Understanding Suicide Prevention and Active Rescues at Crisis Text Line
Reaching out for help can be scary any time. Reaching out for help when you’re experiencing suicidal thoughts? Terrifying. (And, we’d like to add, one of the bravest things you can do).
So often, people are afraid to reach out because they are unsure how people will react or how seriously their confidants will take their feelings.
We’re always here for anyone, any time. We will take you seriously. That’s why we always ask if our texters have thoughts, means, a plan, and an imminent timeframe to die by suicide, and can’t de-escalate. And, our top priority is always helping people in crisis to safety. So, we’re here to set the record straight on our active rescue process.
Here’s the rundown on active rescues and suicide prevention:
- The initial connection. A texter reaches out to 741741 and receives and automated message. Then, we use our machine learning algorithm to triage a texter’s conversation in the queue. On average, our texters who indicate a high risk for suicide connect with a Crisis Counselor within 25 seconds.
- Understanding the crisis. When a texter connects with us, their Crisis Counselor spends some time understanding more about the texter’s crisis. In the beginning phase of the conversation, we will also ask if the texter has thought of ending their own life. If they do, we’ll then ask if the texter has a plan, access to the means to complete the plan, and a 24-48 hour timeframe for doing so. So, yes, we always ask. Why? Because we follow the data. And, the data told us that asking about suicide doesn’t increase suicidality. So, daring to ask the question means saving a lot of lives.
- Making a safety plan. In conversations where the texter indicates suicidal thoughts, a plan, access to means, and an imminent timeframe to complete suicide, we work with the texter to safety plan. This can include working with the texter to put their means intentended to complete suicide in another room. Sometimes it may also include identifying a safe person in their life to reach out to so they can stay safe or exploring things in their life that give them joy.
- Ensuring safety. In the rare cases that we are not able to safety plan with a texter, our supervisors (our all-star clinical staff that oversees the platform) will use their professional discretion to initiate an active rescue for the texter in crisis. Supervisors only call Active Rescues if they have reason to believe that a texter will go through with their plan to complete suicide without intervention. Safety is our top priority, so we share the necessary information with 911 to allow them to dispatch emergency services in time to save a life. Humblebrag, but we’re so good at deescalating a crisis that we only engage an active rescue in .82% of conversations.
- Initiating an active rescue. If a Supervisor decides to engage an active rescue to ensure a texter’s safety, they’ll pull use the texter’s phone number and phone carrier to contact a local 911 center and collaborate with first responders to get help to the person in crisis.
- We’re here for everyone—always. While all of this is happening, the Crisis Counselor will keep texting with the person in crisis to try to keep them safe and healthy. Because, nobody should be alone in this—ever.
We’re here to keep people safe. Usually, that’s by helping a texter find a healthy coping mechanism to work through their crisis. In some cases, that means collaborating to help the texter in crisis get help. As mentioned above, less than one percent of our conversations result in our needing to engage emergency services, where the texter fully ladders up in our risk assessment. Of that one percent, we are able to help deescalate the texter’s crisis 60% of the time. Only 40% of that 1% of our imminent risk conversations end in an active rescue. The math: of the thousands of conversations we have with texters in crisis every day, we currently engage an active rescue to help about 28 texters in crisis each day.
All of this is to say that we’re here to help people in crisis; always, forever and in every way we know how.