Impact Journalism Day 2016

SMS Counseling for When People Aren’t LOL

U.S. teens receive and send about 30 text messages a day, which prompted nonprofit Crisis Text Line to consider a new way of offering a helping hand.

The Crisis Text Line provides a free one-on-one connection with a crisis counselor via SMS. The texts are anonymous and confidential.
Crisis Text Line

The hardest part for Lily Rayne was feeling alone. Rayne is deaf and didn’t grow up with sign language. When she had suicidal thoughts, she couldn’t communicate or sign with a trained professional or a therapist. Nor could she pick up a phone to call a crisis hotline.

She eventually found help online by learning about cognitive behavioral therapy, but not before she had come dangerously close to taking her own life. Years later, she ran across a service that would have eased her sense of isolation in those dark hours: Crisis Text Line, which has brought the 1-800 support line into the age of texting.

Trained counselors, of whom Rayne is now one, are available 24 hours a day, seven days a week, to respond to people in need with SMS texts. The texts are anonymous and confidential.

“Crisis Text Line is not a replacement for mental health care, but when one feels completely overwhelmed, lost and alone, it’s a point of connection and a way to get to a more stable frame of mind,” Rayne said in an email interview.

“This is not really something deaf people have had access to before Crisis Text Line, in my opinion.”

17 million texts

In the three years since it was founded, the not-for-profit service has exchanged nearly 17 million texts. The organization’s founder, Nancy Lublin, got the idea when working with teenagers, some of whom started to text her staff about issues like depression and rape.

Users of the service run the gamut. About 35 percent of the texts come from middle-aged people, many of whom are texting about their children, divorces or job troubles, according to Lublin.

As suicide rates have climbed to alarming levels – the highest in three decades – public health and CDC researchers agree that suicide prevention needs more resources. In 2013, more than 41,000 people in the United States committed suicide, according to statistics collected by the U.S. Department of Health and Human Services.

While hotlines have helped people in crisis for decades, communication methods have evolved. In the age of Snapchat and WhatsApp, talking on the phone can seem awkward or uncomfortable.

For the hearing impaired, using a telephone can be tough or impossible. Even for people at ease talking on the phone, having conversations about mental health issues can put the user at risk of being overheard.

In 2013, Lublin – the CEO at a teenage outreach organization called – and her team sensed the shift in tech habits and started providing crisis counseling via text messaging.

The logic was simple: Go where the teens are. Teens on average receive and send about 30 text messages a day, according to a Pew Research Center study.

Through the volume of conversations, Crisis Text Line has gained insights into hard-to-quantify mental health topics such as suicidal thoughts, self harm and bullying.

It shares some of this data on Crisis Trends: It has found that suicidal thoughts tend to spike between 7 and 9 P.M.; and Tuesdays are most common for texters who come for help about depression and physical abuse.

Lublin expected that they’d help people in the throes of major crises, but she hadn’t anticipated how it would affect one community.

When hotlines aren’t an option

“The biggest surprise, which probably comes out of my own naveté, is how the deaf and hard of hearing have flocked to us. Not only as texters, but also as crisis counselors,” she says.

Rayne knows firsthand how removed she was from mainstream support networks.

Several years ago, a suicide attempt left her hospitalized.

“As a deaf person, getting help before it reached that point was a challenge since I couldn’t call any of the hotlines,” she wrote in an email interview.

She couldn’t use the telecommunication device for the deaf, because those devices tended to be “clunky and frustrating to use,” she noted.

Rayne also found that the hotlines for the hard of hearing were rarely answered. She struggled with anxiety and severe, chronic depression.

“I was pretty isolated socially, and found it too difficult to understand therapists and doctors, so I was pretty much on my own,” she wrote.

The text-based service provided an outlet for deaf and hard-of-hearing people, who hadn’t been able to use traditional hotlines. Relying on text messages meant that people who are deaf and hard of hearing could also volunteer their services.

It’s how Rayne first got involved. She read about Crisis Text Line on a website and felt compelled to join. After years of struggling with mental health issues, she wanted to help others.

“I know what it’s like to not have somewhere to turn in a crisis, and I don’t want others to have to feel that way,” said Rayne.

The steps to becoming a counselor are rigorous, requiring about 32 hours of live training and role-play scenarios. Rayne started volunteering in June 2015 and now works 12 hours a week.

In the spirit of Crisis Text Line, which doesn’t spend money on advertising itself, Rayne began telling others in the deaf community. The service now has more than 30 counselors who are deaf or hard of hearing.

This article first appeared in American daily USA Today.