Personal Health

Crisis Counseling by Text Message — Teens Now Have Another Way to Get Help

The third leading cause of death for young people in the U.S. between ages 10 and 24 is suicide. One text-based crisis hotline is trying to beat the odds.

Photo Credit:

According to the CDC, the third leading cause of death for young people in the U.S. between the ages of 10 and 24 is suicide.

A major public health problem, completed suicide attempts — and the factors that underlie them — point to a need for a new mode of crisis counseling and intervention.

Now, young people who need confidential, private and free counseling can use SMS, or text messages, to get the help they need.

Earlier this month, the New York Times’ Leslie Kaufman reported on an innovative organization’s attempts to bridge a needs gap for reaching teens in crisis.

Crisis Text Line, a New York-based nonprofit, began offering text message-based crisis counseling in August 2013.

Founded by Nancy Lublin, the organization has exchanged almost 1 million text messages with 19,000 young people in the six months since its launch.

Text message-based crisis counseling helps cover gaps in the pressing issues of suicide, depression and sexual abuse affecting young people.

Teens write to the Crisis Text Lines with issues ranging from eating disorders, feeling as though they are trapped in a body of the wrong sex, and those affected by sexual violence.

Lublin, who runs the main nonprofit behind Crisis Text Lines, got the idea after receiving an abrupt and one-time text message: “He won’t stop raping me. It is my dad. He told me not to tell anyone. Are U there?”

She couldn’t sleep for weeks, and later sought to redress the limitations of phone-based counseling by hiring programmers, who surveyed hotline organizations and assessed the ways in which text message interventions might help young people in need.

With the ability to receive counseling by text message, Kaufman’s article states that the organization now receives “messages from distressed teens who were in the same room with their abusers, who might not have reached out by phone.”

In an interview, Newport Beach-based clinical psychologist Jerry Weichman extols the benefits of texting as a means of accessing crucial counseling: “[Teens] can still look ‘cool’ to their peers or friends while receiving assistance that they are in desperate need of.”

Another benefit of text-based counseling is that there is a written record that teens can access later when they feel the need.

However, certain limitations apply with text-based counseling. Although prank calls are avoided, the medium of text messages means young people can abruptly “drop” the conversation in a way that doesn’t happen with telephone conversations.

In 1998, the American Journal of Preventive Medicine published its hugely important ACE (Adverse Childhood Experiences) Study. This study looked at 17,337 participants — most of whom were college-educated, and 74.8 percent of whom were white — and found strong statistical correlations between early childhood trauma and later, cumulative adverse health outcomes throughout life.

The study’s authors, including Dr. Vincent J. Felitti and Dr. Robert F. Anda, found a startling dose response relationship between ACE score and self-acknowledged suicide attempts. In a 2006 presentation on the ACE Study, Dr. Felitti said:

If you go out to an ACE score of six or more, you can get up to between a 31- and 50-fold increase in attempting suicide in adolescence — that is to say a 3,100 to 5,000 percent increase. People who are epidemiologists for a living tell me that these numbers are of a magnitude that they professionally are likely to see once in a career.

AlterNet previously reported on the ACE Study in this December 2013 piece by Charlotte Silver.

Soo Na Pak is a writer and artist currently based in the San Francisco Bay Area. She is a former Fulbright grantee, and completed studies at Hampshire College. Essays and prose have appeared in, "Outsiders Within: Writing on Transracial Adoption" (South End Press), Hamilton Stone Review, and Digital Artifact Magazine. Visit her blog at

Sign Up!
Get AlterNet's Daily Newsletter in Your Inbox
+ sign up for additional lists
Select additional lists by selecting the checkboxes below before clicking Subscribe:
Election 2018