Unraveling Crisis Text Services: Perceptions and Experiences among Low-income Young Adults with Suicidal Ideation

解开危机短信服务：有自杀意念的低收入年轻人的看法和经历

• 批准号: 10732411
• 负责人: KATE LAFORGE
• 金额: $ 4.28万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10732411
• 关键词: Unraveling; Crisis; Text; Services; Perceptions

ABSTRACT Suicide was the third leading cause of death for young adults aged 15-24 in 2021. Young adults experienced increased suicidal ideation during the COVID-19 pandemic and are at an elevated risk for suicidal ideation and suicide attempts. Health systems have struggled to meet the mental health needs of young adults. Crisis text services are free, anonymous, and rapidly accessible resources that can provide critical mental health resources for low-income young adults. In 2020, the largest crisis text service organization engaged in conversations with 844,000 texters, 30% aged 18-24. In July 2022, the federal government established the 988 national suicide crisis line (which connects users to the National Suicide Prevention Lifeline) and volume rose 45% in the first week of service, demonstrating the high demand for crisis text service. Crisis text services can be accessed by young people with low financial resources who may not access care because of rurality, cost, or lack of insurance coverage for mental healthcare. Crisis text services can link to primary care for people who otherwise do not have access to health services and constitute a free resource that clinicians can recommend to patients. Despite the widespread use of crisis text services, little is known about perceptions and experiences using crisis text services among young adults. A better understanding of how young adults use or choose not to use crisis text services during a mental health crisis could improve the effectiveness of crisis text services. This project will use sequential explanatory mixed methods to address two specific aims: Aim 1 Describe low-income young adults' help-seeking behaviors, motivations, barriers to use, and impact of crisis text services for suicidal ideation through a web-based survey with 100-125 low- income young adults who have experienced SI in the past six months. Participants will be recruited using social media. Quantitative close-ended survey items will be analyzed descriptively, describing differences between young adults who engaged with crisis text services and those who did not. Qualitative open-ended survey items will be analyzed using thematic analysis and used to direct the focus of Aim 2 interviews. Aim 2 Explore perceptions of and experiences with crisis text services among low-income young adults with suicidal ideation via in-depth interviewing with adults aged 18-24. The sample will include those who engaged with a crisis text service for suicidal ideation (n=20) and those who did not engage with a crisis text service when experiencing suicidal ideation (n=20). Participants will be recruited via social media, healthcare providers, and local organizations and interviewed via synchronous text, phone, or videoconference. Data will be analyzed using grounded theory. This research will support health service improvements for AHRQ priority populations, including adolescents and those who are low-income and rural. Findings from this study can be used to inform suicide prevention interventions, crisis text service refinement, and as pilot data for future crisis text service research.

摘要 自杀是2021年15-24岁年轻人的第三大死因。年轻人经历了 新冠肺炎大流行期间自杀念头增加，自杀念头和自杀念头的风险增加 自杀未遂。卫生系统一直在努力满足年轻人的心理健康需求。危机文本 服务是免费的、匿名的、可快速访问的资源，可以提供关键的心理健康 为低收入年轻人提供的资源。2020年，全球最大的危机短信服务机构从事 与844,000名发短信的人交谈，其中30%的人年龄在18-24岁之间。2022年7月，联邦政府设立了988 国家自杀危机热线(将用户连接到国家自杀预防生命线)和销量上升 在服务的第一周达到45%，显示出对危机短信服务的高需求。危机短信服务可以 由经济资源较低的年轻人获得，他们可能因为乡村、成本、 或者缺乏精神卫生保健的保险。危机短信服务可以链接到为以下人群提供的初级保健 否则无法获得健康服务，并构成临床医生可以推荐的免费资源 对病人来说。尽管危机短信服务被广泛使用，但人们对危机短信服务的看法和 在年轻人中使用危机短信服务的经验。更好地了解年轻人如何使用或 在精神健康危机期间选择不使用危机短信服务可以提高危机短信的有效性 服务。该项目将使用顺序解释性混合方法来解决两个具体目标： 目标1描述低收入青年的求助行为、动机、使用障碍和 危机短信服务对自杀意念的影响通过一项基于网络的调查，100-125低- 在过去六个月内经历过SI的年轻人的收入。参与者将通过以下方式招募 社交媒体。定量的封闭式调查项目将进行描述性分析，描述差异 参与危机短信服务的年轻人和没有参与的年轻人之间的差异。定性的开放式 调查项目将使用专题分析进行分析，并用来指导目标2访谈的重点。 目的2了解低收入青少年对危机短信服务的认知和体会 通过与18-24岁的成年人进行深入访谈，了解有自杀意念的成年人。该样本将包括 参与自杀意念危机短信服务的人(n=20)和没有参与的人 有自杀意念时的危机短信服务(n=20)。参与者将通过社交媒体招募， 医疗保健提供者和当地组织通过同步短信、电话或 视频会议。数据将使用扎根理论进行分析。 这项研究将支持改善AHRQ重点人群的卫生服务，包括青少年 以及那些低收入和农村的人。这项研究的发现可以用于预防自杀。 干预，危机短信服务的提炼，并作为未来危机短信服务研究的试点数据。