Crisis support for the world, one text away

What if we could help people in crisis anytime, anywhere with a simple text message? That's the idea behind Crisis Text Line, a free 24-hour service that connects people in need with trained, volunteer crisis counselors -- "strangers helping strangers around the world, like a giant global love machine," as cofounder and former CEO Nancy Lublin puts it. Learn more about their big plans to expand to four new languages, providing a third of the globe with crucial, life-saving support. (This ambitious plan is a part of the Audacious Project, TED's initiative to inspire and fund global change.)

"I'm 14, and I want to go home."

"My name is Beth, I'm here for you,

tell me more."

"I've run away before,

but I've never been involved
with anything like this.

I think they put drugs in my liquor."

"It sounds like you feel you're not safe.

The fastest way for me to get help to you

is for you to call 911."

"LOL, Beth.

If they hear me, they'll kill me.

They're about to send another man in
to have sex with me,

please hurry."

"OK, it sounds like you're in danger.

I can call 911 for you and send help.

You're being very brave."

"Thanks, Beth.

Tell the police to be careful,
these men are armed."

I can share this story with you,

because it was widely reported
in news outlets throughout the country.

We did call 911.

The police rescued this girl,

two other girls,

and arrested three men,

all at the Motel 6 in San Jose.

My name is Nancy "Beth" Lublin.

I'm the cofounder and CEO
of Crisis Text Line,

the free 24/7 service

that helps people by text and Messenger,

with mental health
and behavioral health issues.

And when I go on the platform
as a crisis counselor,

I use the alias "Beth."

I happen to be the crisis counselor
who took that conversation.

But this is what Crisis Text Line is.

It's strangers helping strangers
in their darkest moments

to stay alive, feel less alone,

and to remind them how strong they are.

Crisis Text Line launched
quietly in August 2013

in Chicago and in El Paso,

and within four months,

we were in all 274 area codes
of the United States,

because people used the service,

had a great experience
and shared it with their friends --

that's organic growth.

And in six and a half years,

we've now processed
about 150 million messages.

The people who use our free 24/7 service

skew young,

because it's text, so they skew young.

45 percent are under the age of 17.

Also poor, racially diverse.

17 percent identify as Hispanic,

and 44 percent LGBTQ.

The top five issues
that we see are relationships,

depression, anxiety, self-harm

and in approximately one
in four conversations,

suicidal ideation.

Everyone texting us is unhappy,

yet we normally have
about an 86 percent satisfaction rating

from our texters.

What makes it so good?

The technology, the data and the people.

So, the technology.

It is not an app.

It's not something you have to download.

It's free,

there's no complicated intake survey,

so it's really user-friendly.

You just text us.

We use machine learning
to stack-rank the queue

based on severity.

Kind of like a hospital emergency room
would take the gunshot wound

before the kid with a sprained ankle.

We work the same way.

So we take the high-risk cases first.

So the person who swallowed
a bottle of pills

would come before someone else.

This is data science to save lives.

But it's humans who do the counseling.

We've trained over 28,000
volunteer crisis counselors

who apply online,
go through a background check

and then about a 30-hour training.

And if they pass --

not everybody passes,

there's only a 33 percent pass rate --

they can save lives from their couch.

It's a new gig economy for volunteerism,

like Uber or Lyft for volunteerism.

And we also have full-time staff

with a master's degree
in a relevant field.

They're supervisors,

and they watch every conversation
and step in if needed.

Thanks to this technology and data

and our volunteer labor model,

we're able to reach
tons of people in pain.

People who don't have access
to other resources,

like the gay teenager
who can't share with his parents,

because they keep telling him
to pray the gay away.

Or the girl who can't sleep at 2am

because she's got anxiety about finals

and she doesn't want to disappoint
people who love her.

So they text us.

And we love on them.

And we support them,

and we remind them how strong they are.

And we work on a plan
together to stay safe.

And we tell them that if this felt good,

sharing with us --

and 68 percent of people say
they've shared something with us

they've never shared with another human,

so if it feels good to share with us,

maybe find just one other person
in your life tomorrow to share with.

And after our conversation,

they put that safety plan in place.

And maybe they go to sleep.

Or they journal.

Or they listen to BTS or Lizzo,

or they write a letter to their sister

or their boss or to themselves,
to read in 12 months.

They stay safe.

Sometimes, people have the ideation,

the plan, the means and the timing

to hurt themselves or someone else,

and we can't deescalate.

