Nancy Lublin: Saving Lives With Text Messages
In a time of crisis, would you text someone for help? Millions turn to Crisis Text Line and find life-saving support. Founder and CEO Lublin explains why.
A lot of people, as it turns out. Crisis Text Line has processed 80 Million messages and counting.
Who are they? "[The people we serve] skew young, poor, rural and diverse," says Nancy Lublin, founder and CEO of Crisis Text Line.
Lublin is an entrepreneur turned not-for-profit CEO. Seven years ago, she was the head of DoSomething.org when the organization received a message that changed her life.
"Every time Do Something texts out a message, there's always a couple dozen messages coming back that have nothing to do with that campaign," Lublin recalls. "We got a message that said: "He won't stop raping me. It's my dad. He told me not to tell anyone." Then the letters, "R U there?"
Lublin has spent every year since building a way to be there for people who feel they have nowhere to turn — and doing it all by text.
In this episode of Crazy Good Turns, she sits down with host Frank Blake to discuss how text messages can become a much more powerful medium for help than most people realize, and the stunning (and potentially life-saving) things her organization learned from fielding more than 80 million messages from people in crisis. Listen now, or read the transcript below.
Frank Blake: Nancy, I want to start with your founding story for Crisis Text Line. What led you to found it?
Nancy Lublin: I was a CEO of a totally different organization called DoSomething.org. Do Something works with young people, to encourage them to volunteer and get involved in the community and do social change, all by text. It has about six million members right now all by text. Every week, Do Something texts them a different thing they can do, like collecting food for food pantries. Or lately they've been doing a lot of voter registration work.
Every time Do Something texts out a message, a couple hundred thousand kids do those campaigns. I mean, it's a massive, massive thing. But there's always a couple dozen text messages coming back that are out of flow. They'll have nothing to do with that campaign, but about something personal — like about being bullied, or about abuse at home, or something like that.
We would triage those, like anybody would do in customer service, when they get something out of flow.
We would respond by saying, "Hey, you should talk to your school principal or check out this organization." We'd give them a number for a hotline.But then we got a message that said: "He won't stop raping me. It's my dad. He told me not to tell anyone." Then the letters, "R U there?"
Frank Blake: God.
Nancy Lublin: Yeah. So we sent back the phone number for RAINN, the rape and incest organization in DC. They're terrific.
The next day I came in and said, "Have we heard back from her?" It's been seven years now, and we've never heard back from her. I don't know if it was a burner phone. I don't know if her dad saw the message. I don't know if she's dead or alive. About a year ago one of my employees said, "You know? You always use a female pronoun, you have no way of knowing if that texture even was female," which, fair enough. I don't.
Frank Blake: So you left DoSomething.org and just went off on your own and to start Crisis Text Line? How long did it take?
Nancy Lublin: Well, it was a little crazier than that. I did both at the same time for a while, which I don't recommend.
It took me awhile to get it off the ground. Do the math: We got that message seven years ago, and Crisis Text Line is five years old. It took me two years to get it off the ground.
It's hard to start new things. Even if you have experience, it's hard to start new stuff, especially new charitable entities. It was hard to get it off the ground.
Frank Blake: At what moment did you know, "I'm going to devote 100% of my time to this?"
Nancy Lublin: Well, it grew really quickly. I mean when we did launch in August 2013, within four months, we were in all 295 area codes in the United States. I was really just on the board and had hired a number of people to run it. Then about a year and a half in we realized it was taking off very quickly. You know, an organization is kind of like a baby. It needs its mommy. I left Do Something and just did Crisis Text Line full time.
Frank Blake: One of the things that we've been doing on Crazy Good Turns in the past few episodes is talking to folks who are using technology to help others in different and interesting ways. You have one of my favorite quotes on this.
It comes from a TED talk that you did in 2015, which I recommend to all of our listeners to look up, but I want to give you the quote and ask you to comment on it. The quote is:
"The only difference between me and those people in hoodies down the road with their fat funded companies, is that I am not inspired by helping you find Chinese food at 2 a.m. in Dallas or helping you touch your wrist and get a car immediately, or swipe right and get laid. I want to use tech and data to make the world a better place."
That, first, is just an awesome sentence. How did you get to that realization? Was that a starting point? Where does that come from?
Nancy Lublin: The amazing truth behind that is so that was the ending of the TED Women talk that I gave three years ago, and it was not planned. That was totally off the cuff.
