After rolling out in July 2022, the 988 Suicide and Crisis Support Line has seen a rise in calls, per federal data.
There are over 200 call centers fielding calls across the country.
Here's how one Texas crisis center is handling the increase in calls.
The Harris Center, based in Houston, is one of the over 200 crisis centers fielding calls all across the country. The center, which has been working in partnership with the National Suicide Prevention Lifeline since 2007, has fielded about half the crisis line calls in the state. The center serves as the 988 operator for 43 Texas counties.
Jessica Battle, the center's vice president of community access and engagement, told Insider the new three-digit number "has been really exciting" because it could help change the way people think about access to mental health to hopefully have a "stigma-reducing effect in the future."
"Just as there's no stigma for people to call 211 if they need resources — housing support resources; the way there's no stigma when people call 311 in their communities if they need a pothole filled or trash pickup; there's no stigma when people call 911 if they're experiencing a physical health emergency," she said. "So, ultimately, our hope is that there will come a time where there's no stigma involved for people to call 988."
The new 988 number replaced the 10-digit National Suicide Prevention Lifeline number last July. This past January, Battle said, the four crisis line centers in Texas answered over 10,000 calls compared to an average of 5,000 calls in April 2022 — just a few months before the three-digit hotline launched.
"We went from in June of 2022 answering like 6,900 calls to July answering over 9,000 calls. So that's just a huge difference," Battle said.
Manning the crisis lines
The lifeline centers have also increased the number of calls they can field in-state, she told Insider.
The center is the largest crisis center in the state and has fielded a majority of the crisis line calls in Texas. Battle attributed this, in part, to additional state funding to the center, which allowed the center to hire and train more phone line operators to accommodate the demand.
Most of the 200 national centers fielding calls mainly respond to calls from their own state or region. However, if none of the in-state centers pick up a call, it gets rolled over to a backup center. Battle said that just two years ago, Texas centers were only capturing about 39% of the in-state calls. As of February, they answered around 72%, she said.
Across the nation, calls have seen a documented rise, according to data from the US Department of Health and Human Services. Nationwide, there have been a little more than 2.5 million calls routed through the 988 number between July and January 2023 with 89% of them answered.
Battle said Texas is "very interesting" when it comes to 988 operations. The state is third to New York and California for the number of calls answered, KENS5 reported, noting that while California had 88% of calls answered by an in-state counselor this past December, only 67% of calls were answered in-state in Texas at the time.
While states like Washington have passed legislation to create a phone line tax to help operate 988, Texas has not, KENS5 reported. Mental health advocates in the state have also been lobbying for a robust funding system to support the operation line, the outlet reported.
The phone line expansion also comes as Texas grapples with a scarcity of mental healthcare access, with 98% of the state's 254 counties being completely or partially designated as "mental health professional shortage areas" by the federal government, The Texas Tribune reported.
Battle said that despite the increase in demand, the crisis centers are still working to ensure that every call answered is of quality, and investing in training and support for operators has been essential.
"We have basically been able to add an additional like 20 FTE (full-time equivalent) positions, and some additional supervisory support so that we can increase our training and quality assurance programs, which is key," Battle said, adding that the center is still filling more roles.
Call workers work in a hybrid setting, with many going into the physical center and others working from home.
The physical call center is set up in a way where support supervisors are stationed in the middle of the room, and operators take up stations around them.
There are also quiet rooms where operators can go if they need a moment following a difficult call. Battle said in order for operators to work from home, they need to be cleared after a mental health evaluation to ensure they can handle it.
Additionally, workers have video conferences throughout the day for peer-to-peer support.
"We're also wanting to set the standard of a mentally healthy workplace because doing crisis line work and talking with people all day long who are experiencing emotional crises is very challenging and difficult," she said.
"We need to have the infrastructure in place to make sure the teams are well cared for so they want to continue doing it."
Support supervisors work to make sure operators can handle every call, and offer emotional support during tough calls.
Call workers can answer as many as 20 calls in a day, and Battle said their mental health and well-being are a priority so ensuring there are enough employees to not only handle the calls but also support staff is paramount. While operators may need to do full suicide assessments on calls, many callers are looking for information and resources.
According to Battle, every day is different and even if operators answer calls with similar scenarios, they're always different since they're dealing with different people.
"Part of the amazing training that the crisis line counselors get, is that they are trained to listen actively and attentively and mindfully to what the needs of the caller are and then respond empathetically and supportively," Battle said.
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