The worlds of psychology and technology are constantly colliding. While many fear the dissolution of tradition or de-humanization of modern society, others forge forward carving the path to the inevitable future when mental health and technology are irrevocably intertwined.

After a presentation I gave this week on the ethics of using the internet and social media, a large amount of questions posed in the feedback forms were about telehealth. Can you Skype with a client or provide supervision to a student? How secure is email? Is telementalhealth even effective?

This was beyond the purview of my lecture, but it did get me thinking. A few hours later when the latest edition of the New Yorker featured an article entitled R U There? and it seemed almost like destiny.

(Trigger Warning)

Posted in the technology section, contributor Alice Gregory tells the story of Stephanie Shih and how a volunteer experience catalyzed the creation of the Crisis Text Line.

The CTL (shorthand for “control” – how apropos) is exactly what it sounds like, a texting-based crisis line. The service was created for teens in crisis, and enables them to text trained volunteer counselors. The problems fielded by volunteers range from worries about slipping grades to physical and sexual violence, or suicidal ideation.

Since 2013, CTL has received over 5 million texts from teens. If that wasn’t impressive enough, CTL has been a rockstar in terms of managing and analyzing this huge set of data.

The organization’s quantified approach, based on five million texts, has already produced a unique collection of mental health data. C.T.L. has found that depression peaks at 8 p.m., anxiety at 11 p.m., self-harm at 4 a.m., and substance abuse at 5 a.m.

They have also been rockstars at training and supervising the volunteers. While 34 hours over 7 weeks seems a fairly short amount of time to equip someone with the knowledge, judgment, and sensitivity of being a crisis counselor, the strategies techniques, and quality of information presented rivals what I learned about crisis counseling in my doctoral program.

While crisis lines have existed in the United States since around the early 1900s, this service meets teens where they hold most of their conversations – through texting. Gregory points out that texts are four times more likely to be read by the recipient than e-mails. Texting also allows for privacy in public that a telephone call would not. Furthermore, cognitive psychologist Fred Conrad shared

[People are] more likely to disclose sensitive information via text messages than in voice interviews.

So many people including parents, teachers, and even mental health professionals slam their heads against walls trying to “get” to teens and young adults through traditional means. CTL, in my opinion, emphasizes the importance of meeting teens where they’re at, and as of 2015 the “where” is online through their phones.

Of course, I do have concerns about the security of those text messages and how that information is stored and shared, but that does not diminish the accomplishment of around 1.7 million teens helped and heard per year.

Two great resources for those interested in telehealth:
Telehealth Basics, National Center for Telehealth and Technology

Telehealth & TeleMental Health: The Ultimate Resource Page for Ethical, Legal, Clinical, Technological, & Practice Considerations

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