Crisis Text Line Releases Annual Data Report on the State of Mental Health in America

NEW YORK, April 29, 2021 /PRNewswire/ -- Today Crisis Text Line, a not-for-profit organization that provides free, 24/7 text-based mental health support, released its second annual national data report, Everybody Hurts 2020: The State of Mental Health in America, identifying the top issues for texters in 2020. In a year unlike any other, Crisis Text Line's Crisis Counselors supported 843,982 texters in crisis through 1.4 million conversations, resulting in 48 million messages.

Our national American psyche suffered repeated blows in 2020. In a year of tumult, COVID-19 infection and death rates soared against the backdrop of an economic recession, massive protests in response to the murder of George Floyd and a polarizing Presidential election. Between lockdowns, rising death tolls, street protests in cities from coast to coast, political conflict and rampant misinformation, it is no wonder so many Americans reached out to Crisis Text Line for help at unprecedented levels all year, resulting in a 19% increase in total conversations from 2019.

Amid these challenges, data scientists at Crisis Text Line found unexpected information on the state of mental health in America, with an overall 20% decline in conversations about suicide with texters. In March 2021, the Journal of the American Medical Association reported that death by suicide declined by 5.6%. Crisis Text Line's findings in this year's report align with this data.

In 2020, young people actively reached out to Crisis Text Line, with 74% of texters falling under the age of 24. Texters aged 13 and under accounted for 13.74% of conversations, texters ages 14 to 17 accounted for 34.10% of conversations and texters aged 18 to 24 made up 26.48% of conversations.

Crisis Text Line's Chief Transformation Officer, Shairi Turner, MD, MPH, says, "While it seems counterinutuive in nature to experience a decrease in depression and suicide during a crisis like the COVID-19 pandemic, experience has shown us that this is typical of human behavior during emergencies that pose external threats to our safety." She continues, "This year was also marked by devastating racial violence. We know that prolonged exposure to systemic racism, whether through violent incidents or micro aggressions, contributes to chronic anxiety and other risk factors that worsen mental health in the long term. At Crisis Text Line, we aim to increase access to mental health support for all, and especially for our youth in need and Black, LatinX and other BIPOC communities that are disproportionately affected by healthcare disparities."

Key findings of the report include:

Mentions of depression and suicide dropped significantly in 2020.
Texters' feelings of depression and sadness dropped by 10% from 2019 to 2020, and conversations in which texters expressed thoughts of suicide dropped by 20%. This trend was also noticeable in the relative drop in conversations flagged as "at imminent risk of suicide," where a texter indicated they were thinking about ending their life, and they also had a plan, the means and wanted to make an attempt within 48 hours. Suicide was a topic in 23% of all conversations with texters. In Wyoming, South Dakota and Utah, mentions of suicide were significantly higher than the national average. While the overall percentage of conversations related to depression decreased, it was still a topic in 36% of all conversations with texters. In West Virginia, South Carolina and Arkansas, mentions of depression were significantly higher than the national average.

Mentions of anxiety increased in 2020.
Beginning in March 2020, as COVID-19 began to spread throughout the country, anxiety and stress surged. Nationally, anxiety was a topic in almost 36% of all conversations with texters. In Puerto Rico, Connecticut, Massachusetts and New York, mentions of anxiety were significantly higher than the national average. 

Young. 
In 2020, 74% of our texters were 24 or younger. Texters aged 13 and under accounted for 13.7% of conversations, texters ages 14 to 17 accounted for 34.1% of conversations and texters aged 18 to 24 made up 26.4% conversations. It is our hope that with this understanding of the generational challenge facing American youth, Crisis Text Line can play an integral role in expanding America's mental-health safety net to support our youth as they build our collective future.

Diverse.
In 2020, texters who reached out to Crisis Text Line were more diverse than in previous years. Texters who identify as Black accounted for 14.2% of conversations, texters who identify as Hispanic, Latino or Spanish origin accounted for 20.5% of conversations, texters identifying as Asian made up 6.8% of conversations, texters identifying as American Indian / Alaska Native came in at 3.9%, and, those identifying as Middle Eastern, North African or Arab made up 1.6% of conversations. Racism is a public health threat that can worsen mental health, and we continue to work to increase access to mental health support for BIPOC and diverse communities. 

Increase in volunteers.
As the pandemic raged on, thousands of people found themselves quarantining at home, and wanting to do something positive and productive. In March and April, more than 15,000 applied to become a Crisis Counselor.

Everybody Hurts 2020: The State of Mental Health in America
This report highlights what we learned through 1.4 million conversations nationally and in all 50 states, plus Washington D.C. and Puerto Rico. The full report is available here. Click here to view Crisis Text Line data from your state.

Background: A Year Like No Other
Just after noon on Monday March 16, 2020, the light signaling the number of people waiting for a Crisis Text Line Crisis Counselor briefly flashed from green to yellow, and then turned red. A red queue indicated that there was more incoming volume from texters in crisis than current volunteers on the platform. By 2pm, conversation volume was up by 29% from an average day of approximately 3,000 conversations, and by 7pm, it had doubled.

Crisis Text Line was experiencing an epic spike. By midnight, Crisis Text Line had 5,900 conversations with people in crisis, rising to 6,606 conversations by the next day. One week before, the World Health Organization had declared COVID-19 a global pandemic. The mental health crisis was well underway and Crisis Text Line was ready—and already remote—to support people who were working on the frontlines as health care and essential workers, students who found their lives interrupted by quarantines, parents who were trying to hold it all together, and thousands of others who needed a trained counselor to listen to their pain. We had 1.4 million conversations with texters during 2020, with higher than average volume almost every day after March 16.

As the pandemic raged on, thousands of people found themselves quarantining at home, wanting to do something positive and productive. In March and April, more than 15,000 people applied to become a Crisis Counselor.

In 2020, COVID-19 infection and death rates soared against the backdrop of an economic recession, massive protests in response to the murder of George Floyd and other victims of police and gun violence, and a polarizing Presidential election. Prolonged exposure to systemic racism, whether through violent incidents or micro aggressions, contributes to chronic stress and other risk factors that worsen mental health. In April 2021, the Center for Disease Control released a statement identifying racism as a threat to public health. The report states, "A growing body of research shows that centuries of racism in this country has had a profound and negative impact on communities of color. The impact is pervasive and deeply embedded in our society—affecting where one lives, learns, works, worships and plays and creating inequities in access to a range of social and economic benefits—such as housing, education, wealth, and employment. These conditions—often referred to as social determinants of health—are key drivers of health inequities within communities of color, placing those within these populations at greater risk for poor health outcomes."

Throughout the year, Crisis Text Line's data science team watched closely for trends in real time, questioning what the data would tell us about the historic year and the effects of the pandemic and racial trauma on the population. We wanted to understand how mental health issues like anxiety, depression and suicide shifted in 1.4 million crisis conversations in 2020, and learn from the words associated with the complex matrix of concurrent crises in the 48 million messages that were exchanged between texters and volunteers.

Crisis Text Line
Crisis Text Line provides free, 24-7, high-quality text-based mental health support and crisis intervention by empowering a community of trained volunteers to support people in their moments of need.

Text CRISIS to 741741 to be connected to a trained Crisis Counselor, free 24/7.

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Media Contact: Julia Pacetti / Cordelia Sklansky, Verdant Communications, [email protected] / [email protected]

SOURCE Crisis Text Line