health & science

Cyberspace solution to #depressed

Operators of a new, "radically genuine" online support service for vulnerable young people have a simple strategy for a complex problem

Zeal’s head office sits in the same west Auckland building as the West Wave pools. In the foyer is a tidy arrangement of amenities; a pool table here, an arcade machine there, barista gear by the wall – opposite the full service cafe counter - and by the front door rests a ring of couches occupied by a gaggle of giggling kids.

I meet Elliot Taylor, the advocacy and communications manager, in a little side office where two young adults are tapping away on laptops. They look like typical uni students. One moves in his chair with a kind of nervous energy. The other is looking equally engaged in her work, but more relaxed. Resting by her side is a pencil case with the words: “I’m too busy for your bullshit.”

I read it aloud, make my apologies, and turn to leave. My BS is trivial. The pencil case’s owner, a volunteer in a new online communications team, laughs through her embarrassment and tells me it was given to her.

The message is a joke, obviously, but her work is not.

Taylor walks me through the Zeal complex - passing two live concert spaces, a dance studio, an audio engineering classroom, and a couple of nondescript corridors - before we arrive in the art room to talk about the conversations that nobody should be too busy to have, if only they knew where to look and how to listen.

The nuts and bolts of Online Crisis Intervention

Since last year Zeal, a network of support and advocacy services for vulnerable young New Zealanders, has run a small pilot for Online Crisis Intervention. It is a digital counselling service connecting volunteers in New Zealand with young people in crisis – anywhere - disclosing their problems over social media.

Taylor says that to the organisation, “crisis” means when a young person is at risk of harming themselves or someone else, but it’s more important to understand how a potential service user defines it.

“If a young person is using language that would indicate that they feel they are in crisis and don’t have anyone to talk to, that’s something we should honour and respect, and provide support for,” he says.

The process adheres to an “identify, respond, care” model. Understanding the first part is key to understanding the benefit of the service – and the overwhelming odds it faces.

Taylor holds up his phone and opens up his social media dashboard.

“Are we coping with the need? Of course not. Let’s see if we’re coping with the need. I’m searching the hashtag #depressed: 9,598,000 posts.

"38 seconds ago: ‘Can someone save me?’. ‘I want out, I want to fucking die,’ two minutes ago. ‘Took this before I threw up,’ three minutes ago. ‘Help,’ four minutes ago. ‘What is the point?’, four minutes ago.”

It goes on and on.

Taylor continues: “All I’m doing is searching a hashtag here. Anyone could do that. The way we identify young people has obviously a little more smarts to it, but that’s why this project is complex in some respects - but it’s also very simple. All we’re doing is holding this up to the world and saying ‘shouldn’t someone say something, shouldn’t someone do something?’

OCI searches for public social media posts using hashtags like #depressed or #suicidal, then volunteers can start conversations.

“Once we’ve identified the young person that’s struggling, we say something along the lines of ‘hey, I noticed your post and it seems like things are really hard for you at the moment, I’m really sorry to hear that. I’m here for the next hour or so if you’d like to have a chat.’”

Taylor admits different people have different reactions to being contacted with an offer of help.

“We’ll land a comment on their post but largely we find if we direct message someone they’re pretty appreciative that we’re going out of our way to provide them support.

“Sometimes a young person will peek through the curtains, sometimes they’ll open the door a bit, have a look through and say hi. Sometimes they’ll say ‘I’m doing okay’ and sometimes they’ll say ‘I really appreciate you asking.’

“We’ve been able to increase that response rate from about 50 percent up into the 90s just through thinking critically about how to reach out to young people.”

"All we're doing is holding this up to the world and saying 'shouldn't someone do something?'" Photo: Troy Rawhiti-Forbes

Safety matters

Direct messaging, also known as private messaging, is where the real conversations are held. Just as a power company or bank must invite a customer with a service query on Facebook or Twitter into a private chat before personal information like an account number could be disclosed, it is in the direct messages where a vulnerable person can go into detail – as much or as little as they want – with an OCI volunteer.

Taylor and his team take online privacy seriously, and he reiterates the way into counselling conversations is through comments that vulnerable youths have published into public social media streams.

“One of the first questions people ask is ‘how does privacy work with this, is this invasive?’ We’re talking public accounts where people in crisis are reaching out and disclosing what’s going on. We’re reaching out to them, and they opt in to the conversation."

Taylor reads a couple of lines from one interaction that an OCI volunteer had with a young person:

OCI: “Hey there, I just saw your posts and it seems like you’re having a really tough time at the moment. I’m [name] and I’m here to talk if you need some support. :) ”

USER: “Hey, I really appreciate the fact that you’re reaching out to me but it feels pretty hopeless now, so I guess that’ll make it pretty challenging.”

