Dan Strauss, Executive Director
The Alex Project
Dan Strauss lost his 17-year old son, Alex, to suicide on October 11, 2010. Alex preferred communicating by text rather than by phone, and had texted friends and his counselor on the night of his death. Motivated to eliminate that communication barrier for young people in crisis, Mr. Strauss established The Alex Project, which supports crisis help line services by text. Care for Your Mind interviewed Mr. Strauss about youth suicide prevention and Alex’s experience with mental health care.
We Need to Provide Services that Young People Will Use
Crisis Intervention by Text Message for Preventing Youth Suicides
Care for Your Mind: While you were seeking treatment for Alex, what problems did you encounter in finding services and providers that were appropriate for him?
Dan Strauss: One of the biggest problems was the “hammer and nail” or silo syndrome. Understandably, treatment providers tended to have one area of expertise and one set of tools with little visibility to other areas and services. The implication was that when we were working with a psychiatrist, the key to Alex’s treatment was more medications. When we were working with a social worker, the key was for Alex to get a job. With a psychotherapist, the key was for Alex to sign a “No Harm Contract.” With a church counselor, the key was to take away Alex’s iPod. With an athletic coach, the key was to push Alex harder.
CFYM: What resources, if any, did you find helpful?
DS: In theory, an integrated approach could have been helpful. However, not surprisingly, you need to look beyond the program title to verify that the program really is a collaborative effort between different services and providers.
CFYM: You have identified an apparent gap in suicide prevention: the need for crisis support to be more available by text, particularly for young people. Can you explain why this gap exists and what you believe is a solution?
DS: Based on my interviews with crisis center directors, the gap exists because of “fear and funding.” With all good intentions, many crisis center directors are conservative with respect to new technologies, largely because they are literally dealing with life and death. Voice help line processes and technologies are familiar and comfortable.
The other understandable factor is funding. A crisis center executive is typically working with a very tight budget and substantial investments in voice-related help line assets such as staff training. It is not surprising that more than one director told me that the key was “simply to figure out a way to get the teenagers to call them” instead of text messaging.
A solution that seems to work is to find a few leaders who are doing pioneering work, establish some early successes with them, and then market the heck out of it until enough people notice and run with it. The Reno Crisis Call Center is a great example of a pioneering group.
CFYM: What role, if any, do you believe the government should have in making text-based crisis intervention available? Who else should be involved, and in what ways?
DS: Just as in the case with the National Suicide Prevention Lifeline, government can and should provide the funding for the network infrastructure for text-based crisis intervention. This would facilitate nationwide crisis center collaboration. Of course the existing players should be involved as well. There are currently a few early-stage nationwide networks such as Crisis Text Line and 121Help.me that can be brought together along with Reno Crisis Call Center to take advantage of their different strengths.
CFYM: What do you think should be the other priorities in youth suicide prevention?
DS: Short-term: we need to keep the focus on eliminating stigma. Shame leads to concealed pain and death.
Mid-term: we need to keep adapting how we listen; keep reducing hurdles to reaching help. Text messaging access to help lines works because it is familiar, discrete, and available to youth. In a few years there will be another technology that youth are using. In the interim, there is still a lot of work to do in simply helping youth know that they can reach help via text messaging.
Longer-term: it would be wonderful to see more integrated community-based approaches for working with youth at risk for suicide. Think of what we could do if we had collaborative safety networks comprised of well-informed high school volunteers, psychiatrists, therapists, counselors, coaches, social workers, law enforcement, and faith-based groups.
CFYM: What advice or suggestions would you give to a parent who is concerned about their child’s mental health?
DS: Don’t wait for the answer from the experts. No one cares as much as you do. Do your own homework. This is why the type of training, education, and support that Families for Depression Awareness provides is so vital. There are few more important roles for a parent to take than to advocate for their child’s mental health needs.
Your Turn
- How can we overcome the “fear and funding” issues preventing text message crisis center services?
- What are other communication barriers that need to be addressed in the youth suicide prevention effort?
- Have you experienced collaborative care for you or a loved one? If so, did it help?
The Alex Project promotes texting access to lifesaving crisis center services: If you need help, text ANSWER to 839863. The Crisis Call Center will respond 24/7/365 and help get you through it.
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