Dat e: April 2 1, More informat ion: Cont act David Paisley at Met hodology

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San Francisco Suicide Prevent ion Online Survey Research Test ing Elect ronic or Int ernet Based Counseling Programs in t he Bay Area Funded by CalMHSA Dat e: April 2 1, 2 0 1 2 More informat ion: Cont act David Paisley at davidp@sfsuicide.org. Met hodology San Francisco Suicide Prevent ion conduct ed an online survey bet ween February and April 2012 to test interest in electronic and int ernet -based counseling programs. The target group was Bay Area residents 18 years or older. 321 part icipant s were recruited through a link from San Francisco Suicide Prevention s website, advertising on Facebook and advert ising on Craigslist, which account ed for 72 % of respondent s. The remainders of respondent were recruited by sending out emails t o ment al healt h agencies asking agency st aff t o forward t o appropriat e client s. In general part icipant s t rended younger because of t he recruit ment met hod, wit h 48% under age 31 and 74% under age 41. 58% of participants were female. 57% of participants were white. 30% of participants considered themselves part of the LGBT community. Summary of Result s 67% participants have experienced significant depression in their lifetime. They were most likely to respond to their depression by talking to friends and family. Half indicat ed t hey at t ended face-to-face counseling. 8% called a hotline. 17% indicated that they did not seek help. 52% participants have experienced suicidal ideation in their lifetime. They were far less likely t o reach out to friends and family about suicide, than when they felt just depressed. These results may indicate there is far more stigma around suicidal ideation than depression. 46% indicated they attended face-to-face counseling. 14% called a hotline. 30% indicat ed t hat t hey did not seek help.

In t he past t hree years 1 2 % of part icipant s have called a crisis hot line f or any reason. 95% of those calling a hotline found the int eract ion helpful. 13% of participants indicated that they have used a chat service of any kind for emot ional support in t heir lifet ime. 92% found it helpful. Part icipant s were asked t o indicat e what was their preferred method of communication with friends and family when feeling depressed and they could not see anyone face-toface. 59% indicat ed t elephone and 17% indicat ed t ext as t heir first choice. When asked about t heir second choice, t ext, chat and email were about even. When asked about informat ion and referral for ment al healt h concerns, 55% of participants preferred to find information by searching and reviewing mental health websites, 52% preferred a telephone call, and 37% emailing a mental health agency (participant s were allowed multiple choices). Chatting and texting did not score as well. When part icipant s were asked how they would prefer to receive services if t hey felt depressed or isolated and face-to-face counseling services were not available, calling a hot line was most preferred at 67%, followed by one-on-one chat at 35%, searching informat ion websit es at 30%, emailing a crisis counselor at 22% and texting at 20%. When part icipant s were asked how t hey would prefer t o receive services if t hey felt suicidal and face-to-face counseling services were not available, calling a hotline was most preferred at 75%, followed by live one-on-one chat at 31%, texting was third at 18%. Part icipant s were t old t hat some crisis cent ers would be experiment ing wit h one-on-one chat, text and chat room services, and the crisis centers wanted feedback. In general, participants responded best to one-on-one chat and 51% felt they might use that type of service, 30% said they might use a text service and 19% indicated they might use a chat room. Less than 10% of participants indicated that they felt offering one-on-one chat and text services were a bad idea.

What is your gender? (Respondents could only choose a single response) Male 40.6% 130 Female 58.4% 187 Transgender 0.6% 2 Ot her 0.3% 1 Valid Responses 320 What is your age? (Respondents could only choose a single response) Under 18 0.0% 0 18-30 47.7% 153 31-40 25.9% 83 41-50 14.3% 46 51-60 9.3% 30 61+ 2.8% 9 Valid Responses 321

What is your et hnicit y? (Respondents could only choose a single response) Whit e / Caucasian 57.0% 183 Black / Af rican American 4.7% 15 Lat ino / a / Hispanic 10.0% 32 Asian / Pacific Islander 15.9% 51 Nat ive American 0.3% 1 Mixed et hnicit y 9.0% 29 Ot her 3.1% 10 Valid Responses 321 Please check any communit y you ident if y wit h. ( Check all t hat apply) (Respondents were allowed to choose multiple responses) Het erosexual / St raight Male or Female Lesbian or Bisexual Female 70.4% 224 8.8% 28 Gay or BisexualMan 16.0% 51 Transgender or Int ersex 1.6% 5 Quest ioning your sexualit y 1.9% 6 Ot her 5.0% 16 Pref er not t o respond 2.5% 8 Valid Part icipant s 318