I was at TED Women, and I mean as you would assume, it's mostly women. And I was on the stage, and looked up and saw a friend of mine who's a venture capitalist walk in in the back of the room. I was like, "What is he doing here?" Then I remembered he's the diversity partner for his venture firm. He's a white guy. Just to be clear, he's a white guy from Stanford. and he, at the time, was the partner at his firm who was assigned to like understand diversity.
I was just so like, "Are you kidding me? You're just going to sort of stand in the back of the room while I give this talk?" That basically got me fired up by seeing him in the back of the room. And so I just spoke from the heart. Your recanting of that quote was generous and calm. I was more animated when I did it and it was all from the heart and spontaneous, but I mean it.
Nancy Lublin: I mean, look. They're doing so much stupid shit with technology. There's so much stuff in Silicon Valley that's being made for Silicon Valley. We need the best minds on the biggest problems. We need the best technology on the biggest problems. Right now, I'm not convinced that's where the best people are going.
Frank Blake: I have so many different comments of yours to get into. Another one that I'd love for you to share your thoughts with our listeners is how you describe yourself as an entrepreneur, but add that an entrepreneur in a charitable organization basically is raising a round every year. I thought that was such a great description. Maybe you talk about what that feels like. And do you get some cumulative energy behind you, or is every year you're out plowing new ground every year?
Nancy Lublin: Honestly, it's a constant. I mean, anybody who's listening right now who's ever been involved with a not-for-profit organization knows it's like being on a hamster wheel. It's constant. I would love to say that it's like raising a round every year, but at least when people raise a round and it looks like rounds are being raised so quickly these days, like every 12 to 18 months, those are raised like in three months. Then at least the other nine months you're working on the product. I think most leaders and board members of not-for-profits and most board members of not-for-profits, all they're doing is constantly holding out their hand and asking for money.
I mean, there are people who haven't seen the backs of other people's hands in a long time. It's just constant. It's this weird, terrible business model. I mean, it really makes no sense.
Once again, this is for the most important stuff in society. It doesn't have a real business model. It's this weird, "Please give me money so I can do great things and I'll thank you, and I'll give you like a plaque or host a dinner where we honor you so that you feel good."
Frank Blake: What do you find is the most compelling when you set out your vision in front of others, what's more compelling? The personal stories or the data analytics that you're able to drive through what you're doing?
Nancy Lublin: That's a great question. I would say for the first 42 years of my life, I was going off of anecdote. Like most charities, I was doing dinners where you bring up some people on the stage and you make the people in the audience cry, and you hope they've had enough to drink so that they bid on the auction item or write a big check. I mean that is this weird handshake in the not-for-profit sector. With Crisis Text Line, I believe we are running a tech startup, and so I'm trying to run it that way.
I also think it's one thing to run a charity. That doesn't mean you are a charity and so I've decided to just go head on and lead with the data. I talk about the numbers. To answer your question, when I sit down with people, I'm like, "Look, here's the deal. You're either going to be into this or you're not, but I'm not going to make you cry, and I'm not going to tell you an anecdote and I'm not going to have someone whose child evaded suicide because we were there for them not that night."
Instead I'm going to say, "Look, here's the reality. Here's the numbers. Here's what's really hard about what we're doing. Here's what's expensive, and you're either going to be into it or you're not."
Frank Blake: What is some of that data? What do you lay out in front of people?
Nancy Lublin: I mean, it's like a pig in ninth grade biology. I like to kind of splay our insides and lay it on the table, because we have access to all of that data. We skew young, poor, rural and diverse, and so I talk about who our texters are. I talk about what kinds of issues they text in about and what the top five issues are, because I think that's pretty surprising.
Frank Blake: What are the top five?
Nancy Lublin: Relationships, depression, suicide, anxiety and self harm, which I did not anticipate being in the top five. I really thought bullying would be in there.
Frank Blake: Can you see changes over the last several years? Does the data change or does it reinforce patterns? What are you seeing?
Nancy Lublin: Yeah, good questions.
We see seasonality. We know that March through May is the toughest time for suicide. We see that while everybody thinks holiday is a really tough time of year, holiday is actually great. Holiday is terrific. Things kind of slow down for us over holidays, so that's good.
We see time of day. So we see that substance abuse, for example, spikes actually at 6 a.m., which I wouldn't have anticipated. We're busting all kinds of myths by having the volume, velocity and variety in this corpus to draw meaningful conclusions and spot trends.
Frank Blake: That's really interesting. Let me switch gears for a second. We share law school experience, and my description of law school is that it's a place that teaches people to care about things no normal person would ever care about. You've described law school is a place where ideas go to die.
Nancy Lublin: Ideas go to die, yep.
Frank Blake: So you started law school. When did you change your mind, or did you graduate?
