With: Maria Huebner, MSW, LCSW, Follow-Up Programs Manager, Behavioral Health Response (BHR)

*This piece was originally published in the Winter 2013 version of National Safe Place's newsletter, "The Connection"

TXT 4 HELP is a 24/7 text-for-support service for teens in crisis. The service, which is available nationwide, was initially launched in 2009 and then re-launched in 2012 with a new interactive texting component. The interactive service is operated by Behavioral Health Response (BHR). Maria Huebner graciously agreed to participate in an interview about TXT 4 HELP Interactive.

A youth uses TXT 4 HELP and decides to text interactively for more help. Please explain the interactive texting exchange, how it works, and talk about the individuals replying to the messages. 

Youth in crisis can text the word “SAFE” and their current location to 69866 and they will receive an address to the nearest Safe Place site and contact numbers for the local youth shelters in their area. In cities that don’t have a Safe Place Program, users will receive the name and number of the youth shelter or if there is no local youth shelter, the National Runaway Safeline number (1-800-RUNAWAY) will be provided. At that time, users will also receive the option to engage with a live crisis counselor via text by replying with “2CHAT.” Then they will be connected to a crisis counselor at BHR. All inbound texts are answered by a Masters-Level Counselor at BHR, who will determine the teen’s needs, assess for any safety concerns, work to develop a plan to address needs and assist with linkage to appropriate referrals. BHR’s goal is to get youth linked directly to local resources via brief assessment, engagement and plan development to appropriate referrals.

What is the most common issue teens are struggling with when they use the TXT 4 HELP interactive service?

The main trend we see is youth seeking emergency housing because they report their parents have kicked them out of their home. Most of these youth are reporting no safety concerns, but requesting emergency housing.

What protocols do the operators follow when they believe a young person’s life is in danger due to thoughts of suicide or allegations of abuse?

BHR’s main goal is to ensure a young person’s immediate safety. BHR will first determine a teen’s reason for using TXT 4 HELP and assess whether the youth is currently safe. If the teen reports they are not safe, the crisis counselor will explore more about the nature of their safety concerns before taking appropriate action. The crisis counselor will explore the following safety questions: any current thoughts of suicide and/or thoughts of self-harming behaviors, any current homicidal thoughts, being abused and/or at risk of violence by others and/or is there any medical emergencies that needs to be addressed. If a youth reports any of these immediate safety concerns, and is unable to develop a collaborative safety plan and/or a youth is under 18, being abused and is with the abuser, then BHR will begin to ensure the youth’s safety. BHR’s crisis counselors will reach out to a teen via phone if they agree to gather more appropriate assessment information. If not, the crisis counselor will continue to build rapport via text to get the necessary assessment information and will contact local emergency services with the teen’s location information. The crisis counselor will also make an emergency hotline report to the young person’s local state child/abuse hotline when warranted. BHR always follows up on cases where local emergency services are contacted to obtain the final disposition of the situation.

Do you feel the interactive service is an effective way to help youth in need? If so, why?

National Safe Place’s TXT 4 HELP service is very beneficial for youth who are homeless, have immediate safety concerns, and/or being abused. Teens can easily access immediate help via TXT 4 HELP to connect with a crisis counselor 24/7 wherever they are. With the expansion of technology, youth are more comfortable and receptive to texting for help versus using the phone to call for help. Youth also find texting to be a safer way to express their needs, as they can remain anonymous when trying to get appropriate referrals. They like the non-judgmental approach of texting for help.

What is the biggest challenge regarding the TXT 4 HELP interactive service?

The biggest barrier BHR crisis counselors face when helping a youth via text is being able to help the work through the crisis situation in a timely manner.  Texting is very time-consuming versus talking on the phone. It takes time to build rapport with a teen and gather assessment information via text. Often times, youth who are texting can be easily distracted and do not text back right away when the crisis counselor is attempting to understand their needs.  When crisis counselors have the opportunity to talk to a teen via phone, they can assess for any background noise or distractions and gauge the youth’s mood, tone and affect by their voice during the conversation. Sometimes youth are not always cooperative or honest when responding to assessment questions and it’s difficult to further help them with referrals and safety planning steps if counselors do not clearly understand the youth’s needs. Youth also may text from a block number, and if a safety check needs to be sent, it is hard to locate the client to get them the help they need.

Do you have a TXT 4 HELP interactive success story to share?

Client Information:

Female, 17, Memphis, Tennessee

A youth used TXT 4 HELP Interactive and reported that her mother had threatened to hurt her. She was requesting somewhere urgent to stay. The youth reported that her mother threatened to pull a knife on her and she asked the crisis counselor what she should do that night. The crisis counselor inquired if she had called the police and she denied. The counselor then asked the girl if she could go a neighbor’s house or a friend’s house, and she denied. The teen agreed to speak with the crisis counselor on the phone and she reported her mother has taken the doorknob off her door and she does not feel comfortable sleeping at her house tonight. The teen agreed to make a three-way call with the crisis counselor to local police in her area and the counselor waited on the line with the girl until police arrived.  A week or so late, the counselor followed up with local police to get final disposition and they reported that they talked to the youth and her mother and no further action was taken.

To learn more about TXT 4 HELP and the Safe Place program, please visit www.nationalsafeplace.org

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