Here's How to Turn Your Smartphone Into a Life-Saving Device
These days, we increasingly turn to our smartphones whenever we need anything—including help in a crisis.
But when it comes to responding to an emergency, technology still has a long way to go. Earlier this year, the Journal of the American Medical Association published a study that found that voice-assistant systems like Siri and Cortana responded inconsistently and incompletely to traumatic situations. So, if you need help in a hurry, can your phone do anything but dial 911?
Nancy Lublin, who founded Dress for Success and ran the volunteer organization DoSomething.org, says there is another option. Users who text 741-741 will reach her latest endeavor, the Crisis Text Line. The volunteer counseling service has processed over 14 million messages since Lublin founded it in 2013.
I spoke with Lublin recently about the dire situation that inspired the Crisis Text Line, the importance of self-care, the kindness of strangers, and the right—and wrong—way to use big data.
This interview has been edited and condensed for clarity. You can hear the full interview on Inflection Point.
Fortune: Why did you start Crisis Text Line?
Nancy Lublin: I was the CEO of Do Something, which connects with its 5 million members by text. Hundreds of thousands of kids do the campaigns, but a couple dozen every week respond with things having nothing to do with the Do Something campaign. Things like, “My best friend is addicted to crystal meth. What should I do?” Or, “The kids at school are really mean. They bully me. I don’t want to go to school tomorrow.” We’d respond to them with, “Well, go talk to your principal,” or “Here’s a hotline number you can call,” “Here’s this website.”
Then we got a message from a girl who said her father was raping her. We were dumbstruck. We were just horrified and I thought, “If you’re that desperate and yet trust us this much with something so intimate and personal and horrific, we have to do something here.” I started building Crisis Text Line.
How did you respond in that moment?
We gave her the phone number for RAINN, which is a really terrific rape and incest organization. I came in the next day and said, “What happened? Have we heard from her? Send her the number again.” To this day, we’ve never heard back from her at Do Something. I’ve tried to personally reach out to her and I’ve never heard anything back. I don’t know if she’s dead or alive. I talk about her often, because I hope that she’s out there and that she’s safe and healthy and happy and that she hears what she inspired.
Is it mostly teenagers that are reaching out now?
I thought it would be, but it’s not. 30% of our users are middle-aged. I really thought it would be all young people, and I thought it’d all be bullying. 22% of our messages are about suicide and depression. The next chunk after that is anxiety and then family issues—bullying is way down the list. People feel like it’s really private and anonymous, and so they really unload.
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Who are the counselors?
You apply to be a crisis counselor, and then we do a background check. There’s a 35-hour training that includes quizzes and role plays. These are all volunteers, and we have 1,500 of them around the country. We’d like to have 3,000 of them by the end of this year. This is not for everyone. From the start of the application to getting on the platform, it’s only about a 39% acceptance rate. A lot of people get triggered in the training and realize they just can’t do this. For the right people, it’s a phenomenal volunteer opportunity. It’s one stranger helping another stranger through one of the most pivotal moments in their life. It’s pure altruism; it is the kindness of strangers.
What equips somebody to be a successful counselor?
Empathy. Being a really good listener, even though it’s all by text. Listening and being able to mirror back to someone without passing judgment. I think probably having a little of your own security and mental stability helps. Being able to listen to our protocols and our rules and policies and things like that. There are people who have come to us with lots of fancy training—PhDs in psychology. They’ve been trained not for text, not by our organization.
It’s very diverse. We have 50 deaf and hard-of-hearing crisis counselors. I love them and am so excited about them. There aren’t that many volunteer opportunities if you’re deaf, and so that’s pretty fantastic. We also have veteran volunteers. The veterans are fantastic when there’s a spike in volume. There’s a global chat function where the counselors can all talk to each other. The veterans are like, “We got this! We can crush it! Let’s go!” It’s very sweet.
What are some examples of text messages your counselors field and how they help resolve them?
The majority of situations get resolved within 40 to 60 messages. Someone texts in, and they’re really hot about something. Our hope is to get you from that hot moment to a cool moment by the end of the conversation. Most of the time, that’s what happens. 4% of the time, what’s needed is an offline referral—for a rape kit, drug clinic or some kind of in-patient program. Then, there are the messages that are imminent risk, and we do a risk assessment. Ideation: “I want to kill myself.” A plan: “I’m going to take pills.” The means: “I have a prescription.” And timing: “The pills are in front of me on the desk.”
Then, it’s really up to the crisis counselor to try and knock away the timing and say, “Well, how about you put the pills in the desk drawer while we communicate?” We will trigger an act of rescue, so we’ll ask you where you are and say we’d like to send help. If you’ve contacted a text line, you want help, so most of the time they tell us where they are. Sometimes they don’t. Then, we can take the mobile number and work with 911 and the mobile companies and triangulate and find out where you are. We’ll send help anyway, even if you don’t want it, because you’re clearly at imminent risk. We do that seven times a day; it’s not unusual.
Do you ever handle any of these texts yourself?
Hell no. No way.
You wouldn’t pass the test?
Oh my God. I don’t think I could do it, which is one of the reasons it’s such a privilege for me to lead the organization. I’m in awe of our crisis counselors. I read through the conversations sometimes and think, “Oh, that was such a smart thing to say.” I am considering going through the training this summer. I’m really worried that I won’t pass.
The whole organization’s going to be like, “Come on, Nancy!”
How is the protocol for all of this set up?
