New 988 suicide prevention hotline sees increased number of calls in first month

new 988 hotline

The new 988 suicide prevention hotline “is pretty easy to remember, and it's improving people's access to services,” said Rick Oliver, director of crisis services at FrontLine Service, a private non-profit behavioral health organization based in Cuyahoga County. Frontline is part of a national network of call centers for the new 24-hour 988 mental health hotline, and handles calls originating in Cuyahoga County. (Naomi Worthington, FrontLine Service)

CLEVELAND, Ohio — In the month that the new national 988 Suicide & Crisis Lifeline hotline has been up and running, it’s already making an impact locally.

The number of national hotline calls routed to the Cuyahoga County mental health services call center has risen from 18 calls per day to 38, said Rick Oliver, director of crisis services at FrontLine Service, a private non-profit behavioral health organization based in Cuyahoga County.

FrontLine is part of a national network of call centers for the 24-hour 988 hotline, and handles calls originating in Cuyahoga County. Frontline licensed counselors and social workers connect callers with local mental health services and counseling, or sometimes just provide a compassionate listener.

“We’re there to understand why they’re calling, what their service needs are, and then connect them to whatever services are available in their area,” Oliver said.

Calls are up, in part, because the new three-digit number is shorter and easier to remember than the previous 1-800-273-8255 National Suicide Prevention Lifeline, Oliver said. Frontline also handles calls to the 1-800 number.

“People in crisis don’t need to be hunting around, looking for what number to call,” Oliver said. “Anywhere in the country, if you dial 988, you’re going to get connected to an organization that’s set up to help people in a behavioral health crisis.”

Local mental health advocates are optimistic that the new 988 hotline, which launched in mid-July, will help direct mental health calls away from 911 emergency services. Trained counselors are better equipped than police to deal with people experiencing a behavioral health crisis, Oliver said.

That approach is discussed in a policy brief recently released by Policy Matters Ohio, a policy research institute based in Cleveland and Columbus.

“Across the country, communities are implementing new approaches to public safety that reduce reliance on police for emergency calls involving individuals experiencing mental and behavioral health crises,” the Policy Matters paper states.

Cuyahoga County’s Diversion Center, which opened last year, is an example of a new approach to public safety and behavioral health issues.

The Diversion Center gives law enforcement another option beside arresting someone experiencing a mental health crisis. The diversion center is staffed with nurses, psychiatrists and specialists who provide treatment and devise a plan for the person to continue to receive treatment when they leave the center.

Since November 2021, Frontline has referred about 600 Cuyahoga County residents to the center, and will offer the same option to 988 hotline callers, Oliver said.

“It’s a voluntary service, so people aren’t there against their will. If people don’t want to be there, they just walk out,” he said. “I’m so happy that we have the resource.”

988 hotline meets skepticism

Some mental health advocates have voiced concerns about 988 over social media, and warned people not to call it.

A popular Instagram post urged people not to call, post or share the 988 hotline number, saying callers risked police involvement, involuntary treatment at emergency rooms or psychiatric hospitals, and the emotional and financial toll of those experiences.

Other Instagram and Twitter posts claimed that the hotline sends law enforcement officers to check on people at risk of suicide without their consent.

Mental health advocates connected to the new 988 hotline are trying to counteract that information. Hotline staff send law enforcement to a location only if there’s imminent risk to either that person or somebody else.

If a caller is suicidal or threatening to harm themselves or other people, 988 counselors ask questions to understand the situation more fully, Oliver said.

“A lot of people have thoughts of suicide every day; it’s a chronic situation for them and they don’t need necessarily to be in a hospital setting,” he said. “But if someone has taken an overdose, hurt themselves or are about to hurt somebody else, that’s when law enforcement needs to be involved. If we can avoid law enforcement involvement, we’re definitely going to do that.”

Police are the only entity that can take somebody, against their will, to a hospital for an assessment, he said.

“But people don’t need to be hospitalized against their will to get help. There are other ways to get that help, and this 988 hotline is part of that process,” Oliver said.

988 hotline

FrontLine Service staff who field 988 mental health hotline calls relax in the break room with director of crisis services Rick Oliver. From left: crisis intervention specialist Mary Ellen Rodriguez, call center specialist Ashleigh Hamar, call center specialist Ameena Salters, and Oliver. (Credit: Naomi Worthington, FrontLine Service)

Below, Oliver answered additional questions about the new 988 hotline:

Q. Who takes calls and how are these people trained?

FrontLine has licensed counselors and social workers, as well as unlicensed staff who have gone through training to answer these calls.

Call volume goes up starting at 8 a.m. and it peaks in the late afternoon and early evening. The call center is staffed with eight or nine people answering calls during the day.

Q: What types of services are callers connected with?

About 80% of the calls are from people who just need to talk for a few minutes to someone who’s objective and can be a compassionate ear. For the rest, licensed staff does a thorough assessment of their symptoms — which can range from depression, major anxiety, psychotic symptoms or thoughts of suicide.

Callers might need to be linked to a physician quickly for new medication, or to be hospitalized if they are an imminent risk to themselves or others. Callers who need help with homelessness, domestic violence, food, shelter or clothing are referred to the United Way 2-1-1 helpline.

Q: Can people still reach help on the 1-800 National Suicide Prevention Lifeline?

“The 1-800 number is not going away for people who had it programmed into their phone,” Oliver said. “Our local hotline numbers aren’t going away. If you call those other numbers, you still reach someone who can help.”

Q: Does Frontline handle calls from outside of Cuyahoga County?

Calls are routed based on the area code on the caller’s phone. If someone calls 988 from a phone with a 216 area code, and they have moved out of the county or state, the call will be directed to the Cleveland call center. Local hotline staff can connect out-of-town callers with the call center in their area.

Q: In light of the shortage of mental health counselors nationwide and locally, can callers to 988 get behavioral health appointments right away?

It can take several weeks to get linked to mental health counselor. Patients who need to see a psychiatrist for medication might have a longer wait. If someone needs medication quickly, FrontLine can have them see one of its staff psychiatrists on a short-term basis.

Q: Can someone call the hotline on behalf of a child or a friend?

Yes; about 75% of calls regarding suicide come from someone who is concerned about a friend or loved one. The call center strives to help the primary person in crisis.

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