TABLE 1.

Data elements included on Crisis Chat Transcript Abstraction Form

Part I: Chatter Characteristics and Behaviors a Structural Overview: chat start date; start time; end time; length of chat in turns a Demographics: sexual minority status; military status; whether the center had knowledge of the chatter from prior chats Life Stressors Present and Discussed During Chat: breakup of intimate relationship; loneliness/isolation; sexual abuse; bullying; other violence or abuse (including physical and emotional); other interpersonal/relationship problem; death of someone close to them; exposure to suicide or to suicidal threats/behavior; financial problem/worries; financial barrier to mental health treatment access; problem with health insurance; unemployed/lost job; job stress (other than financial or interpersonal); problem with school; problem related to sexuality/gender identity; physical problem (e.g., pain, illness, disability); current homelessness a Suicide Risk Factors: lifetime suicidal ideation; current suicidal ideation (i.e., during chat); imminent risk indicated during chat; passive or suggested suicidal ideation during chat; attempt in progress; history of preparatory behavior toward future/past attempt; method chosen or considered; means available; place chosen or considered; chatter said they had a plan; history of suicide attempt(s); history of non‐suicidal self‐injury Additional Suicide Risk Factors: history of substance abuse; current intoxication; lifetime/current substance abuse treatment; history of psychiatric diagnosis; lifetime/current mental health treatment; lifetime/recent psychiatric hospitalization; reasons for living identified Mitigation of Imminent Risk: whether chatter agreed to any of the following steps: center to send emergency services; self‐ or third‐party rescue; get others involved now; transition to phone now; remove means; receive follow‐up call within 24 h; whether imminent risk was reduced without recourse to any of the first four steps listed here Chatter Behavior at End of Chat: expressed gratitude or appreciation; expressed feeling better or helped; accepted coping suggestion; agreed to pursue new behavioral health treatment; wanted to go to sleep; needed to go do something else; apologized/expressed feeling burdensome; expressed dissatisfaction with counselor or chat; objected to chat's ending; abandoned chat Chatter's Behavioral Changes by End of Chat: less overwhelmed; more hopeful; more confident/in control; less at risk of suicide

Part II: Counselor Behaviors Fostering Engagement/Rapport: created a safe and welcoming environment/affirmed chatter's current use of crisis chat; exhibited empathy/validated or normalized chatter's feelings; affirmed chatter's strengths Collaborative Problem‐Solving: explored what has worked for the chatter in the past/what the chatter had tried to do to solve/cope with the problem; asked what the chatter thought they might do to solve/cope with the problem; offered specific suggestions for the chatter's consideration; reviewed the action plan a Suicide Risk Assessment: Asked: Are you thinking about suicide?/Explored current suicidal thoughts; Asked: Have you had thoughts of suicide in the past/ever?/Explored past/lifetime suicidal thoughts; Asked: Have you ever attempted suicide?/Explored past suicidal behavior; Assessed whether chatter had a suicide plan/had thought of a method/Explored suicide plan; Assessed availability of means; Assessed whether an attempt was in progress/Explored attempt in progress; Explored suicidal intent Establishing Safety & Mitigating Risk: helped chatter develop a formal safety plan; suggested chatter remove access to means/disable suicide plan; suggested chatter transition from chat to phone (now); suggested chatter call 911/go to hospital (now)/offered to send help; asked whether chatter could stay safe Resources, Referrals, & Mental Health Treatment Promotion: explored chatter's openness to/experience with mental health treatment; suggested/explored ways to find a new mental health service provider; made a referral to a specific, new mental health service provider; provided self‐help or other resource(s)

^a These sections (within Chatter Characteristics and Behaviors: Structural Overview, Demographics, and Suicide Risk Factors; within Counselor Behavior: Suicide Risk Assessment) are coded for all chats, regardless of the chatter's response to “Do you have thoughts of suicide?” on the pre‐chat survey. The remaining sections are coded only for chats where the chatter's answer to that question was “Yes, current” or “Yes, recent past.”