Articles, Blog

Crisis Text Line | Nancy Lublin | Skoll Award 2019

65 million Americans are experiencing some form of mental health issue. The numbers of young people are somewhere between one in three and
one in five by the time you graduate high school, will
have contemplated suicide. Back in the 2000s, the
world was majority text, but still, the only way
that they could access care was either in person,
in therapy, or by phone. So we said there is a huge
missed opportunity here. Someone needed to make a hotline by text, so we built it. From the user perspective,
one of the best things about Crisis Text Line is
that there’s nothing you have to download or learn or do special. It’s just like texting your
mom or your best friend. You text us and then the
next thing that happens is you’re connected with an
empathetic, trained human. Crisis counselors apply online, go through a 34 hour training. You only need a laptop
and an internet connection to be able to volunteer. They are home, they
logon to their computer, and then they login to our platform. As a crisis counselor on the platform, you’re supported by supervisors and these are, again, full-time staff who have a master’s degree
in a relevant field. So there’s teams of people behind you, coaches and supervisors, but the crisis counselors are
the ones on the front lines. Everything that you need
to support that texter is available on our platform. So we have the toolbox
with helpful tips on how to support that person in
different types of crises or specialized support,
so you can help them find something in their community. It’s an incredibly powerful
place that connects a lot of people who otherwise
wouldn’t be connected. The nature of text is
really powerful in that you’re not hearing the “like”
and the “um” and the “and”. You’re hearing directly
what they’re experiencing. You’re hearing their
pain, sometimes it’s raw, but the fact that it’s anonymous
enables people to open up. The goal of a conversation is to move someone from hot to cold, but we need or risk
assess, so conversations where someone has the ideation, the plan, the means, the
timing to kill themself or someone else and we can’t deescalate, we will call in what’s
called an active rescue. What our data showed was that it’s not suggestive to ask someone whether they are thinking
of killing themselves or whether they have
thoughts of death or dying. Our data also informed us
of the best way to ask, so we use an expression of care model where we can incorporate the right words into a conversation and ask a texter if they have thoughts
of hurting themselves. We’re handling about
3,000 conversations a day. About 25 turn out to be active rescues. We are a gateway to mental healthcare. Because we’re on text, we skew young and we skew rural, we skew low-income. Two thirds of our texters are saying that they are sharing something that they’ve never
shared with anyone else. At this point, we now have
over 75 million messages exchanged with texters in crisis, the words, the language,
the moment in time, when they were in crisis, which means that we have the largest data
set on crisis in the country. We now have over 200 partners. I think it speaks to the power of our data that we have other organizations reaching out to us to get access to our data and work on problems that can create a sea change in how we think about mental
health in our country. We start to see some of the data that comes in from Crisis Text Line. You know, we’re hoping
to identify some trends that are affecting our youth. So if there is a rise in eating disorders that just happens to be on the west coast, if we can see those numbers and how they’re affecting our kids, then we can also try to
help our local clubs, provide better support, and
help us better serve them. A texter had begun an overdose attempt and she texted us in saying
she really wasn’t sure she wanted to die, then
stopped responding. We were able to get and ambulance to her and we heard from her mom the next day that she was actually unconscious when she was taken to the hospital. And if we hadn’t sent
that ambulance to her, she would have been dead. There’s the conversation that
I had with a man recently who had just found out something terrible and was in his car with a gun. By the end of the conversation, the gun was in the glove compartment and he was ready to drive home that night and kiss his kids good night. We have a lot more work to do. We’re already operating
in Canada and the UK. And my hope is to do 12 more countries in the next three years, so
that we’re in 15 countries by the end of 2021. We’ll be spreading empathy and really creating more human
connection around the world. And that would be awesome.


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