Nancy Lublin: Oh, I started law school. And within the first few weeks I was baking a chocolate cake every week and not even letting it continue to bake before taking it out of the oven and attacking it with a fork. That was within the first few weeks. Yeah, law school sucked almost immediately.
I was like, "This is not like what I thought it was going to be from TV." I was also single. So when I dropped out, I was both single and not going to be a lawyer, so my parents and grandparents were very upset.
Frank Blake: You dropped out the first month?
Nancy Lublin: No, I dropped out after two years.
Frank Blake: Oh, two years. Oh, wow.
Nancy Lublin: Yeah, I know, right? I'm a glutton for punishment.
Frank Blake: You got through the hard part.
Nancy Lublin: Yeah. I did Dress For Success while I was a 1L in my first year, and I did both at the same time because that seems to be my MO. Then after my second year, when nobody drops out, I dropped out. Which was so dumb. And like I said, I was both single and not going to be a lawyer, so my whole family was pissed. I eventually did go back and finish, but by taking classes at the business school and letting me transfer it in.
Frank Blake: You've described yourself as an entrepreneur …
Nancy Lublin: Yeah.
Frank Blake: … and it's great to hear about the other things that you've done along the path to Crisis Text Line.
Nancy Lublin: I mean, I was always doing stuff. I was a weird kid. I tried to dig to China once.
Frank Blake: That wasn't successful.
Nancy Lublin: No, no, but landscapers did have to be called in because I made a very big hole in the backyard.
Yeah, so no, I was in law school and clearly miserable and it was like a really cold February New York day where the rain comes down sideways in your face. I had thick textbooks in my backpack and got home, and there was an envelope with a return address from a lawyer in Hollywood, Florida. I didn't know there was a Hollywood in Florida. I thought, "Oh, someone's suing me." I carefully opened up the envelope and inside was a check made out to me for $5,000 from the estate of my great grandfather.
He had died years earlier. He was amazing. He was the person in my family who came here with nothing. The person who walked uphill both ways, barefoot kind of thing. And it was really strange to get a windfall from his death. I stood there with a check in my hands and was like, "Poppi Max is still gone and this is so weird. I didn't earn this, it's not my money." I got into the elevator, and by the time I got to the sixth floor where I lived, I had the idea for Dress For Success.
Frank Blake: That's amazing. That's amazing. Then leaving that for Do Something, what was the story behind that?
Nancy Lublin: I built Dress For Success. That was my first full time job. It helps women transition from welfare to work. It gives them suits and confidence, and helps them with resume writing and interviewing skills so that they can reclaim their destiny. It really set whole families on a different path, because when you help a woman, you really help everybody around her
It was in over 70 cities and four countries. Then I kind of got bored because it was just more of the same in different locations. And there were these amazing entrepreneurs in each city who were really running things. I did what entrepreneurs do. I left.
It was just like stepping off a flat earth, but I left and then I got this phone call out of the blue from Andrew Shue, who of course had been on Melrose Place. So I giggled my way through that phone call, because he is adorable. He had started something called Do Something, and it was awesome when he was on Melrose Place. But now that he wasn't on Melrose Place anymore, it had really fallen on hard times. They needed someone to come save it and turn it around. I thought, "That sounds amazing. I would love to do an organization that makes volunteerism and social change cool for young people," so I did that.
Frank Blake: Then came the transition from Do Something to Crisis Text Line. Do you ever look back? Do you go, "Boy, I'm sorry I left?" Or, "I should have left sooner or I wish I'd started this earlier"?
Nancy Lublin: I feel both ways. What's so weird is that I miss Do Something every day. It was such a fun job. It was such an incredible group of people. It was a little bit PayPal-ish. You know how PayPal has spawned so many other startups?
Frank Blake: Yeah.
Nancy Lublin: Crisis Text Line grew from the rib of Do Something, but so did so many other organizations — both for profit and not-for-profit. And there are so many people from Do Something who are now off doing incredible social change. We're all in touch with each other. It was just a lot of fun. It was a silly, fun, hopeful…it's like one of the few places with woke, politically correct millennials who are positive, not negative. It was really fun and they kept me young. I watched iCarly on Friday nights for a living. It was part of my job. It was a really good time.
So to answer one of those questions, yeah, I probably stayed too long. But I stayed until I had an amazing successor who had come there right out of college and just crushed it. She kept moving up the ranks and was our COO. I finally looked at her and said, "I am the only thing between you and being CEO, and I've got to get out of the way."
Frank Blake: Good for you.
Nancy Lublin: I just didn't have the idea yet.
Frank Blake: Not an easy thing to do.
