Background Technology-facilitated anonymous/confidential reporting systems (TFRS; app/text-based helplines) are used statewide in 34/50 states, yet little is known about trends of help-seeking using these systems. Methods Data were 44 998 tips submitted to the statewide TFRS in North Carolina between November 2019 and May 2025. Time series, descriptive and regression analyses were used to characterise overall trends and by specific temporal period (time of day, day of week, month of year) relative to tip severity and tip topic (eg, interpersonal violence, mental health, school attack). Results Between November 2019 and May 2025, TFRS submissions increased, with the most tips submitted in October (monthly mean=1046.0) and March (1001.5), and the fewest in June (100.8) and July (48.0). However, a higher proportion of tips requiring emergency responders was submitted when school was not in session—37.5% of tips submitted in July (monthly mean=18.0) and 29.2% in June (25.2) compared with 14.7% in March (153.3). Submission timing varied by concern: interpersonal violence tips were most common during school hours (8:00–17:00; hourly mean range=0.39–0.79), while school attack and mental health tips peaked in the evening (20:00–22:59, hourly mean range=0.18–0.20; and 20:00–21:59, hourly mean range=0.32–0.34, respectively). Conclusions Greater tipping during times when school is in session likely corresponds to higher rates of risks that are not life-threatening but still important to address (eg, bullying). Despite lower numbers of tips during times school is out of session, those submitted are much more likely to be life-threatening, supporting the importance of systems always being available.
Thulin et al. (Fri,) studied this question.