Expanding Suicide Crisis Services to Text and Chat

Responders' Perspectives of the Differences Between Communication Modalities

Published in: Crisis, [Epub May 2017]. doi: 10.1027/0227-5910/a000460

Posted on RAND.org on June 06, 2017

by Zachary Predmore, Rajeev Ramchand, Lynsay Ayer, Virginia Kotzias, Charles C. Engel, Patricia A. Ebener, Elizabeth Karras, Gretchen L. Haas

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Crisis support services have historically been offered by phone-based suicide prevention hotlines, but are increasingly becoming available through alternative modalities, including Internet chat and text messaging.


To better understand differences in the use of phone and chat/text services.


We conducted semistructured interviews with call responders at the Veterans Crisis Line who utilize multimodal methods to respond to veterans in crisis.


Responders indicated that veterans may access the chat/text service primarily for reasons that included a desire for anonymity and possible inability to use the phone. Responders were divided on whether callers and chatters presented with different issues or risk of suicide; however, they suggested that veterans frequently use chat/text to make their first contact with mental health services.


We spoke with call responders, not the veterans themselves. Additionally, as this is qualitative research, applicability to other settings may be limited.


While new platforms offer promise, participants also indicated that chat services can supplement phone lines, but not replace them.

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