Like the man in Texas,
five years ago on Christmas Eve,

who told us he only felt pleasure
when he inflicted pain

and he wanted to kill women
and was going to do it that very night.

In those imminent risk situations,

we call 911.

And thank goodness for 911,

because in that Texas incident,

as reported in the news,

they did send help,
they sent the police to his home,

and they found him with an arsenal
of loaded weapons

and on record as being
in possession of a human foot.

Now, active rescues
are less than one percent

of our conversations.

But still, that's about 26 a day.

And six of those a week are for homicide.

Typically school shooters.

We have now completed
more than 32,000 active rescues.

Our own data and external studies

show that we're very good at saving lives,

and at changing lives.

We use the data to make it possible
for us to change systems.

So for example,

we've learned the best way,
the best language to risk-assess

around suicidal ideation

isn't to use the words,
"Are you thinking of committing suicide?"

Instead, it's to use words like,

"Are you thinking of death or dying?"

Or "Are you thinking
about killing yourself?"

And now, we've shared that language
with journalists, to adopt this.

We've shared that language with activists.

We're advising the National Emergency
Number Association,

the 911 Association,

on best practices
for first responders in suicide.

And we're working
with the Veterans Administration

to identify suicidal ideation
and intent in veterans.

(Sighs)

Pain isn't an American experience.

It's a human experience.

So we've been growing.

So far, we've been expanding
one country at a time:

Ireland, the UK, Canada --
which we did in both French and English.

And we could keep growing,
one country at a time.

And it would take us decades

to reach even just a third
of the people in the world.

And that's just not acceptable.

We've already seen,
since the start of COVID in early March,

a 40 percent increase in our volume.

78 percent of our conversations

include words like "freaked out,"
"scared," "panic."

People are worried about the COVID virus,

and so they're nervous about symptoms

and they're concerned for family
on the front lines.

We're also seeing the impact
of the quarantines themselves.

People are away from their routines,

perhaps they're quarantined
with abusive people.

So we've seen a 48 percent
increase in sexual abuse,

and a 74 percent increase
in domestic violence.

One of the biggest impacts we've seen
of the virus and the lockdowns

is the financial stress.

We're seeing more people
reach out with fears of bankruptcy,

fears of homelessness
and other financial ruin.

And right now,

32 percent of our texters

identify as coming from household incomes
under 20,000 dollars.

That's up from our typical
19 percent low income.

So we need to grow.

Quickly.

For months, we were planning on announcing
that we were going to expand by language:

Five languages in the next five years,

covering 32 percent of the globe.

And then, COVID happened.

Things changed.

And now five years feels like a luxury.

So today, right now,

we are committing
to do it in half the time.

Five languages in two and a half years.

We're going to turn on Spanish everywhere,

English everywhere, Portuguese everywhere,

French everywhere,

and the fifth language?

Arabic.

So we're going to bring our service
to countries and populations

that have limited mental health services

and almost no data about what's going on.

These include immigrant
populations -- who have phones.

And young people, who are often
not counted in studies,

but they have phones.

So we're going to shift to language,

which makes the technology easier,

because in addition to text,

we're going to be using
WhatsApp and Messenger.

And global expansion helps us
with middle-of-the-night capacity,

because we'll have time-zone coverage.

So think about it,

this will be strangers
helping strangers around the world.

Like a giant global love machine.

And the fact that the TED community
has supported our audacious dream

is just deeply, deeply meaningful,

to me and to everybody on our team.

And the best way
for us to show our gratitude

is to just let you know
that we are ready and we are fired up.

And we're going to use this support

to impact millions of lives
around the world.

Times are hard.

And it's confusing, and it's depressing,

and sometimes, we all feel alone,
especially in isolation.

But no matter what age,

no matter what your situation is
or where you live,

we'll be at your fingertips,
in your pocket.

I've been thinking a lot
these last few weeks

about that trafficked girl

who I connected with.

And I hope she's somewhere safe.

I don't know ...

I don't know how she's quarantined

or who she's with,

but I hope she's safe.

And I don't know, last year,
how she had our number,

or even how she had access
to a phone to reach out to us.

I never asked her.

Because it didn't matter.

What mattered was
that she could contact us,

that she did have it,
and we got help to her quickly.

And that's the goal,

it's to make it easier
for people to get help

than avoid getting help.

That in moments of hardship,

of danger, of physical distance,

that nobody is ever alone.

That thanks to Crisis Text Line,

none of us is ever actually alone.

[Support this initiative
at AudaciousProject.org]