This interaction, says Taylor, continued on and off over several hours - as a typical text message exchange might.  He says chat snippets are sometimes shared in situations like our interview, but any hint of personal information is scraped away and conversation transcripts are not available to anyone.

“We did an independent report of randomly-selected conversations we sent to Clinical Advisory Services Aotearoa. (CASA.) They came back to us and said we were protecting privacy incredibly well in these conversations.”

Where safety – a separate and equally critical issue – is concerned, Taylor says Zeal considers two key factors, and the safety of a vulnerable young person is paramount. The team uses an assessment process to determine what kind of risk a young person actually has. This, he says, “changes the trajectory of the conversation” and ensures that the one being had is the one that is necessary.

“We’re not going to fix their life. We aim to provide that listening ear and support, and strengthen coping and protective factors – whatever they may look like.”

Taylor cites a recent interaction with a young person in Canada who said there was no one in her life talking with her about her struggles. (Because users' locations are not readily available to OCI, it serves as a borderless operation.) A volunteer offered to look for local support services in her area and, after some judicious use of Google, made some recommendations.

The safety of volunteers also matters. The team includes students of psychology and social work, as well as people with a genuine interest in mental health and wellness support. It begins each shift with an assessment to gauge whether members are in the right headspace to undergo this uniquely demanding work. They are then supervised in each interaction by a senior member who won’t join the conversation directly but will provide support, and they are debriefed after sessions.

Service with a :)

Taylor says most volunteers are millennials – aged 18-35 – because they are naturals in the context of social media communication.

“We’re having conversations in social media, so you have to understand social. Every conversation has a context, the unsaid, the phatic component, as does the context of social media chat. We have to embody that. If we come across cold and impersonal, then young people won’t engage with us.

“It’s much the same as if you turned up at your mate’s wedding in Stubbies and a singlet, everyone’s going to look at you slightly weird because your manner is not appropriate to the context. It’s just in the nature that if you’re a millennial, you understand the rules of engagement and the lexicon of social. That’s important and it’s why millennials are fairly good at this, with appropriate use of emojis and idioms.

“CASA called the rapport that our volunteers were able to build with these users online ‘radically genuine’ which is quite special for us. One of the things that comes out in research, both in counselling and intervention, it’s the rapport that bears the fruit – not the nature or the context of the conversation. Where a strong rapport is built between a counsellor and client, that’s where growth happens.

"Of course models of practice have to inform all of that and they inform what we’re doing but ultimately we’ve got to get that base of rapport down, so I’m really proud of that fact.”

Taylor says like a typical startup, OCI undergoes a constant cycle of review and refinement. With the support of the Vodafone Foundation and an upcoming $160,000 grant from the telco, OCI is now expanding. A new drive for volunteers is underway and the service is broadening its support networks in New Zealand.

Taylor says the relationship with its giant-sized benefactor is a natural fit. After all, it is with the technology that Vodafone and other digital networks provide that these conversations can take place.

Taylor raises his phone and says “it’s right there in your face. Young people are struggling with mental health, and young people are online.”

There's a responsibility to help when help is needed, he says.

"If a kid just walked up to me or if one of our youth workers in Henderson walked up to a young person hanging out under the bridge, and they said ‘I want out, I want to fucking die’ then don’t you have a duty of care?”

In 2013 a postgraduate academic at Oxford University, Kate Daine, led a global review of 14 different studies into how young people used the internet.

The research revealed a range of contradictions over whether the internet was a positive or negative influence on young people, particularly in respect of their mental health. Daine was clear on one thing:

"There are no known online interventions to date that specifically target young people at risk of self-harm or suicide and yet we find that adolescents who self-harm are very frequent users of the internet. "

That has become the OCI rallying cry.

Where to get help:

- Lifeline: 0800 543 354 (24/7), Youthline: 0800 376 633 (24/7), text free to 234 (8am-midnight) or live chat (7pm-11pm)

- Kidsline: 0800 54 37 54 (24/7; Kidsline Buddies available 4pm-9pm)

- Suicide Crisis Helpline: 0508 TAUTOKO / 0508 828 865 (24/7)

- What's Up: 0800 WHATSUP / 0800 942 8787 (1pm-10pm weekdays, 3pm-10pm weekends) or live chat (5pm-10pm)

- Healthline: 0800 611 116 (24/7)

- Samaritans: 0800 726 666 (24/7)

- Depression Helpline: 0800 111 757 or text free to 4202 (24/7)

- If you feel you or someone you know is at immediate risk, call 111.

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