Nevada Garrett Lee Smith Local Evaluation Updates

1. Nevada Garrett Lee Smith Local Evaluation Updates June 9-10, 2011

2. Local Evaluation Overview • Stakeholder Reports • PreventionPays Text Messaging Service (PPTMS) Program Update • Plans for PPTMS Expansion

3. PPTMS: Reports to Stakeholders Quarterly Reports to Stakeholders and Project Team: • # of texts into system • Frequency, length, duration of texts • Texter demographics • Issues reported by texters • Details of text conversations with suicidal texters • Outcome of text conversations • Highlights from focus group conversations Conclusion Background Program Evaluation Results Evaluation Method

4. PPTMS Pilot Implementation Sites Conclusion Background Program Evaluation Results Evaluation Method

5. Social Marketing Materials Conclusion Background Program Evaluation Results Evaluation Method

6. Social Marketing Materials Conclusion Background Program Evaluation Results Evaluation Method

7. Conclusion Background Program Evaluation Results Evaluation Method

8. Pilot Evaluation Methods • Post-intervention text sheets • Cell phone carrier data • Focus groups with 113 middle and high school youth • Focus groups with Crisis Call Center’s 8 PPTMS staff Conclusion Background Program Evaluation Results Evaluation Method

9. Texter Characteristics Frequency of Texts: • 319 total text conversations • 49.4% of texters have texted in more than once Outcome of Texts: • 61.7% information/support • 30.1% no resolution/opt out • 7.3% texter calmed/de-escalated • 1.0% thank-you/all is well Conclusion Background Program Evaluation Results Evaluation Method

10. Length of Text Conversations Conclusion Background Program Evaluation Results Evaluation Method

11. Texter Demographics • Gender: • 51.7% female • 11.6% male • 36.7% unknown • Age: • 60.8% are ages 17 and under • 9.4% are ages 18 - 30 • 1.9% are ages 31 - 60 • 27.6% age is unknown Conclusion Background Program Evaluation Results Evaluation Method

12. Primary Issues Reported Conclusion Background Program Evaluation Results Evaluation Method

13. Referrals Provided Conclusion Background Program Evaluation Results Evaluation Method

14. Youth Focus Groups Focus Group Questions: • Are youth aware of program? • Do they know how and when to use it? • Do they relate to the social marketing materials? • Do they think people their age would use the program? • What issues do people their age face? • What resources do they currently use during crises? • What barriers would prevent them from using program? • Do they know someone who has used the line already? Conclusion Background Program Evaluation Results Evaluation Method

15. Youth Focus Groups Are Youth Aware of Program? • All youth were aware of program • Most knew when they could use program Do They Know How to Use It? • Nearly all understood how to use it • Some confusion about who responds to texts Conclusion Background Program Evaluation Results Evaluation Method

16. Youth Focus Groups Do they relate to marketing materials? • Positive reaction to marketing materials and location • Frustration with destruction of materials • Considered age and tone-appropriate • Want more information on line confidentiality Would they use it? • Most would refer friends to program • Best when youth “just want to talk” and want anonymity • Might not be appropriate for all crises Conclusion Background Program Evaluation Results Evaluation Method

17. Youth Focus Groups What issues do youth face? • Relational and physical bullying, depression, sex-related issues, drug/alcohol abuse, interpersonal violence and conflict What resources do they use when in crisis? • Frustration with current resources available • Reliance on friends during crisis • Mistrust of school-based resources Conclusion Background Program Evaluation Results Evaluation Method

18. Youth Focus Groups Barriers to text line use • No cell phones (~19%) • Concern about confidentiality/anonymity • May not be appropriate for all crises Know someone who has used it? • 8 knew someone who had used it • Generally positive • “They texted back pretty fast so that kinda shows like… they like care.”“ Yeah it showed they took it seriously and that they were concerned.” Conclusion Background Program Evaluation Results Evaluation Method

19. CCC Focus Groups • Strengths of system • Weaknesses of system • Opportunities to improve system • Threats to improving system Conclusion Background Program EvaluationResults EvaluationMethod

20. CCC Focus Groups Strengths of the system: • Meeting unmet youth need • Anonymity of CCC staff • Saved record of all text conversations • Call line strategies can be used with text line Conclusion Background Program Evaluation Results Evaluation Method

21. CCC Focus Groups Weaknesses of the system: • No voice cues from texter or staff • Length of text conversations • Need to multi-task between texting and calling • Frequent opt-outs Conclusion Background Program Evaluation Results Evaluation Method

22. CCC Focus Groups Opportunities to improve system in future: • Acknowledging differences between texts and calls • Assigning select staff to texting full-time • Resource and strategy-sharing • Identification of staff who excel at texting • Adapting call sheets to text capabilities Conclusion Background Program Evaluation Results Evaluation Method

23. CCC Focus Groups Challenges to Overcome for the Future: • Need more texts • Difficult to connect youth to resources • Difficult to transition crisis texter to phone Conclusion Background Program Evaluation Results Evaluation Method

24. New Social Marketing Materials Conclusion Background Program Evaluation Results Evaluation Method

25. New Social Marketing Materials Conclusion Background Program Evaluation Results Evaluation Method

26. New Social Marketing Materials Conclusion Background Program Evaluation Results Evaluation Method

27. Conclusion • PPTMS increased youth help-seeking behaviors • Response to program and materials very positive • Youth and adults use Crisis Line differently • Phone-based strategies can be adapted for text line • Difficult to gather demographics on texters Conclusion Background Program Evaluation Results Evaluation Method

28. Future Directions • Expansion throughout Nevada • Follow-up with text line users • Coordination with other text-based treatment programs • Development of training materials • Evaluation of long-term outcomes • Publication of evaluation findings • Book chapter on emerging crisis call center technologies in Crisis Intervention & Counseling by Telephone • Journal article in development 28 Conclusion Background Program Evaluation Results Evaluation Method

29. “I personally was like ‘Finally! Something that this school needs.’” -16 year old female “Sometimes, you know, you just want someone to talk to. You don’t really want them to fix the problem, but you just want someone to talk to.” -13 year old male

30. “I don't feel cornered anymore. I feel like I can breathe a little bit better...You have helped so much. Thank you very, very much!” -34 year old male, father of three children