A new report reveals how Shout’s digital service provides timely, targeted and effective mental health support for those in urgent need

The report ‘Help is just a text away: Accessing and scaling mental health support through Shout’s digital service’, released today, underscores the potential of digital services to meet growing demand for mental health services. With waiting times for mental health support rising rapidly, the Shout text messaging service is emerging as a critical support tool, providing timely crisis help and addressing an unmet need. 

This report builds on the long-standing partnership between Mental Health Innovations (MHI) and the Institute of Global Health Innovation (IGHI), Imperial College London. MHI is a leading charity that leverages digital innovation to improve the mental health of people in the UK and who power Shout, the 24/7 crisis text messaging service. The report is the first in a series of four joint reports designed to explore the impact and contribute to the implementation of digital support in addressing poor mental health. 
 
Victoria Hornby OBE, CEO of MHI said: “Shout plays a vital role in supporting people with their mental health, free of charge, any time they need it. The report highlights how Shout complements existing NHS and public services, and often meets a need for people who are not accessing any other form of support. The decline in mental health in the UK, particularly amongst young people, is alarming. Harnessing innovation and technology is critical to meeting this enormous challenge.”   

Professor Lord Ara Darzi, Co-Director of IGHI, said: “To cope with the demand for mental health services we must embrace digital. My investigation found that one million people are waiting to be seen. We need a shift to innovative digital services like Shout to tackle this problem at the scale needed. The data shows that Shout is a hugely valuable addition to the range of mental health services available in this country.” 

The report’s findings highlight the following key areas: 

• Access: The report finds that the highest volume of Shout conversations take place between 6pm and 5am, at times when other traditional mental health services may not always be available. The analysis also shows that texters who have reached out to the service multiple times tend to text Shout during similar times of day/night, and this is especially the case for those who text during the night/early morning.

Distribution of conversations by predominant texting time for each category of texter (all with 5 or more conversations between March 2018 and December 2023)

• Equity: Text-based services were considered by interviewees to offer an additional way in for people to help everyone access the support they need, particularly for young people, for people from stigmatised groups such as the LBGTQ+ community, or for people with specific access needs, such as being deaf or neurodivergent. Furthermore, people do not need sophisticated technology to reach out for support from Shout, making it particularly accessible as a service.  
• Reach: Shout has taken 2.5m conversations with 830,000 children, young people and adults who were struggling to cope. 83% of texters said that they found their conversation helpful, 66% of texters said they felt calmer, and 59% of texters said they could work out their problems better. Since the service began, Shout has developed more than 38,000 safety plans for people whose lives were at risk, and intervened with the support of emergency services on nearly 33,000 occasions. 

Modestas Kavaliauskas, NHS England, one of the interviewees for the report, said: “It's about ensuring our crisis care system is genuinely accessible. We must avoid stigmatising or unintentionally excluding people, providing universal access to crisis care support from the outset.”   

The report is based on insights from a Service User Voice Group (nine people who had previously used Shout), as well as insights from interviews with national experts and commissioning leads from Integrated Care Systems. It also includes pre-existing analyses conducted by MHI’s analytics team, as well as new insights from an analysis of Shout usage patterns. 

Next steps 

Learnings from the Shout service, feedback from Shout texters and the research around the service (such as this report) help MHI identify opportunities for improvement, either through Shout or through the development of new resources and services. Insights created are also regularly shared nationally and with partners across the sector to help develop more targeted and effective policies and service design. 

This report is timely, as NHS England have specified that a 24/7 crisis text messaging service should be provided by every Integrated Care Board in England from April 2025. 

Citation: Illingworth J, Fernández Crespo R, Lawrence-Jones A, Leis M, Lawrance E, Howitt P, Jarvis J, Ungless M, Bolton C. Help is just a text away: Accessing and scaling mental health support through Shout’s digital service. Imperial College London (2024).