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Embracing Direct Messaging

As of May, anyone in a crisis can text ‘Shout’ to 85258 and get immediate support, at any time of the day or night. How might this free direct messaging service be of use to our therapy clients, and what benefits can non face-to-face support bring to the field of mental health? Shout’s Chief Clinical Office Dr Fiona Pienaar gives us the lowdown on the UK’s first crisis text line service.


After a year of quiet piloting, and over 70,000 conversations, on May 10 we launched a new service for anyone seeking support in a crisis. Shout is the UK’s first free 24/7 text service, available anytime, anywhere. It’s a ‘place’ for people to go if they are struggling to cope and need immediate support. Shout exists in the US as Crisis Text Line, but this is the first time this tried and tested technology has come to the UK.

Shout has been launched by Mental Health Innovations, a digital mental health charity that was established as a legacy out of the Royal Foundations’ Heads Together. That campaign focused on lowering stigma and encouraging people to have conversations with others about their mental health. Increasing numbers of people are requiring and seeking support. Offering a digital service that is available 24/7 ensures people can reach out at any time to speak to someone about the crisis they find themselves in.

How does Shout work?

The service is powered by a team of Crisis Volunteers who are at the heart of the operation. They are all trained to communicate using empathy and unconditional positive regard, to help people in crisis move from a ‘hot moment to a cool calm’. We hope Texters leave a conversation feeling more grounded and with a plan in place to manage their crisis and take the next steps to get the help they need.

Conversations are monitored at all times on the platform by a team of experienced Clinical Supervisors, who support the Crisis Volunteers in their interactions with Texters and manage the more critical situations themselves.

Shout is not a counselling service and our Crisis Volunteers don’t provide clinical advice. We can provide links to more specialised charities and statutory services according to the issues that Texters present with. Shout is also not an emergency service but we will (after risk assessment, attempts to de-escalate, safety planning and encouraging Texters to call 999 themselves) contact emergency services – if the Clinical Supervisors evaluate the Texter or others around them as needing that level of support. It is, however, the judgement of the emergency services as to how and when they respond, once contacted.

Why should we embrace a texting service?

Reaching out for help using text provides access to an immediate, silent, anonymous, free conversation with trained Crisis Volunteers, who are supported by Clinical Supervisors on the platform and Coaches off it. The majority of Texters reach out to us after 6pm, with our busiest times on the platform between 8pm and 2am.

Being able to use your phone (no app needed) to text 85258 means there is always someone there to talk to when most other services are shut, or it is just too difficult to speak to

someone on the phone or face to face. Texters do not have to wait, they do not have to pay. They can seek advice, have a conversation, ask for information about a particular service, or just off-load so that they feel more calm.

This is an innovative, much-needed addition to mental health support services and we hope that you will recommend Shout to your clients if you feel it is right for them. It can give them access to support when they are in crisis and unable to reach you or the more traditional face to face services. And while it is well known that younger generations use messaging/texting to communicate, we are finding the service works for older generations as well.

If you are interested in finding out more about the Shout service, or about volunteering (an experience that will give you a new set of skills and awareness), visit


Fiona Pienaar

Fiona is Chief Clinical Officer for Mental Health Innovations (MHI) with responsibility for ensuring high standards of clinical direction and practice. Prior to her present role, Fiona was Director of Clinical Services at Place2Be. Fiona has a background of over 30 years of teaching and counselling in schools, counsellor education in higher education institutes, educational and mental health resource development, academic and clinical supervision, private practice and mental health consultation, research and writing. She has a PhD in Behavioural Science from the Faculty of Medical and Health Sciences at the University of Auckland, New Zealand, a MEd in Counselling, a Professional Certificate in Coaching (Henley Business School, England) and various other counselling, teaching and special needs qualifications.

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