Craig, a Palo Alto native and Gunn High School graduate, spent four hours every Sunday night for several months this year as a volunteer crisis counselor for Crisis Text Line, a free, confidential, 24/7 support service accessible nationwide by simply texting the number 741741. Recently, she joined the nonprofit organization full time and is leading Crisis Text Line's efforts to grow the service in the Bay Area, in part in response to the youth suicide clusters 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 17-year-old cousin died by suicide, and she graduated from Gunn in 2009, the year a suicide cluster began in Palo Alto — persisted.
She came across Crisis Text Line in December and was drawn to the organization's meshing of mental-health support and technology. The service, founded in 2013, not only uses texting but also 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 type of crisis (from anxiety and school problems to sexual abuse and suicidal thoughts), time of day or day of the week, by U.S. state and more. Crisis Text Line also partners with academic researchers who look more deeply at specific datasets. A Data Ethics Committee of medical professionals, academics, a representative from the U.S. Centers for Disease Control and Prevention and others is in place to review Crisis Text Line's data collection, storage and sharing practices.
Craig applied to become a Crisis Text Line counselor and committed to volunteering at least four hours a week for one year. She went through a 34-hour, six-week virtual training — a combination of video modules, personalized feedback, live simulated situations and observation of a real, live text conversation.
Counselers learn how to assess a texter for suicide risk by directly asking if they're having thoughts of suicide, Craig said. If the situation rises to the level of "imminent risk" — a person has a plan, method and immediate access to means of suicide — the counselor flags the conversation and a supervisor, who has more mental-health training, can call the local authorities to send help in person. The counselor also doesn't keep that action a secret, she 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.
This happens about eight times a day, Craig said.
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, according to Craig).
Crisis Text Line's more than 1,500 counselors seek to listen, empathize and validate, then help texters identify their own coping skills. They also provide resources and referrals if appropriate.
The ultimate goal is not to 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 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," Craig said. Soon the group launched the nation's first text line, and 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.
As Crisis Text Line's Bay Area director — a brand new position within the nonprofit — Craig has been tasked with "making 741741 very well-known in the Bay Area," she said.
This is the first time Crisis Text Line has sought to expand awareness in a particular region. A "huge" reason, Craig said, are Palo Alto's most recent teen suicides and the fact that conversations about how to better support teens and others in crisis continue throughout the community.
"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 said.
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.
For example, 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 nonprofit.
"If we know that eating-disorder conversations spike on Mondays, how can we make a support group at Palo Alto high schools on Mondays?" Craig 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."
Help is available
Any person who is feeling depressed, troubled or suicidal can reach trained Crisis Text Line counselors by texting "HELLO" to 741741. People in Santa Clara County can also call 1-855-278-4204 or 1-800-784-2433 to speak with a crisis counselor.
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