Nancy Lublin: Not an easy thing to do. Then Crisis Text Line came along.
I started doing that and I said to her, "I'm really going to leave." She said, "No, you're not." I said, "No, I really am." She is CEO there today and one of my best friends in the world. She made me a better leader then, makes me a better person now. She's incredible.
So answer your question, I probably stayed too long — but it was so much fun and I miss it every day. If I had left any earlier, I might not have done what I'm doing now. Does that make sense?
Frank Blake: Completely. At Crisis Text Line, what are the advantages and disadvantages of having such emotionally profound conversations in a text-only medium?
Nancy Lublin: Well, I mean I haven't done this by other venues. I'm glad that other things exist, like phone, chat, and in-person. I don't think that stuff should stop. I mean, I think it should be easier to get help than not get help. Every mechanism ought to be available to people.
Where text is concerned, here's what we know works well. By the third message, they've told us everything. It's anonymous. It's private. Nobody hears you. There's no judgment. You don't hear someone sighing or gasping when you share something. And 65% of our texters say they've shared something with us they've never shared with another human being. People really open up — and open up quickly.
Frank Blake: Is there a common pattern on the steps to the three texts that you get everything?
Nancy Lublin: It really depends on the texter. The texter really leads. We don't have a script. We have some best practices, but we're not working off a script. The idea is to be human and to be caring, and take someone from a hot moment to a cool, calm.
Frank Blake: Are you at a point with the data that you're collecting, where predictive analytics have a role to play? Where you can say, "Gee, I'm listening to A, B, and C. I know it's likely to lead to this"?
Nancy Lublin: Yeah. We've now processed more than 80 million messages. They're all collected, stored and analyzed in real time. So we have layered on some machine learning onto that.
For example, one thing that we do is we triage based on severity. Instead of taking everybody in chronological order, we'd take them more like a hospital emergency room would take them, where you take the person having a heart attack or a gunshot wound before the kid with the sprained ankle. We do the same thing.
Based on what you say to us, the algorithm reads the message as imminent risk or not. It kind of ranks people in the queue. When we first built the algorithm, we put in some words like die, suicide, overdose, gun, and if those words showed up, we put you number one in the queue and we took you in about two minutes. Then we layered on machine learning after we got to about 20 million messages.
Now we're over 80 million, but then we layered on machine learning, which meant the algorithm got smarter. We found that there were actually thousands of words and word combinations that were more lethal than the word suicide. Like, the word "military" is twice as likely that we will have to call 9-1-1 than the word "suicide." The unhappy face crying emoji is four times as likely that we will have to call 9-1-1 than the word suicide.
There's one family of words that are the most lethal words in America that we've seen. They're somewhere between 3 and 16 times more likely that we're going to have to call 9-1-1 than if you said, "I want to commit suicide." Those are words like Xanax, Percocet, Tylenol, Ibuprofen, Advil, any named pill, any named drug.
If you name those, the algorithm reads that as you not only have the ideation and the plan, but you probably have the means because within your grasp and you probably have the timing. That's the four part ladder up risk assessment. Those people get put number one in the queue. And now that we've put a machine learning layer into this triaging system, we're taking our imminent risk people in about 38 seconds.
Frank Blake: Wow. Our mental health infrastructure has lots of issues to begin with, but do you have ways of sharing this data in a useful way with the 9-1-1 responders and hospitals?
Nancy Lublin: Well, we're not hoarding it, that's for sure. I mean, we're trying to, we're aggregating it, anonymizing it, and putting as much of this out there as we can. Go to CrisisTrends.org.
You asked about the 9-1-1 operators. I'm so glad you did because they are some of my favorite people, and they're just forgotten. I'm so glad that Fox now has that show, 9-1-1. Because for years there are all these cop shows and EMS and fire, but you don't call the police, you don't call fire, you call 9-1-1. They are the gateway for everything in this country. Natural disasters, personal emergencies, everything.
They see at all, they are tireless, they are right there on the front lines and no one throws like a parade for them. They are unsung heroes and I've met some really good ones through doing this work. I've actually watched them do it. You know how you kind of do like a ride along in a police car? I've done a sit along, as it's called, at a couple of 9-1-1 offices. They are masters of multitasking. Oh my goodness. They're amazing. Amazing, amazing people.
9-1-1 is funded — are you ready for this? By local landline taxes. I'm keeping a landline in my apartment in New York City. My husband keeps wanting to get rid of it and I'm like, "No, no," in part because I want to pay the tax on my landline. And I've never wanted to pay a tax on anything.