In what count y do you live? (Respondents could only choose a single response) Alameda 20.6% 66 Cont ra Cost a 9.7% 31 Marin 4.0% 13 San Francisco 41.4% 133 Sant a Clara 14.6% 47 San Mat eo 9.7% 31 Valid Responses 321

In t he last f ive years, have you ever felt so depressed t hat it had a negat ive impact on your life, relationships, school or work? (Respondents could only choose a single response) Yes 67.3% 216 No 20.6% 66 Not Sure / Maybe 11.5% 37 Pref er not t o answer 0.6% 2 Valid Responses 321 How did you respond t o your depression? (Check all t hat apply) (Respondents were allowed to choose multiple responses) I at t ended f ace-to-face counseling or received professional help 50.7% 108 I called a hot line 8.0% 17 I visit ed f riends, f amily or a partner in person to get support I t alked about it wit h friends, family or a partner on the phone to get support I emailed or t ext ed a friend, family or part ner to get support 58.2% 124 56.8% 121 35.2% 75 I did not seek help 16.9% 36 I responded in a way that is not listed 25.4% 54 Pref er not t o answer 0.0% 0 Valid Part icipant s 213

Have you ever felt suicidal in your lifetime? (Respondents could only choose a single response) Yes 52.2% 166 Maybe 11.9% 38 No 33.0% 105 Pref er not t o answer 2.8% 9 Valid Responses 318 Tot al Responses 318 How did you respond t o your suicidal t hought s? (Check all t hat apply) (Respondents were allowed to choose multiple responses) I at t ended f ace-to-face counseling or received professional help 46.1% 76 I called a hot line 13.9% 23 I visit ed f riends, f amily or a partner in person to get help I t alked about it wit h friends, family or a partner on the phone to get help I emailed or t ext ed a friend, family member or partner to get help 35.2% 58 37.6% 62 16.4% 27 I did not seek help 29.7% 49 I responded in a way that is not listed 30.3% 50 Pref er not t o answer 1.2% 2 Valid Part icipant s 165

10. In t he last t hree years, have you ever called any crisis t elephone line or emot ional support line for any reason? (Respondents could only choose a single response) Yes 11.9% 38 No 87.4% 278 Pref er not t o answer 0.6% 2 Valid Responses 318 You indicat ed t hat you called a t elephone line or emot ional support line. Was your int eract ion with the call line helpful? (Respondents could only choose a single response) Signif icant Help 42.1% 16 Some Help 52.6% 20 No Help 5.3% 2 Don't Know 0.0% 0 Valid Responses 38

Let s pret end you are feeling upset or depressed and you are not able t o t alk t o someone face-to-face. What is your first preferred method of communicating with friends and family when you are feeling upset or depressed. (Please check one) (Respondents could only choose a single response) Phone Call 59.2% 184 Text 17.4% 54 Chat ( wit h one person) 12.9% 40 Email 6.4% 20 Chat room ( wit h multiple people) 0.0% 0 Ot her 3.9% 12 Pref er not t o answer 0.3% 1 Valid Responses 311 What is your second most preferred method of communicating with friends and family when you are feeling upset or depressed. (Please check one) (Respondents could only choose a single response) Phone Call 24.8% 77 Text 28.0% 87 Chat ( wit h one person) 17.7% 55 Email 20.3% 63 Chat room ( wit h multiple people) 0.6% 2 Ot her 8.0% 25 Pref er not t o answer 0.6% 2 Valid Responses 311

In t he last week, did you use a chat room f or any non-work related reason? (Respondents could only choose a single response) Yes 14.4% 45 No 85.6% 267 Pref er not t o answer 0.0% 0 Valid Responses 312 How many hours did you spend in chat rooms over t he past week? (Respondents could only choose a single response) Less t han an hour 51.1% 23 1-2 hours 33.3% 15 3-5 hours 8.9% 4 6 or more hours 6.7% 3 Pref er not t o answer 0.0% 0 Valid Responses 45

