According to Nancy Lublin, the chief executive and co-founder of Crisis Text Line, a free mental health texting service providing confidential crisis intervention, the top three topics in conversations since the pandemic began have been “anxiety,” “depression” and “relationships.”
But in the past week, as the demonstrations over the deaths of George Floyd, Breonna Taylor and Ahmaud Arbery and others grew, conversations with the words “black, racism, riots and protest” have made up 10 percent of all conversations at Crisis Text Line. This is a significant increase from the usual appearance of such words in the global service’s conversations: The average is 1.5 percent.
Crisis Text Line, which has fielded 150 million texts since 2013, says many of its users are desperately looking for ways to connect and cope right now. Sixty-eight percent of texters say they’ve shared something they’ve never shared with another human being, Ms. Lublin said. “For many, using the text line is the first time they’ve ever opened up that they’re angry or that they’re scared.”
The service sees itself as an important gateway to the critical mental health services so many are in need of as the country simultaneously wades through multiple crises. A texter is greeted with an automated response asking what the crisis is, and an algorithm places them in the queue according to the urgency of the response. When its trained counselors respond, usually within minutes, they encourage texters to seek ongoing mental health support through in-person and telehealth options like BetterHelp.
[To reach the Crisis Text Line, text HOME to 741741 in the United States and Canada.]
Before the coronavirus shutdowns, 53 percent of the text line’s users were under 17, and the most frequently used word in conversations was “school.”
“It’s still the top word that they use, even though they’re not in school,” said Ms. Lublin, whose trained counselors have also seen a sizable uptick in texts from 18- to 34-year-olds, many of whom have had their lives disrupted in big and small ways. Counselors report an increase in texts about eating disorders and self-harm, and a decrease in suicidal ideation and texts that the counselors feel warrant real-life interventions.
Many texts relate to the long-lasting impacts of Covid and quarantine, including anxiety around “economic and financial ruin for families.”
Some teens have experienced devastating consequences of the pandemic: loved ones losing jobs or becoming ill and dying. And now, like all of us, teenagers are seeing a flood of images and news reports on racial conflict and structural inequality, adding to the distress.
Samantha Canter, a child therapist in child and adolescent psychiatry at Kaiser Permanente in San Francisco, works with teens looking for ways to support Black Lives Matter while respecting their parents’ fears about the coronavirus risk. There were “multiple sessions over the past week or so where teens are wanting to go to City Hall or wanting to go to the Mission District,” where protests have been taking place, Ms. Canter said. Some of the teens live in multigenerational households or see grandparents regularly.
For these teens, finding ways to show support requires assessing different levels of risk. “Does it mean staying home and doing something from your front porch? Does it mean contributing money to organizations that support black lives? Does it mean posting on social media or getting out in a crowd and navigating that risk or opening yourself up to risk in terms of Covid?” Ms. Canter asked.
“When you’re home around other people, it’s hard to talk on the phone about your anxiety or depression or anger or fear,” Ms. Lublin said. “Thank goodness for text.”
Ms. Lublin and the crisis counselors at Crisis Text Line are among those trying to offer help to those with anxieties about the future, but they acknowledge they “can’t solve your problems.” Instead, counselors are trained to help texters focus on “things that make you feel strong, things that make you feel in control, things that make you feel capable.”
Counselors ask texters about their plans for the night or the coming weekend to help refocus young adults on the present, Ms. Lublin said.
Dahyana Paul Schlosser, a child and family therapist and registered nurse from Brockton, Mass., noticed a correlation between the anxiety levels of her clients, who range in age from 6 to 26, and the amount of news coverage at home, often in the background. She advises families to limit media consumption and take time to discuss feelings. “Because everything happened so quickly, with lockdowns and shutdowns and people adjusting to the new norm, there wasn’t a whole lot of space made, oftentimes, to sit down and talk about, ‘Hey, how are we feeling about this?’ ”
Dr. Genevieve Daftary, the pediatric medical director at Codman Square Health Center in Boston, says telehealth visits with her teenage patients are some of her longest, and “pretty universally, they are experiencing real disconnectedness and loneliness.”
Some of Dr. Daftary’s teen patients are truly being tested, she notes. Codman Square is in a largely Afro-Caribbean neighborhood and a number of her young patients have a parent or guardian working in a front-line job. These patients are struggling as they realize the adults around them don’t always know what to do now. Their concerns are amplified because many teens “are heading into a time of year that usually brings them a lot of joy,” she said, but instead “they’re facing rather empty summers.”
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Updated June 12, 2020
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What’s the risk of catching coronavirus from a surface?
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
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Does asymptomatic transmission of Covid-19 happen?
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
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How does blood type influence coronavirus?
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
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How many people have lost their jobs due to coronavirus in the U.S.?
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
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Will protests set off a second viral wave of coronavirus?
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
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How do we start exercising again without hurting ourselves after months of lockdown?
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
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My state is reopening. Is it safe to go out?
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
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What are the symptoms of coronavirus?
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
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How can I protect myself while flying?
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
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Should I wear a mask?
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
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What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
Given the high rates of Covid-19 within the community, many families are afraid to let their kids go outside, and some of her work involves debunking myths and encouraging families to find safe ways to spend time outdoors — like going outside with a mask on and staying six feet away from others. In her conversations with teens, she encourages them to develop daily routines that include adequate movement and sleep. “I never use the word exercise,” she said, but will ask: “Are you getting a chance to move your body around?”
Ms. Canter noted that over the last week in San Francisco, teens and families have found creative solutions to show support for the calls to rethink policing in a time of social distancing, including a caravan protest that stretched throughout the city. “There were people in their cars for upward of two hours just honking and decorating their cars and really finding alternative ways to show up where you’re also socially distancing.”
Ana Homayoun is the author, most recently, of “Social Media Wellness: Helping Teens and Tweens Thrive in an Unbalanced Digital World.”
