According to Nancy Lublin, the chief executive and co-founder of Crisis Text Line, a free mental health texting service providing confidential crisis intervention, the top three topics in conversations since the pandemic began have been “anxiety,” “depression” and “relationships.”
But in the past week, as the demonstrations over the deaths of George Floyd, Breonna Taylor and Ahmaud Arbery and others grew, conversations with the words “black, racism, riots and protest” have made up 10 percent of all conversations at Crisis Text Line. This is a significant increase from the usual appearance of such words in the global service’s conversations: The average is 1.5 percent.
Crisis Text Line, which has fielded 150 million texts since 2013, says many of its users are desperately looking for ways to connect and cope right now. Sixty-eight percent of texters say they’ve shared something they’ve never shared with another human being, Ms. Lublin said. “For many, using the text line is the first time they’ve ever opened up that they’re angry or that they’re scared.”
The service sees itself as an important gateway to the critical mental health services so many are in need of as the country simultaneously wades through multiple crises. A texter is greeted with an automated response asking what the crisis is, and an algorithm places them in the queue according to the urgency of the response. When its trained counselors respond, usually within minutes, they encourage texters to seek ongoing mental health support through in-person and telehealth options like BetterHelp.
[To reach the Crisis Text Line, text HOME to 741741 in the United States and Canada.]
Before the coronavirus shutdowns, 53 percent of the text line’s users were under 17, and the most frequently used word in conversations was “school.”
“It’s still the top word that they use, even though they’re not in school,” said Ms. Lublin, whose trained counselors have also seen a sizable uptick in texts from 18- to 34-year-olds, many of whom have had their lives disrupted in big and small ways. Counselors report an increase in texts about eating disorders and self-harm, and a decrease in suicidal ideation and texts that the counselors feel warrant real-life interventions.
Many texts relate to the long-lasting impacts of Covid and quarantine, including anxiety around “economic and financial ruin for families.”
Some teens have experienced devastating consequences of the pandemic: loved ones losing jobs or becoming ill and dying. And now, like all of us, teenagers are seeing a flood of images and news reports on racial conflict and structural inequality, adding to the distress.
Samantha Canter, a child therapist in child and adolescent psychiatry at Kaiser Permanente in San Francisco, works with teens looking for ways to support Black Lives Matter while respecting their parents’ fears about the coronavirus risk. There were “multiple sessions over the past week or so where teens are wanting to go to City Hall or wanting to go to the Mission District,” where protests have been taking place, Ms. Canter said. Some of the teens live in multigenerational households or see grandparents regularly.
For these teens, finding ways to show support requires assessing different levels of risk. “Does it mean staying home and doing something from your front porch? Does it mean contributing money to organizations that support black lives? Does it mean posting on social media or getting out in a crowd and navigating that risk or opening yourself up to risk in terms of Covid?” Ms. Canter asked.
“When you’re home around other people, it’s hard to talk on the phone about your anxiety or depression or anger or fear,” Ms. Lublin said. “Thank goodness for text.”
Ms. Lublin and the crisis counselors at Crisis Text Line are among those trying to offer help to those with anxieties about the future, but they acknowledge they “can’t solve your problems.” Instead, counselors are trained to help texters focus on “things that make you feel strong, things that make you feel in control, things that make you feel capable.”
Counselors ask texters about their plans for the night or the coming weekend to help refocus young adults on the present, Ms. Lublin said.
Dahyana Paul Schlosser, a child and family therapist and registered nurse from Brockton, Mass., noticed a correlation between the anxiety levels of her clients, who range in age from 6 to 26, and the amount of news coverage at home, often in the background. She advises families to limit media consumption and take time to discuss feelings. “Because everything happened so quickly, with lockdowns and shutdowns and people adjusting to the new norm, there wasn’t a whole lot of space made, oftentimes, to sit down and talk about, ‘Hey, how are we feeling about this?’ ”
Dr. Genevieve Daftary, the pediatric medical director at Codman Square Health Center in Boston, says telehealth visits with her teenage patients are some of her longest, and “pretty universally, they are experiencing real disconnectedness and loneliness.”
Some of Dr. Daftary’s teen patients are truly being tested, she notes. Codman Square is in a largely Afro-Caribbean neighborhood and a number of her young patients have a parent or guardian working in a front-line job. These patients are struggling as they realize the adults around them don’t always know what to do now. Their concerns are amplified because many teens “are heading into a time of year that usually brings them a lot of joy,” she said, but instead “they’re facing rather empty summers.”
Given the high rates of Covid-19 within the community, many families are afraid to let their kids go outside, and some of her work involves debunking myths and encouraging families to find safe ways to spend time outdoors — like going outside with a mask on and staying six feet away from others. In her conversations with teens, she encourages them to develop daily routines that include adequate movement and sleep. “I never use the word exercise,” she said, but will ask: “Are you getting a chance to move your body around?”
Ms. Canter noted that over the last week in San Francisco, teens and families have found creative solutions to show support for the calls to rethink policing in a time of social distancing, including a caravan protest that stretched throughout the city. “There were people in their cars for upward of two hours just honking and decorating their cars and really finding alternative ways to show up where you’re also socially distancing.”
Ana Homayoun is the author, most recently, of “Social Media Wellness: Helping Teens and Tweens Thrive in an Unbalanced Digital World.”