BACKGROUND
Mental health problems are the leading cause of disability worldwide. Despite the prevalence and cost of mental illness, there are insufficient health services to meet this demand. Crisis hotlines have a number of advantages for addressing mental health challenges and reducing barriers to support. Further, mental health crisis services have recently expanded beyond telephone hotlines to include other communication modalities such as crisis chat and text messaging services, largely in response to the increased use of mobile phones and text messaging for social communication.
OBJECTIVE
Despite the high uptake of crisis text line services (CTLs) and rising mental health problems worldwide, CTLs remain understudied. Thus the current study aimed to address an urgent need to evaluate user experiences with text-based crisis services.
METHODS
The current study explored user experiences of CTLs by accessing users’ publicly available Twitter posts that describe personal use and experience with CTLs. Data were qualitatively analysed using inductive thematic analysis.
RESULTS
Six main themes were identified from 776 tweets: (1) approval of CTLs, (2) helpful counselling, (3) invalidating or unhelpful counselling, (4) problems with how the service is delivered, (5) features of the service that facilitate accessibility, and (6) indication that the service suits multiple needs.
CONCLUSIONS
Overall, there was strong evidence to support the value of text-based crisis support, as many users reported positive experiences of effective counselling that provided helpful coping skills, de-escalation, and reduction of harm. Results also identified areas in need of improvement, particularly ensuring more timely service delivery and effective communication of empathy and support. Text-based services may require targeted training to apply methods that effectively convey empathy in this medium. Moving forward, CTL services will require systematic attention in the clinical research literature to ensure their continued success and popularity among users.
Experiences and satisfaction of children, young people and their parents with alternative mental health models to inpatient settings: a systematic review
