Is Crisis Chat for Kids?

Background: Use of online crisis chat has been increasing as a means of help-seeking, especially among young people. Adolescents are more likely than adults to use online tools, such as chat, for impulse control and emotion regulation. While crisis chat is often used as an emotion regulation tool, the effectiveness of this brief intervention across age groups remains unknown. Therefore, this study examines whether crisis chat is more effective among adolescents than adults, and whether crisis chat is associated with increased regulation of suicidal thoughts and reduced desire to attempt suicide.

Methods: Data were collected from pre- and post-chat surveys conducted between 2017 and 2019 from a non-988 chat service in a Midwestern state. Chat users provided their age, gender, and zip code, and reported their concern, level of distress, and the presence of suicidal ideation prior to starting the chat. Eligible participants must have thought about suicide in the past few days, chatted with a counselor for 20 minutes or longer, and agreed to complete pre- and post-chat surveys. There was a total of 241 participants, classified into quartiles roughly corresponding to early to middle adolescence (12-15: 25.7%), middle to late adolescence (16-19: 25.7%), late adolescence to early adulthood (20-24: 24.5%), and adulthood (25 and older: 24.1%). The surveys included the Regulations of Suicidal Thoughts Scale (RSTS) and an item asking how certain they were that they would attempt suicide. Descriptive statistics, generalized linear models (GLMs), and correlational analyses were used for the analysis.

Results: Findings showed that all age groups benefited from using the crisis chat, as suicidal thoughts were more regulated post-chat than pre-chat. Crisis chat showed a strong association, with effect sizes ranging from d=0.59 to 1.11 Specifically, chat users between the ages of 12 and 15 and 16 and 19 reported more change in their ability to regulate the intensity of their feelings, their hope for the future, their belief they could work through this. Younger visitors were less certain they would attempt at post-chat, while older chat users who were 25 years and older reported no change in whether they would attempt suicide from pre- to post-chat, despite improvements in their thought regulation.

Conclusions and Implications: Crisis chats serve as brief interventions that support the regulation of suicidal ideations, with greater effectiveness among adolescents. Future research should examine the mechanisms underlying age-specific change in crisis intervention, and how these mechanisms can be utilized to improve outcomes across different age groups.