National Suicide Prevention Lifeline crisis chat interventions: Evaluation of chatters’ perceptions of effectiveness

Abstract

Objective: As part of the National Suicide Prevention Lifeline's crisis response system, the Lifeline Crisis Chat Network (LCC) answers chats from hundreds of thousands of at-risk individuals yearly. The study's objective was to assess the effectiveness of these online crisis interventions.Method: Data from 39,911 pre-chat surveys and 13,130 linked pre-and post-chat surveys completed by LCC chatters from October 2017-June 2018 were analyzed.The relationship of several effectiveness measures with chatter demographics, pre-chat distress, suicidal ideation, and chatters' perceptions of engagement with their counselors was examined using a series of logistic regression analyses.Results: Chatters were significantly and substantially less distressed at the end of the chat intervention than at the beginning. By the end of the chat, two-thirds of suicidal chatters reported that the chat had been helpful, while just under half reported being less suicidal. Conclusions:Our study offers empirical evidence for the Lifeline's online crisis chat services' effectiveness, but also highlights areas for improvement. This is of critical import in light of the recent designation of 988 as the nationwide number for the Lifeline beginning in 2022, which will increase the Lifeline's prominence in providing suicide prevention and mental health crisis interventions in the United States.

Individuals who text crisis text line: Key characteristics and opportunities for suicide prevention

“…CTL texters are predominantly young, with 76% under the age of 25 and 66% between 14 and 24. These numbers are very similar to those using an Internet chat service in a recent study of the National Suicide Prevention Lifeline (Gould et al, 2021), in which 71.4% of texters were 24 years old or younger.…”

What twitter can tell us about user experiences of crisis text lines: A qualitative study

“…This lends tentative support to the notion that at least some CTL users may experience improved distal outcomes. Taken together, the two largest themes identified in the current study are consistent with emerging empirical evidence that text-based crisis services appear to be effective in reducing distress and that the majority of users find such services helpful ( Gould et al, 2021 ; Williams et al, 2020 ).…”

“…Interjecting brief statements while the client is sharing (e.g., “yes, tell me more,” “please go on,” “I hear you”) may help to mimic the verbal strategies of active listening in voice communication, and to help compensate for the lack of nonverbal cues that are used in in-person communication (e.g., nodding, eye contact, leaning forward). In addition, crisis text lines may benefit from training volunteers to address a wide range of psychological and emotional health concerns and conditions, as recent evidence suggests that the effectiveness of text support is strongest among users with depression, but less effective for users with different presenting concerns ( Gould et al, 2021 ). Training to respond to diverse conditions may reduce volunteers' reliance on formulaic, cliché, or parroted responses identified in the current study.…”

Suicidal Ideation Among Children and Young Adults in a 24/7 Messenger-Based Psychological Chat Counseling Service

“…Furthermore, a growing number of studies indicate that children, adolescents, and young adults turn to the internet for accessing mental health resources, as it is familiar, easy to access, affords anonymity and may satisfy the perceived need for self-reliance found in some youths and young adults ( 21 – 25 ). Recognizing this trend, a number of crisis hotlines and similar services started incorporating online services, such as chat or e-mail counseling, into their portfolios ( 26 – 29 ). Preliminary evidence suggests the general acceptance and satisfaction of users with those services.…”