Whether to expand a program into Koochiching County that has saved lives elsewhere is not a question in Meghann Condit’s mind — regardless of funding uncertainty.
“If we can save a life by making sure every kid has that (access to the program), we want to get it out sooner rather than later,” said Condit, regional TXT4LIFE grant co-coordinator.
The TXT4LIFE suicide prevention program gained presence last week in all Koochiching County schools, and plans are in the works for adding more services to the local community.
Nancy Lee, public health nurse for Koochiching County Health Department, presented information about the service to students at Littlefork-Big Falls, Indus and International Falls schools. She also educated county social service and public health staff to spread the word.
TXT4LIFE provides text counseling for suicide prevention and follow-up mental health services. Its focus is to provide an outlet for teens to seek help with a mental health crisis or suicidal thoughts, but is open to people of any age.
The program is based on research that shows, with the onset of the digital age, young people are more willing to reveal sensitive or difficult thoughts, behaviors or feelings through text messaging at far greater rates than verbally addressing them.
Starting in Carlton County, the plan was to wait a year to expand TXT4LIFE to other areas of the seven-county Arrowhead Region, which includes Koochiching. But urgent demand for the program and the discovery that it has already saved teens’ lives is pushing it to roll out on a regional level earlier than planned.
“We have to be really careful about how fast we can grow — we have to have the capability and capacity to answer the texts,” Condit said. “Basically the demand is really there, it’s just a matter of building the infrastructure.”
Reaching more teens is a priority, even in the face of staffing shortages and uncertainty of future funding.
The program is funded by a three-year $1.4 million federal grant through the Garrett Lee Smith Foundation. That makes $480,000 available each year to the seven counties. Carlton County is the fiscal host of the funding, but most of the money will be spent regionally, Condit said.
The future of the program beyond the three years is unknown, and there are concerns about current staffing not being able to meet the volume of texts the center receives.
Before TXT4LIFE, the program was the National Suicide Prevention Lifeline in which people experiencing life difficulties could call a toll-free number. The line was receiving about two to three calls per month.
With the inception of the text line, the center gets on average between 10 and 30 people texting per day — up to 36 people a day on a day with the highest volume. That’s 300 to 500 people using the service per month, compared to two or three per month on the voice call line.
Seeing such a need for the service, these statistics caused Condit and Joanne Erspamer, the other program coordinator, to roll out to Koochiching, St. Louis, Itasca, Aitkin, Cook and Lake counties to link area youth texters to a community call center and have local volunteers trained to help and raise community support and awareness.
“I’ve been presenting this to as many kids as I can in Koochiching County,” Lee said. “The kids were pretty attentive — they took it seriously.”
She and Condit are discussing the next steps.
“It’s not like we’re giving one piece of information and that’s it,” Lee said. “There will be new things coming to the community.”
Northeastern Minnesota has a “disproportionately higher concentration of suicides in the state,” according to a news release from Carlton County Public Health and Human Services. Some counties in the Arrowhead Region rank in the top 10 counties in the state for the highest concentration of suicides based on population.
“Basically, we don’t want the resources to stop at the text line,” Condit said. “The text line is a great initial step, but we want to connect them with something that’s local for crisis response.”
Condit and her team are building a network of organizations.
“There’s a combination of resources already, but we want to make it more official and have a process or protocol of what to do,” she said. “We have had quite a network of state support.”
Since word has gotten out, she added, organizations such as colleges and universities from other areas of the state have asked when they can get the information for the text line and make it available to their communities. The team is hoping to have a place holder in the next legislative session to secure funding for statewide expansion, Condit said.
Why the texting help line has quickly grown is because it’s “reaching the kids where they’re at,” Condit explained.
“Where they’re at is texting,” she said. “They know that the conversation is silent; there’s no worry about someone overhearing. You don’t have to say your feelings outloud, you can just write them down.”
