JMIR Publications

ABSTRACT

Background:

Suicide remains a leading cause of death among young adults aged 18-25. Young adults experiencing suicidal ideation (SI) are increasingly using crisis text services (CTS), a free and accessible option for crisis intervention. Emerging research indicates that CTS can effectively reduce short-term, suicide-related distress.

Objective:

This study aimed to characterize young adults’ experience with and perceptions of CTS for SI.

Methods:

We conducted in-depth interviews with young adults (N=39) in the United States with a lifetime history of SI by phone, Zoom, or text. Semi-structured interviews were conducted from January to July in 2024. Data were analyzed using a modified grounded theory approach.

Results:

We constructed five key themes to characterize young adults’ perceptions of and experiences with CTS for SI. Young adults perceived CTS as an integral and unique component of their mental health crisis management. They appreciated its technological features, particularly the privacy it provided and the ability to reflect on and edit responses. However, they expressed dissatisfaction with the non-specific nature of many CTS interactions. Anonymity played multiple roles, both as a motivator for CTS use and as a potential point of vulnerability should it be lost during a CTS interaction. Participants’ perceptions of CTS’s impact varied; some viewed it as beneficial, whereas others reported neutral or inconsistent effects over time.

Conclusions:

Among young adults with SI, CTS is a key, yet imperfect, resource. Quality improvement and evaluation efforts may be needed to understand how responders can better tailor responses to improve conversational quality and consistency for young adult texters.