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Q&A With Crisis Text Line: The Impact of COVID-19 and How to Help Those Struggling

man texting
June 11, 2020
From the WebMD Archives

By Debbie Koenig

The Crisis Text Line started in 2013 as way for struggling young people to reach out for help, simply by texting the number 741741. Since then, more than 147 million texts have been exchanged between texters in pain and trained volunteer counselors. As the coronavirus pandemic has affected almost every aspect of life, more Americans are experiencing anxiety and reaching out for help.

We spoke with Jen James, Crisis Text Line Founding Supervisor, about the worries haunting Americans, as well as how we can help loved ones who are hurting. Our interview has been edited for clarity and length.

WebMD: What kind of changes have you seen since the pandemic started?

Jen James: The biggest thing is that volunteers have increased substantially—probably within a week, hundreds of new volunteers have gone through the training process and joined the platform. People are stepping up and wanting to support each other, which is such a beautiful thing to see.

WebMD: And what are you seeing in terms of the texts themselves?

Jen James: Our volume is about 20% higher than it was pre-COVID. Anxiety, depression, and relationships, in that order, are the top three things we’re seeing at the moment. More than 60% of texters say they or someone in their household has either been laid off or lost a job as a result of coronavirus. And despite 91% of our texters reporting that they’re under lockdown, 25% of our conversations are still mentioning school—that’s down from 32% before COVID. Online schooling can be challenging for a lot of people.

We're seeing more conversations mentioning domestic violence and substance abuse, those have all increased as well as job loss, grief, and racism. But with the increased number of volunteers we have, we’re helping those people right away, in the moment. Nobody is waiting and everyone's able to be supported through their crisis.

We’re processing a lot of positive in our conversations as well. People are talking about hope and strength and feeling like they're going to be able to make it through, and self-care. They’re finding ways to help themselves. That’s encouraging, because in our conversations we always look for ways that they can help themselves after they connect with us.

WebMD: Are you seeing mostly younger people reaching out?

Jen James: Actually, no. We’ve seen a shift towards people over 35 having anxiety because they’re not sure how they’re going to support their families. And more people on the front lines. There’s an overall feeling of “What’s next?” The fear, the hopelessness. It’s such a stressful time for everybody.

WebMD: Is there one group of people that seems to be struggling more than others?

Jen James: Yes, in the LatinX community texters are mentioning significantly higher rates of recent discrimination or racism, financial issues, recent loss of a loved one, or difficulty caring for a loved one versus the other texters we’re seeing. And they’re significantly more likely to have a parent that is an essential worker. Asian-Americans are experiencing three times higher rates of racism and discrimination compared to other texters. And African-Americans are experiencing loss of a loved one two times the rate of other texters.

WebMD: Have you found that you’ve needed to change your approach or use different tools in responding to texts during this pandemic? Has it required a different kind of response?

Jen James: We’re approaching things differently in the research and referrals we offer. We’ve created a tip sheet for our volunteers to use with COVID-related texters. It has specific resources like the World Health Organization, the Centers for Disease Control, coronavirus checkers, places to get help with bills, and stuff like that. We help with anything and everything, so we continue to use our training. We validate their feelings, and any texter coming in will be supported. If they’re interested in resources, that’s where the shift has come.

WebMD: How is this work affecting your volunteers?

Jen James: Everyone is struggling. This isn’t something anyone prepared for. What’s helping our volunteers is supporting others. A lot of people are using their lived experience, giving back, being there in that moment—it’s a great thing. The volume of volunteers increasing shows how much people want to give back.

WebMD: What are things we can look for in our loved ones as red flags, since we can't be with them in person right now?

Jen James: It’s interesting, pre-COVID 29% of our conversations had suicidal ideation. That’s decreased to around 22%. We haven’t been doing as many active rescues, where we call 911 to help someone planning to harm themselves. As an organization we’re able to deescalate the situation. If you’re looking at behavioral signs, there might be increased use of alcohol or drugs, that kind of self-medicating, or withdrawing from activities. In general isolating from family and friends is a red flag, but now we’re all isolated. It’s more about if they’re not reaching out or wanting to chat, isolation in terms of communication. You may notice they sleep too much or talk about being so tired. Sometimes people will say something in a weird way, it feels like saying goodbye, or they’re giving away prized possessions. Another is aggression—they’re struggling, they’re in so much pain, it can come out as aggression.

WebMD: What are some actionable things people can do if they’re concerned that someone they love may be suicidal?

Jen James: The best thing to do is reaching out, talking, listening. Don’t call them out in a group—do it privately. Check in to let them know you’re there, then just listen. You don’t have to have answers or even respond, you just listen to their story. You care for them, so let them know. Sometimes when you’re feeling suicidal it feels like a tunnel, and it helps to have loved ones trying to poke holes to bring in the light and say, “I’m here for you.”

Also, it’s OK to directly ask if they’re thinking about suicide—some people have a misconception that bringing it up will plant a seed. In reality it’s helping them and bringing relief. It lets them know it’s OK to not hide it anymore, this person cares and they can talk about it. After you’ve listened to their story, if they’re interested in getting support they can text us, that’s always a resource. You don’t have to know all the answers—you can direct them to a place that can support them.

You don’t want to say, “What about your kids?” or make them feel guilty. That minimizes their problems and doesn’t really help. Giving direct advice or anything like that can really come off the wrong way.

WebMD: And what if there are readers who recognize those red flags in themselves? What should they do?

Jen James: Reach out to us, know you’re not alone. Somebody will be there to help in minutes. The Text Line is anonymous, and because it’s texting you don’t have to talk.

In addition to the Text Line, reach out to someone who’s a support in your life. Sometimes people don’t want to do that, they don’t want to be a burden. We hear that a lot. We remind them they’re cared for when they ask for support. When somebody says, “I don’t know what to do,” we don’t give advice. We say, “Would you be there for your friend if they came to you?” They always say yes, absolutely, so then we say, “I’m wondering the reasons you think that friend wouldn’t be there for you.” It’s about making sure they know they’re not alone, which is often something they forget.

Everyone’s story is different, everyone has different needs, and reaching out for support through the Crisis Text Line is a great first step.




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