One year after the federal crisis number was rebranded and relaunched as 988, Indiana call centers have answered nearly 4,000 calls per month. (Photo by Danielle E. Gaines//Maryland Matters)
Indiana officials are renewing their push to make Hoosiers aware of the 988 suicide prevention hotline, although more funding will be needed to further expand the state’s crisis response system.
One year after the federal crisis number was rebranded and relaunched as 988, Indiana reported one of the highest in-state response rates for calls. The state’s crisis hotline answers nearly 4,000 calls per month.
Dr. Daniel Rusyniak, secretary of the Indiana Family and Social Services Administration (FSSA), said during a news conference Tuesday that “with more awareness, we’re going to receive additional calls.”
I think everyone, at some point, is touched by mental health crises, suicides, substance use disorder. And so I do think what we're doing is so impactful
– Dr. Daniel Rusyniak, FSSA secretary
For now, that’s a good thing, he said. Many Hoosiers still aren’t aware that 988 exists — meaning they aren’t being connected to necessary, sometimes life-saving resources.
“Since we launched 988 last July, we have seen tremendous benefits already — both in the number of folks who are reaching out to call to us that we can help, but also in our numbers. He noted, too, that Indiana routinely is in the top five states for connecting callers with a local counselor,” Rusyniak said.
“I think everyone, at some point, is touched by mental health crises, suicides, substance use disorder,” he continued. “And so I do think what we’re doing is so impactful.”
More help for Hoosiers
A September 2022 report from the Indiana Behavioral Health Commission estimated that one in five Hoosiers experience mental illness each year, and that for every four Hoosiers treated for mental illness, one additional Hoosier is left untreated.
Between 2011 and 2021, the age-adjusted suicide death rate per 100,000 residents jumped 22% in the Hoosier State, from 13.5 deaths to 16.4 deaths, according to the Centers for Disease Control and Prevention (CDC).
The 988 line launched nationwide in July 2022 as the new number for the National Suicide Prevention Lifeline. Since then, calls have skyrocketed, jumping from 161,678 dial-ins in February 2022 to 404,194 in February 2023. Texts to the line have also increased by 700%.
The federal government made the initial investment but states are responsible for funding the local call centers. Indiana’s crisis system has so far been funded with $133.6 million in federal funds, along with an additional $100 million provided by state lawmakers earlier this year in the current two-year budget.
Currently, 988 call centers in Gary, Muncie, West Lafayette and Indianapolis are on a single telephone platform, which ensures that they are able to answer calls regardless of where they are initiated from, said Kara Biro, FSSA’s director of behavioral health crisis care.
Previously, when the call centers were divided up across Indiana 92 counties, more heavily-populated areas experienced more calls, which meant a potential for longer wait times.
Biro emphasized that the transition to a statewide platform now ensures that callers reach a crisis specialist “as quickly as possible.” The average speed-of-answer is about 10 seconds, she said.
Additionally, Biro noted that Indiana has “very few” calls that are sent back to the national backup line. If a call isn’t answered in a state call center, it’s instead forwarded to the 988 national line instead.
New funding means call centers no longer run on volunteers only. Indiana’s call centers are responsible for hiring their own staff — some in-house, and some remotely — and “they’re all hiring at this time,” Biro continued.
She said, too, that more crisis specialists are still needed to cover additional shifts and to help take on an expected increase in calls as 988 awareness increases.
Crisis specialists working at call centers are trained to help and support individuals through any type of crisis. That could include thoughts of suicide or substance abuse, as well as crises stemming from new jobs, unemployment, financial instability, and relationship or family problems.
Oftentimes, crisis specialists provide “a listening and empathetic ear” to individuals experiencing a crisis before connecting them to local resources and crisis intervention services, Biro said.
“But a big thing that we’re trying to ensure the community is aware of is that we’re not defining what that crisis is. It is not up to me to define when you’re in a crisis,” she said. “It is important to ensure that our community, and the people in our state, feel that no matter what their crisis looks like, no matter how big or small, that they can reach out to 988 for support. No crisis is too big or too small to reach out for support.”
With federal and state funding, the goal is to have a comprehensive, three-part crisis system in place by 2027.
State officials maintain that additional funding will be needed to build out the current system even more, however. Some of that could come from grants applied for through the federal government, but other appropriations will have to be decided by the state legislature.
One possibility for this is to add a fee on cell phones similar to what is used to fund 911.
“We have our call center, assuring that an individual in crisis has a safe place to call where, you’re going to have a trained professional and an empathetic year,” Rusyniak said. “But we know that a comprehensive crisis system has to have more than that, because there are going to be individuals who call who are going to need more resources than we can provide on a telephone.”
More mobile crisis services on the way
The state’s next area of focus is on mobile crisis response teams, Rusyniak said. That way, teams of trained mental health professionals can provide services — in-person and onsite — to Hoosiers who need more help than what’s available via the 988 call line.
Jay Chaudhary, director of FSSA’s mental health and addiction division, said it’s “really important” for Indiana to have those mental health- focused teams, which can respond to crises anywhere within a community.
“They go out to people — they meet people where they are. These are peer-led, oftentimes being led by behavioral professionals,” Chaudhary said. “Most importantly, that will look different depending on where they are, but they’ll share a common thread of delivering therapeutic, evidence-based, culturally-competent crisis response services around the state.”
Four mobile crisis pilot programs launched last year and have so far helped crisis teams respond to roughly 100 calls per month across 16 counties. Chaudhary said state officials and health professionals are now making plans to further expand their efforts.
“Our system is built on the philosophy of ‘no wrong door.’ This is really important,” he said. “This means that no matter who you are, what your crisis is, what your diagnosis is, whether or not you can pay, our system will be available to you, and our providers understand that’s our baseline expectation — that they have to help anybody that comes to them for help.”
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