Effect of helping suicidal people using text messaging: An evaluation of effects and best practices of the Canadian suicide prevention Service’s text helpline

Background Empirical research on best practices in suicide prevention text intervention is scarce. We present analyses of exchanges concerning suicide on the Canadian Suicide Prevention Service (CSPS) text helpline. Objective To describe the users of the CSPS text service, explore the perceived impact of the service, and identify intervention characteristics associated with a greater likelihood […]

An analysis of young clients’ communications about their suicidality on a text message helpline: “I’m scared of what I might do to myself”

Background: Youth suicide is a major international concern and prevention is a priority. In most cases suicidal behavior would be preceded by a period of suicidal ideation. Although feeling suicidal is recognized as a risk factor for suicide, there is little research which captures young people’s own experience of suicidality in a moment of crisis. Aims: This […]

Individuals who text crisis text line: Key characteristics and opportunities for suicide prevention

Objective Text-based crisis services are increasingly prominent, with inclusion in the national 988 crisis number launching in 2022. Yet little is known about who uses them. This study seeks to understand the population served by Crisis Text Line (CTL), the largest crisis text service in the United States. Methods Secondary data analysis was conducted on […]

Evaluation of outcomes for help seekers accessing a pilot SMS-based crisis intervention service in Australia

Background: In July 2018, Lifeline Australia launched Australia’s first short message service (SMS) crisis support service. Lifeline Text aims to reduce psychological distress and increase coping and social connectedness among help seekers, particularly those who prefer text-based communication. Aims: We aimed to independently evaluate the pilot SMS service over a 240-day period. Method: The service evaluation used operational data, pre […]

Implementation of a pilot SMS-based crisis support service in Australia: Staff experiences of supporting help-seekers via text

Background: Australia’s first short message service (SMS) crisis support service was launched by Lifeline Australia in July 2018. The pilot program was independently evaluated over a 240-day period. Aims: We aimed to examine the experiences of key staff employed in the Lifeline Text pilot and identify the skills and types of support required to deliver a high-quality SMS-based […]

Mobile texting and lay health supporters to improve schizophrenia care in a resource-poor community in rural China (LEAN Trial): Randomized controlled trial extended implementation

Background: Schizophrenia is a severe and disabling condition that presents a dire health equity challenge. Our initial 6-month trial (previously reported) using mobile texting and lay health supporters, called LEAN, significantly improved medication adherence from 0.48 to 0.61 (adjusted mean 0.11, 95% CI 0.03 to 0.20, P=.007) for adults with schizophrenia living in a resource-poor village in […]

Augmenting safety planning with text messaging support for adolescents at elevated suicide risk: Development and acceptability study

Background: Suicide is the second leading cause of death among adolescents. A critical need exists for developing promising interventions for adolescents after psychiatric hospitalization who are at a high risk of experiencing repeated suicidal behaviors and related crises. The high-risk period following psychiatric hospitalization calls for cost-effective and scalable continuity of care approaches to support […]

Coronavirus disease 2019 pandemic: Health system and community response to a text message (Text4Hope) program supporting mental health in Alberta

In an effort to support the mental health of Albertans during the coronavirus disease 2019 (COVID-19) pandemic, Alberta Health Services launched a supportive text message (Text4Mood) program on March 23, 2020. The program was simultaneously approved for funding by the 6 regional health foundations and launched within 1 week of conception. Residents of Alberta can […]

Engagement with crisis text line among subgroups of users who reported suicidality

Objective: Despite the interest in technology-enhanced preventive interventions for suicidality, there is minimal peer-reviewed research on conversations of text message hotlines. In this large-scale study, the authors explored distinct classes of users of the Crisis Text Line who reported suicidality. Classes were based on texters’ presenting psychosocial issues and were explored across frequency of hotline […]

Texting for help: Processes and impact of text counseling with children and youth with suicide ideation

Objective To explore: (1) how children contacting a child helpline with suicide ideation differ from children discussing other topics, (2) whether text messaging effectively helps, and (3) which counselor behaviors are most effective. Method Of 6,060 text sessions at the Danish national child helpline, 444 concerned suicidality, of which the 102 sessions that included self‐rated, […]

Effect of augmenting standard care for military personnel with brief caring text messages for suicide prevention: A randomized clinical trial

IMPORTANCE: Accessible and cost-effective interventions for suicidality are needed to address high rates of suicidal behavior among military service members. Caring Contacts are brief periodic messages that express unconditional care and concern and have been previously shown to prevent suicide deaths, attempts, ideation, and hospitalizations. OBJECTIVE: To test the effectiveness of augmenting standard military health […]

Mobile phone intervention to reduce youth suicide in rural communities: Field test.

Suicide is a leading cause of death among 10- to 19-year-olds in the United States, with 5% to 8% attempting suicide each year. Suicide risk rises significantly during early adolescence and is higher in rural and underserved communities. School-based universal prevention programs offer a promising way of reducing suicide by providing strategies for emotion regulation […]

Efficacy of web-based collection of strength-based testimonials for text message extension of youth suicide prevention program: Randomized controlled experiment.

Background Equipping members of a target population to deliver effective public health messaging to peers is an established approach in health promotion. The Sources of Strength program has demonstrated the promise of this approach for “upstream” youth suicide prevention. Text messaging is a well-established medium for promoting behavior change and is the dominant communication medium […]

Expanding suicide crisis services to text and chat: Responders’ perspectives of the differences between communication modalities

Background: 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. Aims: To better understand differences in the use of phone and chat/text services. Method: We conducted semistructured interviews with call responders at the Veterans Crisis Line who utilize multimodal methods to respond to […]

Fundamentals for future mobile-health (mHealth): A systematic review of mobile phone and web-based text messaging in mental health.

Mobile phone text messages (short message service, SMS) are used pervasively as a form of communication. Almost 100% of the population uses text messaging worldwide and this technology is being suggested as a promising tool in psychiatry. Text messages can be sent either from a classic mobile phone or a web-based application. Reviews are needed […]

Interactive text messaging as an intervention for monitoring and supporting veterans at high risk suicidal.


In texting era, crisis hotlines put help at youths’ fingertips.