Crisis Text Service Use Among Young Adults With Suicidal Ideation: Findings From a Survey Study

Suicide continues to be a leading cause of death among young adults aged 18-25. Young adults are increasingly turning to crisis text services (CTSs) for support with suicidal ideation (SI). This study identified characteristics associated with young adults' CTS use and outlined suggested improvements from users ("texters").

Young adults with a history of SI (n = 118) were recruited online and completed a cross-sectional survey. The quantitative data were analyzed using descriptive statistics and chi-square tests, and the qualitative data were analyzed using content analysis.

CTS use was associated with female sex, minoritized sexual orientation, having a mental health provider, and prior hospitalization for SI or a suicide attempt. Texters were more likely than nontexters to use other support sources. The most common barriers to CTS use were thinking it would not help (46%), embarrassment (41%), and wanting to solve the problem independently (35%). Texters recommended enhancing CTS by fostering warmer, more validating, and personalized interactions; improving availability and response times; and counselor training to tailor support to individual needs.

While young adults often use CTSs alongside other supports for SI, this study identifies opportunities to strengthen their usefulness and impact. Enhancing accessibility, personalization, and cultural responsiveness may help CTS better meet the needs of diverse young adults.