Someone who is crushed about a breakup. Someone whose parent is struggling with an addiction. A transgender person who is suicidal because they hate the body they were born with.
These people all reached out for support via Crisis Text Line, and at the other end of the text was Libby Craig.
Craig, a Palo Alto native and Gunn High School graduate, spent four hours every Sunday night for several months as a volunteer crisis counselor for Crisis Text Line, a free, confidential, 24/7 support service accessible by simply texting the number 741741. She's since joined the nonprofit organization full time and is leading Crisis Text Line's recently launched efforts to grow the service in the Bay Area specifically, in part as a result of the recent youth suicide cluster in her own hometown.
Craig worked in product management for several years after graduating from college, but an interest in psychology and personal ties to suicide her cousin died by suicide when he was 17 years old, and she graduated from Gunn in 2009, the year a previous suicide cluster began in Palo Alto eventually persisted.
She came across Crisis Text Line in December and was drawn to the organization's meshing of both mental-health support and technology. Crisis Text Line, founded in 2013, makes aggregate data publicly available online in what it claims to be the nation's largest open set of crisis data.
The database is searchable by types of crisis (from anxiety and school problems to sexual abuse and suicidal thoughts), time of day or day of the week, by state and more. Crisis Text Line also partners with approved academic researchers who can apply to look more deeply at specific datasets. An established Data Ethics Committee made up of medical professionals, academics, a representative from the Centers for Disease Control and Prevention and others is in place to review Crisis Text Line's data collection, storage and sharing practices.
Craig went through Crisis Text Line's rigorous application process to become a crisis counselor. Counselors are asked to commit to volunteering at least four hours a week for one year and go through a 34-hour, six-week virtual training, a combination of video modules, personalized feedback, live simulated situations and observation of an actual, live text conversation.
They learn how to assess a texter for suicide risk by directly asking, if it's relevant, if they're having thoughts of suicide, Craig said. If it rises to the level of "imminent risk" a person has a plan, method and immediate access to means the counselor flags the conversation to a supervisor, who has more serious mental-health training and can call the local authorities to send help in person. This happens about eight times a day, Craig said.
The counselor also doesn't keep that a secret, Craig said: "We will often say, 'I'm really worried about your safety tonight and I want to get you help."
The counselor will then ask for the person's location and confirm when help is on the way.
An algorithm also ranks incoming texts by severity, much like an emergency room triages patients, so anyone who is actively suicidal will get to a counselor more quickly (in an average of 1.8 minutes, to be exact, according to Craig).
Crisis Text Line's more than 1,500 counselors seek to listen, empathize and validate, then help the texter identify, on their own, coping skills. They also provide further resources and referrals if appropriate.
The ultimate goal is not to provide or be a substitute for ongoing, long-term mental-health support, but rather to "bring people from a hot moment to a cool moment," Craig said, echoing a description oft-used by the nonprofit organization.
"Our goal is really to bring people to a place where they can be safe tonight," Craig said.
Crisis Text Line CEO Nancy Lublin founded the organization in 2013 after realizing that texting was an untapped means to reach and support people in crisis, particularly young people. Lublin was previously the longtime CEO of DoSomething.org, a nonprofit that seeks to motivate young people to get involved in social change. The organization used texting to communicate with teens, such as to coordinate an upcoming food drive. Every so often they would get a completely unrelated text back, about being bullied at school or needing help in some way, Craig said.
Then, one day, came the text that said, "R U there? He won't stop raping me. It's my dad."
The DoSomething.org team "decided at that moment, this is a space that really needs help," and soon launched the nation's first text line, Craig said. Within four months, it was being used in all 295 area codes in the United States. People can also now access Crisis Text Line from Facebook Messenger and through YouTube's Crisis One Box, which provides video, information and resources on major crises and disasters.
The nonprofit, which functions like a tech startup, has raised major funds from sources like Melinda Gates and LinkedIn founder Reid Hoffman. Crisis Text Line's Bay Area efforts are supported by Battery Powered, a philanthropic venture from San Francisco private social club The Battery.
After about six months of volunteering as a counselor, Craig joined Crisis Text Line as Bay Area director, a brand new position within the organization. This is the first time Crisis Text Line has done a "targeted push" in a particular region, Craig said.
A "huge" reason for this push, Craig said, is the fact that several Palo Alto teenagers have died by suicide in the past year or so, and conversations about how to better support teens and others in crisis continue throughout the community. At certain times of year, particularly in the spring, Crisis Text Line's data shows that suicidal ideation becomes the No. 1 issue for texters from Palo Alto, according to Craig. Nationally, suicidal ideation is the third most common issue behind depression and anxiety.
And 80 percent of Crisis Text Line texters report being under the age of 25, according to the organization.
In her new role, Craig has been tasked with "making 741741 very well known in the Bay Area," she said.
"I want 741741 to be as known as 911 in the Bay Area. I definitely want schools to offer this in their handbooks and their resources. I want schools to put 741741 on the back of student IDs, in bathrooms, where people sometimes go when they're feeling upset. I want people to enter the number in (their phones) on first-day-of-school assemblies," she added.
Craig is starting to meet with local school and community representatives in Palo Alto (and elsewhere) to pursue this vision. And beyond her goal of making the crisis line a ubiquitous resource locally, she hopes that Crisis Text Line's data can help inform ongoing efforts in Palo Alto to improve mental-health support and services.
"If we know that eating-disorder conversations spike on Mondays, how can we make a support group at Palo Alto high schools on Mondays?" she offered as an example. "There are really cool things we could do with this data and we are happy to share that data with the people who can make policy changes."
Any person who is feeling depressed, troubled or suicidal is urged to call 1-800-784-2433 to speak with a crisis counselor. People in Santa Clara County can also call 1-855-278-4204.
People can also reach trained Crisis Text Line counselors by texting "HELLO" to 741741.
Links below provide more resources where one can receive help: