988 – Suicide and Crisis Lifeline

When you’re having a mental health crisis, call 988, the three digit number for the National Suicide and Crisis Lifeline. These calls are answered by local call centers with trained mental health professionals. New Vista answers 988 for Central Kentucky. In this episode we chat with Darcy Miller, New Vista’s Regional Director of Emergency Response and Client Engagement, about 988 and how New Vista answers the call.

If you or someone you know are in crisis, call or text 988 or chat online at 988lifeline.org.

Find out more about New Vista at newvista.org or by calling our 24-Hour Helpline 1.800.928.8000.

Tara Starwalt

Hello and welcome to the Good Ahead podcast by New Vista. I’m Dr. Tara Starwalt, Community Engagement Specialist.

 

Nicolas Scott

And I’m Nicolas Scott, Digital Media Specialist. It’s early December. It’s getting cold. We’ve had a couple of holidays. We have a couple more. We’re in the midst of the holiday stretch.

 

Tara Starwalt

We are. And it just feels like it gets so busy during this time of year between gathering with friends or family or if you are fortunate enough to have a community to shop for or to shop with. But I think even, you know, sometimes the increase of all these good things, those good things can be a little bit stressful too, and can maybe increase some of the anxiety or depression that may be going on before the holidays.

 

Nicolas Scott

Yes, According to a survey by NAMI, the National Alliance on Mental Illness, 64% of people who are living with mental illness report worsening symptoms around the holidays.

 

Tara Starwalt

Absolutely. I would think with the need to travel, sometimes feeling the need to shop for people that those symptoms absolutely increase. Nicolas you had the opportunity to chat with someone recently that taught you a lot about a new resource that people can use for those increasing mental health symptoms.

 

Nicolas Scott

Yes, I was able to sit down with Darcy Miller, New Vista’s Director of Emergency Response and Client Engagement, and we were able to talk about 988, the National Suicide and Crisis Lifeline.

 

Tara Starwalt

That’s great.

 

Nicolas Scott

Yeah, it launched nationwide in July of last year, July 2022. And while the National Suicide and Crisis Lifeline is not a new resource, it’s been around since 2005, the three-digit 988 number is a new way to call in to that resource. But just like you would call 911 for a physical health emergency, you call 988 for a mental health emergency. Join me as I talk to Darcy about 988, The Suicide and Crisis Lifeline.

 

This is Nicolas Scott with the Good Ahead podcast. And I’m sitting down with Darcy Miller, New Vista’s Regional Director of Emergency Response and Client Engagement. Today we’re going to talk about 988, the National Suicide and Crisis Lifeline, which new Vista answers, and Central Kentucky. How long have you been involved with new Vista?

 

Darcy Miller

23 years.

 

Nicolas Scott

You’ve been here for a while.

 

Darcy Miller

Yeah. I came as a practicum student, and I’m still here.

 

Nicolas Scott

So you haven’t always been the Regional Director of Emergency Response and Client Engagement?. As we were talking before the podcast started rolling, you talking about how role has grown and it has kind of been built. What first got you interested in emergency services?

 

Darcy Miller

There was an opportunity to be a mobile crisis therapist 16 years ago for teens and kids, and that’s something that I ended up doing. I had started in nontraditional services anyway when I came. I did something called wraparound services, where you would go and see kids in the school or see families in the home, and you’d drive and do counseling in the living room kind of thing. I’ve also done some work with outpatient, but in any of those positions there were elements of crisis work.

 

Nicolas Scott

Tell us more about 988.

 

Darcy Miller

So 988 is a crisis line for when someone is experiencing a mental health issue or crisis. It is a three-digit number where you can call easily and get supports in the moment. So if you are experiencing feelings of depression with thoughts of suicide, you may not have a plan, but you’re beginning to feel overwhelmed. You’re beginning to lose hope. You’re beginning to feel helpless. You are having such feelings of anxiety that you don’t know how you’re going to function anymore. And you think, I don’t know how much more I can live this way.  That’s for  988. To call and have supports.

 

We talk about depression and anxiety. But there are people that struggle with serious mental illness like bipolar disorder and schizophrenia. And those things can even if you’re getting treatment and in recovery, you still may have moments where those things are very, very difficult and you begin to kind of lose futuristic thinking or not sure what to do next. Then call and get supports. So if you’re dealing with some type of mental health—and sometimes it’s an immediate trauma, something has happened. You’ve had a death, that your partner has died unexpectedly or a parent, and you’re like, I don’t know how I can function without that loved one in my life. They’re there to support you.

 

Nicolas Scott

And 988 launched nationwide in July of last year, July 20, 22. What was the catalyst for 988? Where did this all start? Why this become a national conversation?

 

Darcy Miller

Well, if people are familiar with the ten-digit number that came prior to 988 1. 800.273 (TALK). So that was the national lifeline number prior. And, you know, the catalyst for that, just kind of like we have  had a crisis line for several years now as a mental health center is for people to be able to call when they’re having a mental health crisis. But remembering a ten-digit number when you’re experiencing a mental health crisis is a little bit more difficult than remembering a three-digit number. And think about remembering when you’re having a medical health crisis. Everybody knows 911. Right. And it is universal. It doesn’t matter where you’re at in the United States of America, if you’re having a medical emergency, you know you can call 911. And that’s the same idea for a behavioral health crisis, that wherever you’re at, if you’re struggling with severe depression and thoughts of suicide, thoughts of harming yourself in any way and you need some supports, you can call 988.

 

Nicolas Scott

That’s excellent. Yeah, it’s much easier to remember.

 

Darcy Miller

Three digits to ten. Yes.

 

Nicolas Scott

So I imagine going from a ten-digit to a three-digit number isn’t easy and doesn’t happen overnight. What were some of the struggles you all faced in adapting to this new three-digit number?

 

Darcy Miller

I think probably maybe a better context to put that in is barriers, and that is making sure that we have the funding, that we have the capacity, like those are still issues because it’s a new way to contact, it’s a new national number. It’s easier to remember, which is wonderful. But we also have got to make sure that we have enough people answering those phone calls. It’s got to be very frustrating to be in a crisis and feel like you’re on hold. So building capacity, making sure that we are funding that line and we are doing it effectively and efficiently. So I think those are some of the barriers that people have seen within our state and just across the country. It may look a little bit different in each state and what that looks like.

 

I think it’s also trying to conceptualize, okay, you’ve got, the tag is someone to call, someone to respond and some place to go. So we’ve got to kind of figure out the when we call, then what happens, making sure that there someone there to answer and that we’ve got those next steps lined up. But I’m also reminded that it took—how long has it been for 911, 40 years? That they have worked on developing 911 and that network was not developed overnight.

 

So I don’t expect the crisis continuum to be developed overnight either. So those are some of the things, the issues, the barriers, the challenges that we’re working out right now. And the good thing is I think we have a good foundation being a part of a human mental health center because we’ve had parts and elements of this already.

 

Now it’s how do we mainstream it? How do we grow it? How do we work more effectively with our community partners, with schools and law enforcement and court systems and things like that? So those are some of the things that I think we’re still trying to work out.

 

Nicolas Scott

What was the preparation like? Because your call center had to be ready.

 

Darcy Miller

Yes, Well, our call center was already taking 988 calls prior to that. So basically, you know, this was kind of years in the making. So different call centers around the country, states each have a different way of answering the call for988. So some have a one call center just for the entire state. In Kentucky, we are working through our community mental health centers because they already had a crisis line established for the community mental health for the community in our community mental health centers. So we became a certified 988 center. All the CMHCs work towards that. And we were, I think, in March or April of 2021, April of 2021 is when we began to officially answer 988 calls. So the July deadline for 2022 is to make sure all the call centers were ready and also the phone carriers were ready. So that was kind of the last day, but it was a bit like you got to think of building a house like it was the last brick was in place. But we were answering calls before them.

 

Nicolas Scott

So we had a good foundation already built, correct? It seemed like an easy transition.

 

Darcy Miller

So it was a little bit different, probably, for our call center, because we started in—literally right before the lockdown—in February, March of 2020. So we actually started the beginning of 2020. And then the lockdown happened, which not only affected, well, it affected the entire country, but affected our call center. But it also affected Vibrant was which is the on the national level, the one that manages the lifeline and the 988 crisis line. And they are out of New York City. So they were lockdown. We were lockdown. So it took about a year with all of that because everything was virtual and going back and forth and making sure we had our policies and our workflows in place. So it took about a year to make sure we had everything working the way it needed to be and the training and all the pieces put together.

 

Nicolas Scott

And that was about a year before 988 launched, right?

 

Darcy Miller

Yes.

