JAACAP Open (Sep 2025)

Characteristics of Youth Crisis App Users: Mental Health Service Access and Barriers and Perceptions of Helpfulness

  • Mindy Westlund Schreiner, PhD,
  • Brian W. Farstead, BS,
  • Myah Pazdera, MS,
  • Amanda V. Bakian, PhD,
  • Brent M. Kious, MD, PhD,
  • Karen Manotas, MD,
  • Sheila E. Crowell, PhD,
  • Erin A. Kaufman, PhD,
  • Scott A. Langenecker, PhD

DOI
https://doi.org/10.1016/j.jaacop.2024.06.006
Journal volume & issue
Vol. 3, no. 3
pp. 421 – 430

Abstract

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Objective: By developing a more nuanced understanding of youth using crisis line services, greater strides can be made in addressing their mental health needs. SafeUT is an app-based mental health crisis service that is offered to nearly all youth living in Utah and provides 24/7 access to licensed clinicians by phone or text. This study characterized youth using a statewide mental health crisis service and identified barriers to care. Method: SafeUT users were offered the opportunity to complete a survey regarding demographics, their experiences with mental health services, and self-injurious thoughts and behaviors. Results: A total of 210 youths completed at least part of the survey. More than half of the sample identified as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and others). Less than half of the sample had received mental health services. Not wanting to talk to a parent/guardian was the most frequently endorsed barrier. In the 2 weeks preceding the survey, 50% of youth engaged in self-injurious behaviors (18% suicide attempts). Following their SafeUT encounter, youth indicated significant reductions in the intensity of their presenting concerns. Conclusion: SafeUT appears to be effective in reducing acute concerns. However, youth still receive insufficient mental health support. Addressing barriers is imperative in ensuring that youth receive appropriate mental health care. Plain language summary: Youth mental health crisis app users were asked to complete a survey after completing an encounter with an app clinician. About half of respondents reported engaging in self-harm in the past two weeks. Less than half reported receiving formal mental health services, with not wanting to talk to a parent or guardian being the most endorsed barrier (54%). While a significant decrease in the intensity of presenting concerns followed app interaction, more work is needed to address barriers to additional community mental health services for these high-risk youth.

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