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Adolescents in crisis: A geographic exploration of help-seeking behavior using data from Crisis Text Line

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  • Thompson, Laura K.
  • Sugg, Margaret M.
  • Runkle, Jennifer R.

Abstract

Nearly 3 out of 4 all lifelong mental disorders occur by the age of twenty-four. Remote crisis support holds great potential in filling a critical gap in complementing and expanding access to mental health services for acute episodes of mental distress in adolescents and young adults; yet little is understood about the individual factors that influence help-seeking behavior in this group. Recent evidence suggests technology-based mental health services have high acceptability among youth and may be used to treat anxiety and depression. The objective of this study was to examine county-level help-seeking behavior among adolescents and young adults using Crisis Text Line (CTL). CTL is a free, text-based crisis counseling service that has been available nationally since 2013. Spatial error regression was used to (1) identify the individual-level factors that correlate with help-seeking behavior for depression, anxiety, and suicidal thoughts and (2) to explore the geographic trends in text-based help-seeking behavior between adolescents and young adults across the rural-urban continuum. Increased rates of text-based help-seeking occurred in counties with higher mean household incomes, higher divorce rates, and lower residential stability. Rurality was the strongest predictor for low rates of help-seeking, and this finding is particularly concerning in light of elevated rates of suicide among rural counties. Rural communities, particularly those with low support-seeking behavior and comparatively high suicide rates, should be the target of future research and outreach.

Suggested Citation

  • Thompson, Laura K. & Sugg, Margaret M. & Runkle, Jennifer R., 2018. "Adolescents in crisis: A geographic exploration of help-seeking behavior using data from Crisis Text Line," Social Science & Medicine, Elsevier, vol. 215(C), pages 69-79.
    • Handle: RePEc:eee:socmed:v:215:y:2018:i:c:p:69-79
    DOI: 10.1016/j.socscimed.2018.08.025
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    References listed on IDEAS

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    1. Reiss, Franziska, 2013. "Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review," Social Science & Medicine, Elsevier, vol. 90(C), pages 24-31.
    2. Singh, G.K. & Siahpush, M., 2002. "Increasing rural-urban gradients in US suicide mortality, 1970-1997," American Journal of Public Health, American Public Health Association, vol. 92(7), pages 1161-1167.
    3. Hempstead, Katherine, 2006. "The geography of self-injury: Spatial patterns in attempted and completed suicide," Social Science & Medicine, Elsevier, vol. 62(12), pages 3186-3196, June.
    4. McLaughlin, Katie A. & Breslau, Joshua & Green, Jennifer Greif & Lakoma, Matthew D. & Sampson, Nancy A. & Zaslavsky, Alan M. & Kessler, Ronald C., 2011. "Childhood socio-economic status and the onset, persistence, and severity of DSM-IV mental disorders in a US national sample," Social Science & Medicine, Elsevier, vol. 73(7), pages 1088-1096.
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    1. Hollar, Sara M. & Siegel, Jason T., 2020. "Self-distancing as a path to help-seeking for people with depression," Social Science & Medicine, Elsevier, vol. 245(C).

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