Massive setup underway for new 988 suicide hotline

Talawanda High School students walk past a poster promoting Butler County Mental Health System Health Board’s Crisis Hotline during a class change at the school. By July 16, 2022, people can call 988 and be routed to their local call center for crisis mental health help. FILE

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Talawanda High School students walk past a poster promoting Butler County Mental Health System Health Board’s Crisis Hotline during a class change at the school. By July 16, 2022, people can call 988 and be routed to their local call center for crisis mental health help. FILE

The easier to remember number should save lies, experts say, but first, infrastructure needs to get in place.

A massive effort is underway so Ohioans with a mental health emergency can soon call 988 instead of 911.

The national initiative to add a 988 mental health emergency line means people can start calling the number by July 16. Many counties in Ohio are also adding other services to pair with the 988 center, like mental health workers who can go into the field.

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This new system will replace the harder-to-remember national suicide lifeline (1-800-273-8255). Having a simple, specific hotline for mental health crises is expected to drive a surge in calls.

“People have known for decades that they shouldn’t call 911 unless it’s a life or death situation. So then what do you do if you’re feeling that emotional crisis, that behavioral health crisis, especially related to suicidal thoughts? This will give them that tool and that resource to get help,” said Stacey Frohnapfel-Hasson, chief of Ohio Department of Mental Health & Addiction Services’ prevention services, who is leading the 988 implementation.

The need is great. More than 1,800 Ohioans died by suicide in 2019, the most recent statewide data available.

The Dayton Daily News looked into how the new 988 system will work, why it matters, and what infrastructure needs to be in place for the hotline.

The basics

While the deadline for 988 to go live is in July, the national suicide lifeline has been around since 2005 as a national network of community call centers. People in a crisis or who are worried about someone in a crisis can call and get help.

“It’s important to make sure that Ohioans understand that this isn’t a new system that’s switching on in July. This is being built on decades of work,” said Lori Criss, director of Ohio Department of Mental Health & Addiction Services.

You can trace the origins of 988 back to 2019, when the FCC proposed to Congress that there should be an easy-to-remember nationwide number that’s the “911″ for suicide prevention.

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Over the past two years, the plan has grown and people will be able to call the new 988 line not just for suicide prevention but also for mental health crisis help.

People who call the hotline will talk with a trained behavioral health professional who will assess their needs and determine the next steps for mental health services.

When can people start calling 988?

The national deadline to go live is July 16.You’ll still also be able to call the original lifeline for a while at 1-800-273-8255.

Increase expected

When the number gets easier to remember, more people are expected to call.

In Ohio, calls are forecast to increase 65% in the first year of the transition, according to a consultant’s projection.

Sallie Luther, a Dayton-area prevention advocate whose sister died by suicide in 2000, said she leads prevention trainings and encourages people to save the current harder-to-remember lifeline in their phone in case of a crisis. She expects many more people to call when the change to 988 happens.

“This is going to be a huge improvement,” Luther said.

About a 25% growth in calls is forecast for both year two and three of the new 988 system. After that, they predict 14% annual growth.

Nearly 2.4 million people called the National Suicide Prevention Lifeline in 2020, including about 72,560 in Ohio.

High need

Suicide is the cause of thousands of Ohioans’ deaths.

In 2019, 1,809 Ohioans died by suicide, according to state health data. That year, suicide was the second leading cause of death among Ohioans 10-34 years of age, and the 11th leading cause of death in Ohio overall, according to the latest annual report by the Ohio Department of Health.

“It’s really incredible how many people die by suicide,” said Leigh Ann Fulford, who lost her sister to suicide and directs GEM Project Dayton, doing suicide prevention work.

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Getting prepared

There’s a massive effort at the state and local level, getting prepared for the roll-out.

There had been 12 suicide prevention call centers in place in Ohio, which covered only 45 counties in the state. In other counties, callers would be dispatched to an out-of-state backup center.

Over the past year, Frohnapfel-Hasson said that’s been expanded to 18 call centers to make sure all 88 counties are now covered.

Local and statewide backups for additional calls will also be in place. If none of these tiers can pick up a call, it would get sent to another state. But the goal is to prevent that from happening.

Getting more lifeline providers ready will help with the state’s goal for 90% of lifeline calls and 50% of lifeline chats and texts to be answered in-state by July 2022.

During 2021, Ohio was able to answer an average of 67.2% of incoming calls in state. Ohio’s in-state answer rate dropped in November 2021 to 58% and to 56% in December 2021. Ohio as of January had the capacity to answer only 8% of the chats and texts made by Ohioans.

Between layers of federal, state, local and private funding sources, there’s funding for 988 through June of 2023, which is about $21 million, according to Frohnapfel-Hasson.

“We’re working with the General Assembly to look at what we need to do to put sustainable funding in place into the future,” Frohnapfel-Hasson said.

Some of the 988 implementation plan is pending on more information from the federal level. The national marketing plan is not finalized, limiting Ohio’s ability to strategize marketing implementation and costs.

Counties adding services

The 988 system is about not just talking to a professional on the phone, but also getting callers who need more help connected to the right resources.

Ohio counties have a lot of flexibility in what kind of services they set up. Some are building out mobile response units, where teams can respond to meet a person in crisis.

The state is also supporting counties adding crisis stabilization centers, a mental-health specific alternative to an ER where someone can get dropped off and evaluated, Frohnapfel-Hasson said.

Montgomery County has a call center and mobile response unit already running and is working on a stabilization center.

The Dayton board of zoning appeals will hear the request for the new center on March 22, which Montgomery County Alcohol, Drug Addiction and Mental Health Services is requesting to open at 825 S. Ludlow St. MCADAMHS has been holding public meetings to get community buy-in prior to the hearing.

Mental Health Recovery Board Serving Warren & Clinton Counties said it will keep working with its current hotline operator Sojourner Recovery Services.

There are still questions about how calls will be routed through 988 to local providers, said John Cummings, deputy director of communications for the board.

“Boards like ours are working closely with the state to ensure those questions and the necessary structures are in place to ensure prompt response to crisis calls,” Cummings said.

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Getting help

For now, several ways exist to get help. Some examples include:

  • The 24/7 National Suicide Prevention Lifeline is at 800-273-8255 for free and confidential support and connection to resources. You can call the number for personal help or because of concerns about someone else in crisis.
  • Many people are not sure how to recognize the risks for suicide or what they should do if they are concerned about a loved one. Like CPR, learning QPR (Question Persuade Refer) can save a life in an emergency. Dayton Children’s has a free 60-minute QPR course. Go to qprtraining.com/setup, enter the organization code DCH, and get registered for an online training to be taken anytime.
  • If you’re not in a crisis, but need support, the Miami Valley Warmline is available 11 a.m. to 7 p.m. Monday through Friday by calling 937-528-7777. This is not a crisis hotline and not for emergencies, but can help you get support and resource referrals to prevent a crisis.
  • Knowing when to seek help can save a life. Some signs can range from feeling like a burden, being isolated, increased anxiety, increased substance use, extreme mood swings, sleeping too little or too much, or talking or posting about wanting to die.

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