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The unexpected red-flag words and emojis suicide counselors look for, including ‘vampire’ and ’11:11′

  • An analysis of 129 million texts sent to non-profit Crisis Text Line showed the words people were most likely to use in a crisis. 
  • The more concerning words were not "suicide," they included "nightstand," "vampire," "800 milligrams," 💊, and 😭.
  • 75% of Crisis Text Line users are under 25 years old, and 12% are under age 13, making this a unique window into young Americans at their most vulnerable. 
  • Visit Insider's homepage for more stories.

A new data analysis released by Crisis Text Line, a non-profit that provides crisis counseling via text across the US, shows how young Americans express themselves in moments of need.

By studying 129 million texts sent over the course of six years, mostly from under-25s, the team created a word cloud of words that most often predict suicidal ideation or attempts.

As the coronavirus pandemic wears on, looking out for red flags that a person needs mental-health help has become even more important.

An August CDC report found that 10.7% of US adults contemplated suicide in June at the height of the pandemic, Insider previously reported. That's to compared to the 4.3% who contemplated suicide in 2018.

The population the reported the most suicidal ideation was 18- to 24-year-olds at 24%, followed by caregivers for adults at 30%.

The pill emoji and words like 'vampire' are signs a person needs immediate support

"Excedrin," "800 mg," and "ibuprofens" were the most commonly-used terms among teens struggling with suicidal thoughts, while slightly less popular terms included "nightstand," "vampire," and "railroad."

People who used the pill emoji were 4.4 times more likely to be in a life-threatening situation, while people who used the crying face emoji were 1.6 times more likely, Crisis Text Line's chief data scientist, Bob Filbin, told Insider.

People who text these crisis words will get a response within 5 minutes 

Some of the words, like "die," would be expected — it's something parents, teachers, friends would recognize as a concern. Others, like "vampire," "looney," and "11:11" are not typically thought of as red flags, Filbin said. 

"The why, of why these particular words were used, is less important than the what," said Filbin. "What's important is the what, which is knowing what words are associated with suicidal risks."

Using any of these words in a text to Crisis Text Line will have your call pushed to the front of the queue.
Crisis Text Line

If someone texts one of those words, they will be flagged by the Crisis Text Line system as a high risk for suicide attempts in the next 24 to 48 hours, and their message will be pushed to the front of the queue of people waiting for counseling help.

"96% of the people judged by the algorithm as in need of help will be helped in under five minutes," said Filbin. Two out of three counseling requests come in between 8pm and 4am, and 5,500 volunteer counselors are on hand waiting for them.

Evaluating if someone is at risk means evaluating if they meet all four of these criteria: if people are having suicidal ideation, if they have a means of suicide, if they plan to act in the next 24 to 48 hours, and if they have a specific plan for the process. 

If a situation cannot be de-escalated there is an active rescue. If the artificial intelligent system behind Crisis Text Line, as well as the counselor and the counselor's supervisor, all agree that the person is in need of rescue, emergency services may be called. If the texter's location isn't known, the counselor will work with the texter to figure it out. 

"The first step is to check in with the texter, then turn to other options," said Filbin. "Whether or not they want the police to come is in their hands."

Suicide rates are soaring among teens

The suicide rate in the US is steadily on the rise, increasing 24% from 2000 to 2012, with increases in nearly every single state, according to the CDC. In 2018, there were 48,344 suicides in America, and the year before that there were 1.4 million attempts, according to the American Foundation for Suicide Prevention.

The rate of suicide is highest for middle-aged white men, and men are in general are three times more likely to die by suicide than women.

Though lower among teens, the suicide rate has climbed significantly, up 56% among 10- to 24-year-olds in the US between 2007 and 2017. Crisis Text Line, which launched in 2013 in El Paso and Chicago, has expanded to cover all of the US, as well as Canada, the UK, and Ireland, and there is no shortage of messages. 

According to the report, published in February, 75% of Crisis Text Line users are under 25 years old, and 12% are under age 13, giving Crisis Text Line a unique window into young Americans at their most vulnerable. Some 68% of their texters tell the helpline things they've never told to another human being.

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