{
  "abstract": "Objective: To examine the relationship between counselor communication techniques and students seeking referrals to care within the American Foundation for Suicide Prevention’s (AFSP’s) Interactive Screening Program’s (ISP’s) text-based chats. Participants: Data included 14,931 text-based chats between students and counselors from 58 U.S. colleges that used the ISP between 2009 and 2024. Methods: Natural Language Processing was used to analyze ISP counselor communication techniques within the online chats. Results: Counselor informing statements (aOR: 1.98, 95% CI: 1.78–2.21), emotional reactions (aOR: 1.11, 95% CI: 1.02–1.20), and longer dialogue length (aOR: 1.30, 95% CI: 1.28–1.32) were positively associated with seeking a referral. Counselor interpretations (aOR: 0.32, 95% CI: 0.29–0.35), explorations (aOR: 0.32, 95% CI: 0.28–0.36), and normalizing statements (aOR: 0.69, 95% CI: 0.61–0.78) were negatively associated with seeking a referral. Conclusions: Findings advance understanding of how counselors might prioritize using specific language in text-based chats to support students seeking a referral to care.",
  "abstract_shown": true,
  "affiliations": [
    "Student Health and Well-Being – Mental Health Services, Johns Hopkins University, Baltimore, MD, USA.",
    "Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.",
    "Department of Computer Science, Johns Hopkins University Whiting School of Engineering, Baltimore, MD, USA.",
    "Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Susanna Lewis"
    },
    {
      "affs": [
        1
      ],
      "name": "Ashley M. Witmer"
    },
    {
      "affs": [
        0
      ],
      "name": "Susan Han"
    },
    {
      "affs": [
        2
      ],
      "name": "Mark Dredze"
    },
    {
      "affs": [
        1,
        3
      ],
      "name": "Holly C. Wilcox"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "James Aluri"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/22w1tk46fyqda.bib",
  "cited_by": 0,
  "doi": "10.1080/07448481.2026.2717318",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711413/",
  "id": "22w1tk46fyqda",
  "issns": [
    "0744-8481",
    "1940-3208"
  ],
  "landing_url": "https://doi.org/10.1080/07448481.2026.2717318",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "3203|Suicide and Self-Harm Studies"
    ]
  ],
  "openalex": "W7204462749",
  "pdf_url": null,
  "pmcid": "PMC13711413",
  "pmid": "42658094",
  "published": "2026-08-27",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/22w1tk46fyqda.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:22:11Z",
      "native_id": "PMC13711413",
      "source": "pmc",
      "url": "https://doi.org/10.1080/07448481.2026.2717318"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Suicide and Self-Harm Studies",
      "subfield": "psychiatry"
    }
  ],
  "title": "Relationships between Counselor Statements and Student Connection to Mental Health Care: A Cross-sectional Analysis of Digital Screening Platform Conversations",
  "title_text": "Relationships between Counselor Statements and Student Connection to Mental Health Care: A Cross-sectional Analysis of Digital Screening Platform Conversations",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:11Z",
  "url": "https://research.draconitic.com/paper/22w1tk46fyqda",
  "venue": "Journal of American college health : J of ACH",
  "versions": []
}