More Than a Hotline, a Lifeline: 988 Suicide & Crisis LifelineDec 27, 2022 09:56AM ● By Sara Locke
Photo by Bill Sitzmann
It can be difficult to know where or when to begin a serious discussion about mental health. For many, the stigma that surrounds asking for help prevents them from reaching out to friends and family, even as symptoms mount and begin impacting their livelihood. While newfound understanding has ostensibly improved perceptions surrounding mental illness, the issue remains steeped in stigma, with a “tough it out” mindset still prevailing in a variety of professional and personal contexts. A great many of those touched by mental illness—with conservative estimates suggesting one in five people suffer from depression and/or anxiety—feel isolated and “othered.”
Although the numbers suffering are staggering, finding commiseration, resources, and treatment too often feels beyond reach. Left untreated, depression and anxiety can lead to psychosomatic responses, including cardiovascular disease, malnutrition, and a host of otherwise preventable, life-shortening illnesses. That’s without factoring in that suicide is currently the 10th-leading cause of death in Nebraska overall, and is the second-leading cause of death among young people.
While the nation’s collective mental health endured the challenges of pandemic isolation, economic instability, and political and societal unrest over the past several years, mental health resources haven’t matched the increasing demand. But that’s beginning to change.
On July 16, an easy-to-utilize suicide prevention and crisis hotline rolled out nationally. Dialing 988 works in tandem with the previously existing number, 1-800-273-TALK (8255), and both will bring you to the same qualified and compassionate counselors armed with the tools and training to respond to nearly any mental health crisis. While the program is national, calls are filtered by location data and directed to local responders.
Kyle Kinney, program manager of Boys Town’s crisis center, has seen improvement in the accessibility of resources since 988 was incorporated into Boys Town’s existing suite of crisis prevention services.
“We have provided crisis intervention at Boys Town since 2005, as well as offering national backup [for the existing hotline]. New federal legislation took it from a national structure to a local structure, and transitioned what was in place for the suicide prevention hotline,” Kinney explained. “For years, calling was the only available option. We have now implemented a mobile crisis activation, but the goal is for them not to be necessary...[rather] for us to continue assessing safety, deescalating the crisis, creating a safety plan, and helping them navigate resources remotely. Then we always follow up.”
An estimated 97% of calls received by the hotline are handled directly on the phone, according to Kinney, who said, “Increased awareness of the hotline has definitely increased utilization. We had about 30 calls a day for years, and then July 16th, 2022, came and overnight it jumped to 50 to 60 a day. It has stayed pretty consistent since then, and we may see that number grow over time as awareness spreads. But managing to deescalate over the phone really continues to remain the goal, to connect those people with sustainable resources and help within their community.”
“That really speaks to the intent.” Kinney continued. “There are a lot of spokes involved with getting help—sometimes people need a safe place to go, peer support, resource navigation... The crisis line is important, but everything needs to evolve together to create a robust system that grows to meet the needs of the community. There is a big difference between helping someone, and someone feeling helped. Our counselors are truly motivated to help every call that comes in. And that really sets the tone for what happens after the call.”
When isolation is part of the illness, community is the cure. Kinney and his team of counselors assist callers in navigating an often-complex system of care, costs, and insurance deductibles to identify and mobilize a course of action—hopefully leading to long-term and lasting success.
As the state planner for 988, and system of care administrator, Michelle Nunemaker oversees the use of a grant provided through SAMHSA (Substance Abuse and Mental Health Services Administration). This includes reviewing answer rates and other metrics, and evaluating problem-solving with the crisis team.
“Kyle [Kinney] and I work hand in hand, seeing that this is more than a phone number, but a transition to a full crisis continuum. That ranges from mental health to substance abuse, to counseling callers who are concerned for a loved one’s safety,” Nunemaker said. “I also work with our six regional behavioral health authorities to raise up those community-based crisis services for mental health and substance use respite.”
Once the automated navigation system has matched callers with a qualified local counselor, their task goes beyond talking someone off the ledge, proverbial or otherwise. Sometimes, a compassionate ear is all it takes to get through to an especially difficult day. However, the mental health experts on-call are determined to help ensure that those hard days are fewer and further between.
“Crisis counselors are connecting people with long-term care over the phone. Even our crisis mobile is working to help people find support. We expect follow-up calls and contact to be made. We want to see how the caller is doing, if they’re feeling better, if they connected with the services we helped them find, and then help them overcome any barriers to getting the resources they need,” Nunemaker said. “Providers identify same-day services for medication management, counseling services, and then support and problem-solving for any possible future crisis.”
While crisis deescalation is a core function of the 988 hotline, the service is also positioned to reduce strain community-wide via preemptive counseling and a wide network of mental health resources.
“988 has a preventative focus as well,” Nunemaker continued. “The goal is to help decrease folks accessing emergency rooms when facing a crisis. We are also decreasing the response of law enforcement and letting health providers and law enforcement officers do what they need to do, while behavioral health professionals are doing what they are trained to do.”
Helping remove some of the burden on first responders ensures that resources are directed where they are needed most. Additionally, 988 has the capacity to connect callers with Spanish-speaking counselors, veteran support services, eating disorder specialists, substance abuse counseling, financial assistance, and a host of other local, context-specific support options.
If you or a loved one are experiencing a mental health crisis, dial 988 for 24-hour support, counseling, and other resources.