What’s interesting is it’s a new technology applied to an old space. There’ve been phone hotlines for 40 and 50 years. These protocols have existed for a very long time—risk assessments and mandatory reporting and all that stuff. Now we’re just using a different mechanism: text.
Is there quality control?
We do quality control, and we can see who’s a great crisis counselor. We can do things like look at time stamps and see if you’re a little bit delayed. Does it take you longer to respond to someone who’s LGBTQ? Maybe you have some latent homophobia you’re not even aware of that makes you struggle to communicate with LGBTQ texters. Are there word choices that you use that are better than others? We’ve recently discovered that there are three magic words, the three words that have the highest indication for a successful conversation: smart, brave, and proud.
That would be a counselor’s response to someone who reached out.
Exactly. When a crisis counselor says, “You know what? That was a really brave decision you made to talk to your boyfriend about this.” Or, “I am so proud of you for meeting with your principal and raising these issues.” Or, “Wow, that was a really smart thing to say.” Those words are positive trigger words.
Do you use those words with your own middle school-aged daughter?
I do all the time now, since our chief data scientist gave me those three words. I’m totally Jedi mind tricking her. She hasn’t found me out yet, but if she listens to this, I guess I’m busted.
You’re aggregating tons of data: the types of texts that are coming in, when they’re coming in, the topics that they’re covering. Without sounding crass, what is the opportunity with having all of that information?
I think the opportunity is to do a heck of a lot of good. There have been some douchey finance people who have contacted me asking me if they could buy the data to trade on.
Like, to advertise?
No, more like, “You probably know when there’s something like a shooting or a drug epidemic. We want to find out so we can trade on it first.” It’s just gross, so I said, “No, that’s not how this is going to go down.” Instead, we use the data to make us faster and better and to make the world better. We do have the largest mental health data set that’s ever been collected, and we see aggregate trends, so we know the worst day of the week for eating disorders is Sunday. We know the worst time of day for substance abuse by far is 4 a.m. and 5 a.m. We know that there are states that always indicate highly for suicidal ideation: Montana, Alaska—states with high Native American and rural populations. We also know that suicidal ideation starts to increase in the spring.
Are there macro issues that you see that set off certain trends?
In November, I turned to our chief data scientist, Bob, and said, “All of this anti-Muslim political rhetoric. I’m really curious, are we seeing any impact?” We don’t ask people for personal details such as their religious background. He looked for people who self-identified in a conversation as Muslim and saw that in October, there was a 600% increase, and in November a 900% increase, in people who self-identified as Muslim and were experiencing anxiety, depression, or bullying. Yeah, hate speech has impact on everyday people’s lives, on real people, it matters.
How does Crisis Text Line handle privacy?
Everything’s encrypted. It’s very easy to be scrubbed from our system, if you just want to be pulled completely and have it look like you never texted us at all. All you do is text in the word “loofah,” and we scrub you. Misspellings we’ll also pick up. We also reached out to the mobile carriers and asked them to waive our fees and our texters’ fees, and more importantly to pull this from peoples’ bills so that it doesn’t show up in a billing statement.
Do you feel there’s a point at which parents should be pulled into a crisis situation?
Again, we don’t ask for the age, but if you tell us your age and it’s a violent situation, we are triggered to mandatory report, so that does happen sometimes.
Between Dress for Success, DoSomething.org, and now Crisis Text Line, what is the connective tissue between these things for you?
I know, right? Besides an aversion to making money, apparently. I think I’m really into things that help people help themselves. Dress for Success wasn’t giving people jobs. It was and is giving people the confidence and the tools to go nail it and change their own destinies. DoSomething.org wasn’t telling people you have to do X, Y, Z. It’s not part of community service requirements. It’s, “If you want to take ownership for the world around you, here are great ways to do it, and you can make it happen.” Crisis Text Line is really helping you help yourself get to a place of health and safety. I think that’s my thing. I like seeing other people thrive.
So how do you make a living doing all this good?
I’m a CEO of an organization with 34 employees. I’m paid. I’m not paid what my father would like me to be paid. He still asks me when I’m going to take the Bar Exam. I dropped out of law school and then sort of finished in 2000, so that’s not going to happen. I do some paid speeches and things like that on the side. I don’t live particularly extravagantly.
How do you keep yourself in balance with all the things that you do? Do you consider yourself a balanced person?
I don’t think so. Here’s what I know. I’m not doing a great job about exercise or eating well. I’m not taking great care of myself, which is totally hypocritical, because that’s the whole point of the organization. Our crisis counselors have to practice self care. Here’s what I am: I’m really happy, I really love my life, I love my family and friends, I love knowing that every day I get up and I get to work on something that’s going to help someone else seize the day. We’re doing so many interesting things with the data and building products that really solve problems. I’m really happy. Am I balanced? Hell no—but I’m really happy.
What’s the best advice that you’ve ever been given about handling a crisis?
I think it is this idea of mirroring, of asking questions back, which we do a lot of. I do this with my own kids: Instead of solving something for them, you want them to develop the skills where they can solve things for themselves and where they can get themselves out of a hot moment and learn to take a deep breath and be practical, not angry. I think mirroring is really smart.
Lauren Schiller is the host of Inflection Point, a public radio show and podcast produced at KALW 91.7FM in San Francisco, featuring conversations with women who are changing the status quo. The above article is an edited and condensed version of the broadcast interview. Click here to listen to the full audio.