 

Nicolas Scott

So you all were ready to adapt.

 

Darcy Miller

Yeah, we were already that piece of the puzzle was already in place for us.

 

Nicolas Scott

Changing to 988. There have been barriers that you have, that we have overcome. How do you feel like New Vista and Kentucky have done to overcoming these barriers? How have they adapted to increasing calls center capacity, to getting the funding they need and what barriers are still ahead that you see on the horizon?

 

Darcy Miller

So funding was probably the scariest barrier for me up front, making sure that that we were able to support our staff, that we provided the right kind of training, we were able to pay them well because it’s a tough job. And that with the volume of calls coming in, now that it’s a three-digit number and it’s easier to remember and we have seen an increase in volume, that we were going to be able to financially support it.

 

So I’ve been very thankful that as the state is actively making choices, our legislature, our governor, are looking at ways for sustainable funding. So I know they’ve put some money in the budget and they’re looking at kind of long term goals for how do we sustain this. Because I don’t think 988 is going anywhere. And I think people have who have utilized it have found it helpful. So how do we make sure that it stays? I’m really thankful for that. And I think our next steps in the development of the crisis continuum. And because 988 is one part of it, right. But we also want to include text and chat. And so this year, I know our call center is exploring that and looking at what we need to do technology-wise, skill set-wise, growing our staff. We have started a volunteer program that we’re super excited about, that people can come who want to give back, they can answer calls. I would love to eventually grow that into also responding to text and chat. So we’re in that planning process also because text and chat does already exist for 988. Our call center isn’t taking those at this time, that goes to the national level. But if we can begin taking that also and supporting our people locally with that, I think that would be fantastic. So that’s one of the things that we’re working on.

And some of the other steps are, you know, that that’s the three piece, right? Answering the call, but the other is having someone to respond. And we are we already have a mobile crisis team, but we are working with community partners of growing and kind of figuring out what the needs are and how we respond efficiently and effectively. So I think that’s just in the beginning stages of that. And then long term, some place to go. And as a community developing beyond going to an emergency room or a hospital system. Is there a crisis unit that we can develop? And that’s kind of a long term goals, right? But that doesn’t mean that it’s not necessary and that it isn’t needed.

 

Nicolas Scott

That’s great to have what we’re doing now, what we are doing in the near future and what is further down the line, but also as exciting, as exciting as change from the ten-digit number, tiny eight and making that more accessible, it’s encouraging to hear that we’re not satisfied with like, “Yup, that’s good enough.” Like we’re wanting to continually make and be the most accessible and the best it can be.

 

Darcy Miller

Absolutely.

 

Nicolas Scott

And it’s exciting to hear the vision that that’s being cast for that.

 

Tara Starwalt

You’re listening to The Good Ahead podcast brought to you by New Vista, the Certified Community Behavioral Health Clinic serving 17 Central Kentucky Counties.

 

Nicolas Scott

We offer resources and supports in the areas of mental health, substance use, developmental and primary care services in order to help individuals and their families live their best lives.

 

Tara Starwalt

You can find out more about these resources by contacting our 24-hour helpline at 1.800.928.8000. Or you can find us online at newvista.org

 

Nicolas Scott

You heard Darcy talk about the foundations and barriers that we needed to overcome to get 988 established here in Central Kentucky. Now, let’s join her as she talks about what it takes to keep the line running today.

 

Nicolas Scott

And we’re back. Darcy, you talked about 988 getting started at New Vista. Now let’s talk about the line itself. Who’s answering the call when someone calls in?

 

Darcy Miller

Call takers, call agents that are trained with 988. Not only are they taking the call, but they play a dual role as kind of the first responder for mental health. So it’s a little bit different than 911. 911, and a lot of times you’ll hear them call dispatch because they dispatch first responders, they’re dispatching police or fire or paramedics. Whereas with 988, we try to resolve the call over the phone with the call taker, the 988 trained call agent. So they already have listened in skills and coping skills that they can share with the caller. So they are not only the call taker, but they’re also kind of our first line of response. And then, and I would say honestly, about 80%, at least 80% of our calls are resolved just with the call taker. And then after that, it may be, do you need an emergency next day appointment? Do we need to connect you with mobile crisis? You know what? It seems like you are really, really struggling. Do we need to look at going to a hospital and get you another level of care? It kind of depends on what’s going on in that situation. But our call takers are also first responders. So I think that the way that is built is a little bit different than 911 and actually kind of exciting because our whole goal is to support you in that phone call and for it not to go any further. And if it does need to go further, that it’s getting you the supports that you need and the treatment that you need. Not calling police, not calling fire, but rather getting you getting you connected with a treatment team or services for care that you need.