The program includes training sessions in the community for the general public. Two people from Koochiching County have been identified to start certification to give one-hour training sessions called QPR, which stands for Question, Persuade, Refer. The trainers will teach the public about how to question a person after warning signs, persuade them to get help, and refer them to resources. Condit said the sessions for the general public will hopefully start late summer or early fall this year.
The other piece is offering two-day trainings to the general public to learn how to conduct an intervention, called ASIST, which stands for Applied Suicide Intervention & Skills Training. It teaches anyone from the general public to sit down with someone who is having life difficulties and talk them through what is going on.
“You don’t have to be a therapist or counselor to do this model, even though it’s a more in-depth intervention,” Condit said.
Four people have been identified in Carlton County to become certified to conduct the trainings. Those four will be shared with Koochiching County. The grant is funding training and certification, at a price tag of about $500 per person, Condit said.
“We wanted to keep it local and locate them around all the counties,” Condit said.
Some of the trainers will go to schools in the area to train students on QPR and ASIST, she said.
In the meantime, Condit and other people in the network working with the program — locally including Northland Counseling Center, Range Mental Health, Lutheran Social Services, University of Minnesota-Duluth, four tribes, and many other partners are developing ideas to stabilize funding for the program.
“We’re trying to wait for that funding to make the program sustainable,” Condit said. “We don’t want to create a really good resource and then have it gone.”
Currently, the text line is available from 3 p.m. to midnight every day and can be accessed by Arrowhead Region residents by texting “life” to 839863.
Conversations are underway to either open the center for extended hours, or go full-fledged statewide. Condit said it’s likely that the center will slowly increase hours, first from noon to midnight, and then open it 24/7.
“We assume that 3 p.m. to midnight is the heaviest time when kids are texting, but we don’t know for sure because we’ve never tried other hours,” Condit said. “The difficulty is the staffing.”
Lee emphasized in her presentations that suicide is the second leading cause of death for teens in Minnesota, second to vehicle crashes.
“These days, teens are talking with their thumbs,” Lee said. “When they don’t feel comfortable talking with their voice, they can text — it’s pretty non-threatening to them.”
Lee is working on putting up TXT4LIFE posters around the community with the text number. Locally, she is planning to talk with Northland Counseling Center, Friends Against Abuse advocates, psychiatrist Jeff Hardwig’s team at Rainy Lake Medical Center clinic campus, and Blue Heron Counseling. Lee plans to share the text numbers with those organizations to help spread the word in the community.
For now, Lee is not only informing people of using TXT4LIFE in a crisis situation, but how to help prevent suicidal thoughts from the start.
She gave examples of warning signs in all of her presentations that someone is not doing well.
“Warning signs, to me, means danger — don’t go there,” Lee said. “We need to flip around our thinking and start seeing warning signs as invitations. Invitations to ask questions and give people permission to talk about what they’re going through.”
2010 Suicidal thoughts and behavior survey, Koochiching County
6th grade:
•Self-harm: Nineteen percent of males and 13 percent of females have hurt themselves on purpose during the last year.
• Suicidal thoughts: Nineteen percent of males and 18 percent of females thought about killing themselves during the last year.
• Suicide attempts: Six percent of males and 3 percent of females have tried to kill themselves during the last year.
9th grade:
• Self-harm: No males and 7 percent of females have hurt themselves on purpose during the last year.
• Suicidal thoughts: Nineteen percent of males and 18 percent of females thought about killing themselves during the last year.
• Suicide attempts: No males and 2 percent of females have tried to kill themselves during the last year.
12th grade:
• Self-harm: Ten percent of males and 15 percent of females have hurt themselves on purpose during the last year.
• Suicidal thoughts: Twenty-one percent of males and 6 percent of females thought about killing themselves in the past year.
• Suicide attempts: Four percent of males and no females tried to kill themselves during the last year.
Source: Minnesota Center for Health Statistics, Minnesota Department of Health
