Suicide is a major public health concern, underscoring the importance of understanding communication practices used in crisis intervention. Text-based crisis services are increasingly used, yet little is known about how counselors construct messages across encounters. One understudied feature of this setting is counselor text reuse, or the repeated use of identical or highly similar message content across different clients. Although reuse may support efficiency and consistency, it may raise questions about how personalised responses are across counselors. This study provides a descriptive analysis of counselor text reuse in a large dataset of 4.7 million messages of real-time text-based crisis counseling conversations. Across 136 counselors, mean message similarity was very low, indicating little overall text reuse for most counselors. However, 103 counselors showed at least one instance of detected reuse, and a smaller subset demonstrated more consistent reuse. Reuse was also positively associated with counselor encounter volume across measures of reuse. Frequently reused longer passages primarily involved structured coping-oriented or psychoeducational content, such as coping strategies, grounding exercises, self-care tips, and relaxation techniques. The findings suggest that counselor text reuse increased with encounter volume, but average levels of reuse were low across counselors and they provide a foundation for future work examining associations with service delivery and client outcomes.

Ensuring the effectiveness of text-based crisis counseling requires observing ongoing conversations and providing feedback, both labor-intensive tasks. Automatic analysis of conversations—at the full chat and utterance levels—may help support counselors and provide better care. While some session-level training data (e.g., rating of patient risk) is often available from counselors, labeling utterances requires expensive post hoc annotation. But the latter can not only provide insights about conversation dynamics, but can also serve to support quality assurance efforts for counselors. In this paper, we examine if inexpensive—and potentially noisy—session-level annotation can help improve label utterances. To this end, we propose a logic-based indirect supervision approach that exploits declaratively stated structural dependencies between both levels of annotation to improve utterance modeling. We show that adding these rules gives an improvement of 3.5% f-score over a strong multi-task baseline for utterance-level predictions. We demonstrate via ablation studies how indirect supervision via logic rules also improves the consistency and robustness of the system.