Frank Blake: Fascinating. What's the best advice that you've gotten from others who are helping you, encouraging you in what you're doing with Crisis Text Line?
Nancy Lublin: The board treasurer from DoSomething.org, this is like 10 years ago, once gave me advice: Somebody else doesn't have to lose for you to win.
That was pretty darn good advice. I've been very surprised at how competitive the mental health space is. There's a lot of organizations who all really care about the same thing, but who don't necessarily care about each other.
Frank Blake: Which is an interesting comment more generally.
Nancy Lublin: It is! I mean, I think the not-for-profit sector, we all care about the same stuff. But there's this small pool of money that most people are fighting for. Also there's so much pride in what you do, that you kind of tend to look down your nose at everybody else.
Like, in the animal space, in the autism space, in the breast cancer space, these organizations are so passionate about what they do, but they don't necessarily hang with each other much. That has been one of the surprises in the mental health space, I'll be honest. There's a handful of organizations who've been lovely and have really kind of showed us the ropes. And we'd like to work with everybody. We don't really think of ourselves as having any competitors, but there's definitely some competitive feelings out there in the space.
Frank Blake: What keeps you going? What gets you to the next round of fundraising or the constant effort on fundraising? What's the vision that's propelling you or the energy source that's propelling you?
Nancy Lublin: I'll be honest. I have really hard days. I mean, the thing about being an entrepreneur is that you have signed up to live on the roller coaster of the excitement of going up and the excitement of going down. That's just normal, and it is exhausting. Then you put that in America in 2018, which already feels exhausting, and I'm on that roller coaster.
The thing that keeps me going this morning, at 4 a.m., was that I was on the platform handling conversations for a couple of hours. And that thing that we make, the thing we do, is what I'm really in love with.
At Crisis Text Line it's about our community. It's really about our volunteers, our crisis counselors and being on the platform with them, helping other people. It's magical. It's amazing. It's this group of people and the service that we do is just strangers helping other strangers in their darkest moments. I'm really there for that mission.
I'm really there for the purpose, side-by-side with the volunteers, and that's the thing that keeps me going and fires me up.
Frank Blake: Where do you see Crisis Text Line three years from now?
Nancy Lublin: My hope is to be in 15 countries in the next three years. I think it will grow in the US also, but I'm really, I've got my eyes out outside the US.
Frank Blake: Why is that?
Nancy Lublin: Because there are a lot of countries that have no mental health services at all.
If we can grow outside the US, eventually I think the translation tools and the privacy standards will flatten and be more standardized so that we can actually counsel each other. That will help us with nighttime capacity needs in the US with other time zones chipping in.
Frank Blake: How about yourself personally, three years from now? As an entrepreneur, how do you think about this?
Nancy Lublin: I don't. That's the irony. I think people think entrepreneurs are always looking at the horizon and thinking about what's next. But the thing about every entrepreneur I know is that we are lousy at thinking about ourselves. I haven't had a physical in eight years. Finally, I'm going to the doctor in a couple of weeks. I have not been to a doctor in eight years. I also just don't get sick, because I just don't have time. That's just not really an option.
The entrepreneurs that I know are kind of like this, we are terrible planners for ourselves. We're great for our kids, for our friends, for our companies. But we come last. And that's whether you're a not-for-profit entrepreneur or for-profit entrepreneur.
Frank Blake: Can you think of a distinction between the for-profit entrepreneur and the not-for-profit entrepreneur? You've interacted with different folks on both sides.
Nancy Lublin: I don't have a Tesla.
Frank Blake: (Laughs) That's great. That's terrific. One final question for you: Advice that you would give to others who are thinking about how they might approach doing something similar?
Nancy Lublin: Going out and doing something great for other people is easy. I mean, you could do it right now for a stranger, or for someone you haven't talked to in a long time or a family member, or repairing a relationship that's fallen. I mean, doing something nice for somebody else is not hard. You could do it immediately and it doesn't even have to cost any money.
Starting an entire organization around it is hard and expensive, and I don't recommend it. I really don't. I don't think we need more organizations. I think we need better run organizations, and better funded organizations.
I think we've become obsessed with founders. I think we should become obsessed with COOs and just make the things that we have work better. I think we need some M&A activity in the not-for-profit space. Some efficiency. There are no market forces to encourage that, but we need them.
If you want to make a difference there is nothing holding you back this very second but your own imagination.
Frank Blake: That's fantastic. Nancy, thank you so much for being on this episode, and for allowing us to highlight the amazing things you and your organization are doing.
Nancy Lublin: Thanks. We need volunteers. CrisisTextLine.org. We're looking for volunteers, always.