After the 2021 mass shooting at a Colorado supermarket, Tony Coder was in communication with a northeast Ohio resident unable to get help from the National Suicide Prevention Lifeline. He told Coder that he was considering shooting up a grocery store and that by killing himself first, he would save many lives.
Coder, executive director of the Ohio Suicide Prevention Foundation, recalled talking to him and referring him to a mental health professional.
“People end up calling us because they’re not getting the answer to the help they need,” Coder said. “Some of these crisis calls are literally life or death.”
On July 16, the federal government asks states to launch a more robust, easy-to-remember 988 hotline in an effort to provide more capacity — costing Ohio $136 million over five and a half years. Questions remain as to how this total cost will be covered.
The current 24/7 Suicide Prevention Hotline, (800) 273-8255, is for people who are considering suicide to get immediate help. But nationally and in Ohio, lack of funding and staff means some have long wait times and are unable to reach anyone.
Already, Ohio’s answering service for people in crisis is being stretched as suicides rise. Twenty-two of the 88 counties have no coverage in the state, and for the rest, Ohio’s rescue centers are unable to handle all the calls.
What the 988 suicide hotline will do
At least 72,560 calls in Ohio were made to the National Suicide Prevention Lifeline in 2020, according to the lifeline. This is a 57% increase from 2016 and likely to grow under the stress caused by the COVID-19 pandemic.
Yet only 60% to 70% of calls from Ohio could be answered by an in-state rescue center, by state and by vital data. When this does not happen, callers may drop calls or are connected to out-of-state people in a nationwide relief network.
The number of suicides has steadily increased since 2014, from 1,488 to 1,809 deaths in 2019, according to the Ohio Department of Mental Health and Substance Abuse Services, which is in charge of the 988 deployment.
Prior to 988, the limited capacity of the 12 state relief centers should come as no surprise. They are part of a patchwork system, often relying on their own limited funding, staff and volunteers. Additionally, 22 of the 88 counties had no coverage in the state.
The number of lifeline staff per center can range from 20 to just one, Coder said. A state survey showed that most centers received funding of $10,000 or less to manage vital budgets often over $100,000. The rest must generally be compensated by other sources of financing, mainly local.
Coleman Professional Services, based in Kent, responds to vital calls in Canton with a staff equal to eight full-time employees, said Michelle Smith, who oversees the operation. There are typically two workers per shift responding to 5,000 crisis calls per month from all types of hotlines, including 250 from the lifeline.
Although they managed to answer at least 90% of calls, it was harder to keep up during the pandemic when the percentage of more serious calls, such as those involving suicide, increased.
“The calls were longer, they were more intense,” Smith said. “We had more employees testing positive for COVID. My managers and I were working night shifts, backfilling.”
The new 988 system will do more than make it easier to remember the hotline number, much like 911. Ohio will expand coverage to every corner of the state, adding six providers. There will also be a statewide backup network. Staff will increase to meet the goal of a 90% response rate in the state.
Another feature aims to allow Ohioans, especially young people, to text or chat to 988. Only two centers have recently added this capability and technology upgrades are needed.
The improvements should boost demand for the hotline – as well as costs. The 988 line could receive at least 179,000 calls and texts in the first year alone, the department estimated.
How will the 988 suicide hotline be paid?
For the first time, there will be a state-level funding source for the lifeline, though state lawmakers will have to figure that out. Some have called it an unfunded federal mandate.
While the federal government has and may give more 988-designated money, it won’t be enough so far to cover the estimated $136 million needed to last through 2027.
Coleman Services said many technology upgrades to 988 will require moving relief personnel who can help with high call volumes to focus on data entry and collection. He will have to increase his workforce by adding one more person per shift.
States have struggled to fund 988; only four have passed such legislation, according to the National Alliance on Mental Illness.
Ohio has taken a unique position: postponing any funding decisions. Instead, it will fully fund the launch as well as the first year of the 988 program with at least $20 million in COVID-19 relief money and other federal sources, just in time for upcoming budget discussions. of State.
“In this first year, we’re going to learn a lot about the use and cost of running the system,” Lori Criss, director of the Ohio Department of Mental Health and Substance Abuse Services, said in a statement. interview. “So we wanted to make sure we were really measuring twice, reducing once, and being accountable with public taxpayer dollars.”
Not having long-term funding, however, worries some defenders. This could jeopardize a running 988 system if lawmakers fail to find a solution.
Rep. Gail Pavliga, R-Atwater, said any long-term funding decisions are still in the early stages. Pavliga carries a bill that would simply establish a benchmark for receiving money for 988.
Ideas have been floated, such as a 50-cent monthly charge on phone bills, similar to how 911 is funded. The state could also allocate money from other revenues. The responsibility for funding 988 will not fall primarily on local governments, Criss said.
Other challenges remain, such as the shortage of behavioral health workers, a persistent problem plaguing all healthcare sectors amid the pandemic.
But at the very least, the department is confident the 988 hotline will be up and running by July 16.
“It will take years, if not decades, for this to fully form,” Criss said.
Titus Wu is a reporter for the USA TODAY Network Ohio Bureau, which serves the Columbus Dispatch, the Cincinnati Enquirer, the Akron Beacon Journal and 18 other affiliated news outlets in Ohio.