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Article History

Received: 12 March 2025

Accepted: 29 September 2025

First Online: 10 November 2025

Declarations

:

: J.T is employed and receives a salary from krisenchat.This needs to move to the competing interests section. krisenchat had no impact on the design of this study and did not influence the collection, execution, analyses, interpretation of the data, or the decision to submit the article/contribution for publication. L.K. and Z.E. have no competing interests. G.M. received funding from the Stanley Thomas Johnson Stiftung & Gottfried und Julia Bangerter-Rhyner-Stiftung under projects no. PC 28/17 and PC 05/18, from Gesundheitsförderung Schweiz under project no. 18.191/K50001, from the Swiss Heart Foundation under project no. FF21101, from the Research Foundation of the International Psychoanalytic University (IPU) Berlin under projects no. 5087 and 5217, from the Swiss National Science Foundation (SNSF) under project no. 100014_135328, from the German Federal Ministry of Education and Research under budget item 68606 in the context of an evaluation project conducted amongst others in collaboration with krisenchat, from the Hasler Foundation under project No. 23004, in the context of a Horizon Europe project from the Swiss State Secretariat for Education, Research and lnnovation (SERI) under contract number 22.00094, and from Wings Health in the context of a proof-of-concept study. G.M. is a co-founder, and shareholder of Therayou AG, active in digital and blended mental healthcare. GM receives royalties from publishing companies as author, including a book published by Springer, and an honorarium from Lundbeck for speaking at a symposium. Furthermore, GM is compensated for providing psychotherapy to patients, acting as a supervisor, serving as a self-experience facilitator (‘Selbsterfahrungsleiter’), and for postgraduate training of psychotherapists and supervisors.

: All methods in this study were carried out in accordance with relevant guidelines and regulations. All experimental protocols were approved by the Ethics Committee of the International Psychoanalytic University (IPU) Berlin (approval number: 2023_08). Informed consent was obtained from all subjects through krisenchat’s terms of service, which explicitly state that user data may be used for research purposes without direct identification of individuals. All personally identifiable information was removed from chat transcripts during preprocessing. The study utilized existing data from the crisis helpline, and participants were not compensated as this was a secondary analysis of routine service data. Research was performed in accordance with the Declaration of Helsinki.  Use of artificial intelligence tools We used artificial intelligence (AI)-based tools, including Claude and ChatGPT to support manuscript preparation. Further, we used publicly available search technologies, which we recognize likely utilise AI capabilities. We confirm that the contributions of AI were strictly in an assistive capacity. AI was not involved in conceptual tasks. Human oversight was continuously employed to ensure the accuracy of content and address any ethical concerns.

: Krisenchat had no impact on the design of this study and did not influence the collection, execution, analyses, interpretation of the data, or the decision to submit the article/contribution for publication.