned out okay and I doubt they're any less empathetic.   We could all use more empathy but I doubt very much our capacity for feeling empathy is hindered by texting.  

In fact, there has always been a need to communicate and for those who text it's the most intimate form available to them. They use text to illicit empathy.  Studies have shown that written and verbal skills actually increase with texting and, contrary to popular opinion, they don't rely on short hand nearly as much as people think. In our crisis textline evaluations, most text conversations use full sentences. In fact most youth using the services are very well-spoken and able to distill complex emotions into eloquent, well-composed verse. There is absolutely nothing detached about it. Their texts are soul-searching and succinct, terse and poignant. They are putting their feelings into words, a quality that eludes many of us. Depicting loneliness is no easy task. And doing it in 160 characters is virtually impossible. If you don't believe me, try it. Today's teens are incredibly capable young adults with enormous ideas and an uncanny ability to convey those ideas with complete clarity. They are using text as their canvas and we should be applauding, rather than trying to impugn them.

For more information about texting services for public health (health departments, crisis lines, helplines and 211s) visit us at www.educationalmessageservices.com

PreventionPays Text is Subject of Published Research: Increase Youth Help-Seeking Through a Text-Based Crisis Line for Youth

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.

Link to full article published in the Journal of Community Psychology