If you were seeking counseling or ment al healt h services f or yourself or f or someone else, which of t he following methods would you prefer to use to get information or a referral? (Check all that apply). (Respondents were allowed to choose multiple responses) Phone call t o a crisis counselor at a hot line Email t o a ment al healt h service agency Text communicat ion t o a ment al healt h service agency Live chat (one-on-one) to a mental health service agency Searching and finding informat ion on a ment al healt h websit e Calling an inf ormat ion line, for example 411 or 211 51.9% 160 37.3% 115 17.2% 53 32.8% 101 54.9% 169 16.2% 50 Ot her 10.7% 33 Pref er not t o answer 0.6% 2 Valid Part icipant s 308

18. Do you have medical insurance of any kind? (Respondents could only choose a single response) Yes 83.6% 260 No 15.4% 48 Ot her 0.3% 1 Pref er not t o answer 0.6% 2 Valid Responses 311 Does your healt h insurance cover ment al healt h appoint ment s? (Respondents could only choose a single response) Yes 62.9% 163 No 8.1% 21 I do not know 29.0% 75 Valid Responses 259

If you had a st rong f eeling of depression or isolat ion, how would you pref er t o get help if a face-to-face counseling service was not available? (Check all t hat apply) (Respondents were allowed to choose multiple responses) Phone call t o a hot line and speaking wit h a crisis counselor Email t o a crisis counselor Text communicat ion t o a crisis counselor Live chat (one-on-one) on the computer wit h a crisis counselor Chat f orum ( mult iple people) facilitated by crisis counselors Searching and looking on a website for informat ion 66.7% 202 22.1% 67 19.8% 60 35.3% 107 9.9% 30 29.7% 90 Pref er not t o answer 1.0% 3 Ot her 7.9% 24 Valid Part icipant s 303

If you felt suicidal how would you prefer t o get help if a face-to-face counseling service was not available? (Check all t hat apply) (Respondents were allowed to choose multiple responses) Phone call t o a hot line and speaking with a crisis counselor Email t o a crisis counselor Text communicat ion t o a crisis counselor Live chat (one-on-one) on the computer with a crisis counselor Chat f orum ( mult iple people) facilitated by crisis counselors Searching and looking on a website for informat ion 75.2% 228 15.5% 47 17.8% 54 31.4% 95 6.3% 19 14.2% 43 Pref er not t o answer 1.7% 5 Ot her 5.0% 15 Valid Part icipant s 303

Have you ever chat t ed online wit h a counselor or used inst ant messaging f or emot ional support for any reason? (Respondents could only choose a single response) Yes 12.8% 39 No 86.6% 264 Pref er not t o answer 0.7% 2 Valid Responses 305 You indicat ed t hat you have chat t ed online or used inst ant messaging for crisis or emot ional support. Was your int eract ion helpful? (Respondents could only choose a single response) Signif icant Help 44.7% 17 Some Help 47.4% 18 No Help 7.9% 3 Don't Know 0.0% 0 Valid Responses 38

Some crisis cent ers are t hinking about offering crisis services by int ernet or t ext. What do you t hink of t he idea of offering crisis counseling services by text? (Check all that apply) (Respondents were allowed to choose multiple responses) It ' s a good idea, I would use t he service It ' s a good idea, but I probably would not use the service 30.2% 91 51.8% 156 I t hink it is a bad idea 9.3% 28 I do not use t ext 5.0% 15 I don' t t hink many people would use this service 12.3% 37 Pref er not t o answer 1.3% 4 Valid Part icipant s 301 What do you t hink of t he idea of offering crisis counseling services by chatting one-onone on a computer? (Check all that apply) (Respondents were allowed to choose multiple responses) It ' s a good idea, I would use t he service It ' s a good idea, but I probably would not use the service 50.8% 153 43.9% 132 I t hink it is a bad idea 2.7% 8 I do not use one-on-one chat services I don' t t hink many people would use this service 5.3% 16 4.3% 13 Pref er not t o answer 0.7% 2

Valid Part icipant s 301

What do you t hink of t he idea of offering crisis counseling services on an on-line chat room with multiple users and a crisis counselor to moderate? (Check all that apply) (Respondents were allowed to choose multiple responses) It ' s a good idea, I would use t he service It ' s a good idea, but I probably would not use the service 18.6% 56 41.2% 124 I t hink it is a bad idea 24.3% 73 I do not use chat rooms 17.3% 52 I don' t t hink many people would use this service 7.6% 23 Pref er not t o answer 3.7% 11 Valid Part icipant s 301