Written by Tracy Costigan. Tracy is a distinguished behavioral scientist and a senior learning officer at the Robert Wood Johnson Foundation. Through her role, she is involved in the process of understanding and measuring key health and health care issues essential to the Foundation’s strategy to move our nation toward a Culture of Health.
Reprinted with permission from the Robert Wood Johnson Foundation’s Culture of Health Blog.
It began with a shocking text message that left the staff at DoSomething.org deeply shaken.
The non-profit organization was originally created to promote youth volunteer and social action opportunities. It uses texting—the primary way in which teens communicate—to send thousands of daily messages alerting members to clothing drives, health fairs, park clean-ups, and more. Responses have been common. In addition to the usual sign-up requests, texters have also sought advice on how to handle a bully at school or help a friend struggling with addiction.
But as DoSomething’s CEO Nancy Lublin explained in a memorable TED Talk, one particular message from an anonymous girl changed their world.
DoSomething’s alarmed team asked who was assaulting her. A few hours later they got this reply:
And a few minutes after that:
Staff scrambled for guidance from a nearby sexual assault center and reached out to the girl again, but sadly, never heard back. Yet the anonymous girl’s desperation and courage spurred Nancy Lublin into convening a small team that created the Crisis Text Line.
Throwing Out a Lifeline with Text
Crisis Text Line initially launched quietly in Chicago and El Paso using 4,000 mobile numbers that were pulled from the DoSomething.org database. A text message invited recipients to opt in.
Despite the complete absence of marketing to promote the new effort, it grew at lightning fast speed as recipients spread the word across their own networks. Within four months, Crisis Text Line was in all 295 area codes of the United States yielding faster geographic growth than when Facebook launched.Now an independent nonprofit, Crisis Text Line provides free, text-based support to people in crisis anywhere in the United States, 24/7. Their average texter is 18 years old and Lublin notes that text has proven to be an ideal way to counsel young people. It offers anonymity, privacy, and access to a team of trained professionals who can work together to provide support that’s tailored to the crisis at hand. According to Lublin, almost two thirds of all texters are sharing something for the very first time that they never felt comfortable confiding in friends or family. This underscores just how trusted the service and medium are.
Many messages express struggles with anxiety and bullying; suicide and depression comprise 35 percent of messages received. Staff perform on average at least one active rescue a day, intervening when a texter has shared plans for imminently harming themselves or others. Real-time surveying of texters also reveals that the service is reaching rural and low-income areas. For example, they are disproportionately reaching the state of Montana which ranks number one in the nation for suicide rates, and where the Native American population is also high. In fact, 6 percent of Crisis Text Line texters self-report as Native American—a very sizable percentage considering that only 1.7 percent of people in the United States are Native American or Alaska Native.
After a little more than three years of operation, the organization’s volunteer Crisis Counselors and texters have exchanged more than 30 million text messages, accumulating the nation’s largest set of crisis data. It created www.CrisisTrends.org to help researchers, journalists, and public health experts better understand what drives teens to crisis and help policymakers and community leaders work together to focus on prevention.
Expanded Data and Analytics will Help Inform Interventions
The Robert Wood Johnson Foundation (RWJF) recognizes the incredible impact that Crisis Text Line is having on social and emotional development of adolescents across the country. That’s why we recently funded a major expansion of Crisis Text Line’s data infrastructure and analytics program. Our goal is to help stakeholders use local, anonymized data to examine patterns of adolescent crises. This will inform interventions that can promote the health and well-being of our future generations.
Researchers are already taking advantage. For example, social work and public health experts at the University of Montana are sifting through tens of thousands of messages to better understand patterns of suicidal thought in the state. They hope to learn why Montana texters are ranked number one in the nation for prevalence of suicidal thoughts by exploring how suicidal ideation correlates with seasonal events, such as harsh winter weather and the academic calendar. They will also explore how loneliness, substance abuse, and relationship changes may affect suicidal thinking.
When their analysis is complete, researchers will work closely with state, tribal, and nonprofit leaders to improve mental health and suicide prevention programs and better target local interventions.
We hope this evidence-based, coordinated approach will spread throughout the United States, covering a wide variety of issues, including relationship challenges, eating disorders, LGBTQ issues, and other sources of teen stress and anxiety. You can view broader trends uncovered by the analytics team, and explore the interactive data visualizations available at www.CrisisTrends.org.
We R Here 4 U
We believe that whatever your geographic, ethnic, socioeconomic, or physical circumstances, you deserve an equal opportunity to live the healthiest life possible. That’s the essence of a Culture of Health, the Northstar that guides the work of RWJF.
Building a Culture of Health requires more than treating illness; it means creating an integrated and comprehensive approach. A Culture of Health puts well-being at the center and ensures that all children and families have access to the social and emotional building blocks of lifelong health and resilience. Crisis Text Line is advancing that vision by supporting teens and deepening our understanding about the root causes of stress and anxiety among young people today.