Veterans May Seek Crisis Counseling Via Internet Chat

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washington, dc—The VA and Substance Abuse and Mental Health Services Administration (SAMHSA) want to take advantage of new opportunities afforded by evolving technology to reach those who are suicidal, officials said last month at the 2010 DoD/VA Suicide Prevention Conference. “It has been part of our effort to try to adapt ourselves [to changing technologies],” said SAMHSA suicide prevention expert Richard McKeon, PhD.

In 2009, over 625,000 calls were answered through the National Suicide Prevention Lifeline, a toll-free number that is funded by SAMHSA. In an effort to broaden the reach to suicidal veterans, the Veterans Suicide Prevention Hotline was launched in 2007 as a collaborative effort of the VA and SAMHSA to help veterans access crisis counseling and behavioral health services. By calling the hotline at 1-800-273-TALK, veterans can press “1” and be connected with a VA-operated call center in Canandaigua, NY, staffed by professional crisis workers.

In order to reach an increasing number of veterans who are online, the VA last year launched “Veterans Chat,” a pilot online chat service. “Probably, they are not watching TV as much as they are on the Internet and communicating with people via the computer,” said Jan Kemp, RN, PhD, VA’s National Suicide Prevention coordinator. The chat allows veterans, families, and friends to anonymously chat with a VA counselor. If the VA mental health clinician decides that the veteran with whom they are chatting is a danger to themselves and a crisis intervention is needed, the veteran will be asked to provide a phone number where VHA Suicide Hotline staff may contact the veteran.

Kemp said VA decided that providing a chat service was important because many people are reluctant to call a suicide hotline, but are comfortable communicating online. In addition, for many of those who had deployed, the computer was their lifeline in theater and so they would prefer to communicate online. “We started getting e-mail messages from veterans who said, ‘I don’t want to talk over the phone, will you talk to me over e-mail?” she said.

Chat Service Is Useful

The portal for the chat service is located on the National Suicide Prevention Lifeline website. Since its launch in July, nearly 2,500 real chatters have accessed the chat service despite limited promotional efforts, according to Kemp. Of those people who had used the chat service as of mid-January 2010, about 1,000 had talked about suicide. About 330 of those who talked of suicide were referred to the Suicide Prevention Hotline so they could receive additional assistance, and over 80 were rescued.

One difference between the chats and the suicide telephone hotline is that conversations in the chat room are not “linear” as they would be in a phone conversation, Kemp noted. The chat can also be challenging because it is more difficult to physically locate a person who is engaging in a chat who may need an immediate rescue, versus someone who calls the suicide hotline. “We really do have an inability to know who is on the other end. We don’t get their e-mail address, so we cannot even e-mail them,” said Kemp.

Kemp noted that they have learned that people will use this service if it is available. In addition to veterans, servicemembers are also using the chat service. “People truly are much more apt, I think because they are anonymous and because it is safe, to talk about what is really bothering them over the chats than they are actually over the phone,” she said.

McKeon said that phone texting has even been explored as an option to reach those who are suicidal. He said that in Great Britain a texting crisis service is being promoted by the Samaritans, but there are still issues they are working on. “What they are struggling with is being able to get the text response back quickly…but they are grappling with it, which is what we all need to be doing.”

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