 

Nicolas Scott

Letting mental health professionals deal with correct mental behavioral health issues. That’s fantastic.

 

Darcy Miller

Yeah.

 

Nicolas Scott

Okay. So how does it work if I call 988? How am I connected to your call center?

 

Darcy Miller

So right now, the way the system is set up, it’s set up by area code. So the tricky thing about that is, though I love that we’ve got cell phones, it also means that you can move anywhere in the country and take that number with you. So I think of my mom, who, I grew up in Pennsylvania and I moved down here to Kentucky for school, well she moved down to be closer to me and grandkids and all that kind of stuff. She still has a Pennsylvania number, so if she were to call 988, it would be routed to Pennsylvania. Now, here’s the good thing. They recognize that that’s happening. And so the call centers across the state, well, we’ll find out where they’re located, if people are willing to share that, and route them to their local center. And if they’re not willing to share that and they just want to talk to the person on the phone, we’re all of our call takers across the country are trained. So we’ve had calls from Florida, we’ve had calls from Arkansas, we’ve had calls, we’ve even had calls out of the country because people have looked it up on the Web, the Internet, and found the 800 number and they have called it. So we’re trained no matter where you live. But if you need resources locally, we will connect you to that call center locally, if you’re willing.

 

Nicolas Scott

So that’s the benefit of having call’s answered locally is you’re able to provide more accurate local resources.

 

Darcy Miller

Yes, the skill set doesn’t change, but if you need follow up care, if you want to have an emergency appointment, if you need counseling, we know the local resources because people can call for all different kinds of reasons. Maybe they’re in crisis because of a domestic violence situation. Maybe they’re in crisis because of a sexual assault. So you really need to go to a rape crisis center. That’s something that the caller may be willing to do after talking to one of our crisis line workers. Well, it helps if you have those resources locally. That doesn’t mean we can’t connect you. It just may take a few extra steps.

 

Nicolas Scott

So when I call 988, no matter where I am in the country, I can be connected to someone who I can talk to. And then if I need local resources and if this call center isn’t where I actually am, they can connect me to my local call center who has local resources that are in my area and knows the region I’m in. That. That’s incredible. That’s fantastic. That’s great.

 

So the three-digit 988 number launched nationally in July of 2022. But New Vista had been answering calls to the National Suicide and Crisis Lifeline before that. Have you noticed any changes into the calls to the Lifeline or the number of calls since 988 launched nationally?

 

Darcy Miller

We’ve been answering calls for a little over two years now, almost two, two and a half years. So if you look at when we started in April of 2021, we have seen a 19% increase in our call volume. When we moved into­—overall over the past two years—­that 2021, 22, when we went live nationwide, we saw about a 15% increase within that first year. And then there’s been an additional 4% increase on top of that. So there’s definitely an increase in call volume. The interesting thing, I think they just did a survey, and I’ll be honest with you, I can’t remember it’s on the state level or the national level. I think it’s the national level, but only about 30% of the public, which is actually higher than I thought, are familiar with 988. So we still have a lot of work to do marketing-wise. I do know we kind of did a soft launch with marketing because they weren’t sure what the call volume was going to be, and we’ve had the volume has increased enough that it’s outpacing us being able to hire. So we hire people, we get them trained, but the call volume continues to increase and we’re beginning to catch up, which I’m super excited about. That doesn’t mean that we’re not going to answer the call. We have with our local call center within 2 minutes to answer the phone, and if it doesn’t hit within 2 minutes, then it goes to the National backup. The goal is for it not to go to the national backup, though. We want to be answering these calls locally. We still have a pretty high percentage answer rate, but we want to get higher and we’re hitting those goals with our volunteers and expanding our call center. So I’m super excited about that.

 

Nicolas Scott

Tell me more about volunteering. So we do have paid staff for the 988 line

 

Darcy Miller

We do, and that will not go away.

 

Nicolas Scott

Tell me about what do we do with volunteers or how are volunteers involved in the call line?

 

Darcy Miller

So the interesting thing is, in other parts of the country, there are crisis lines that are completely volunteer based with only a handful of paid staff. So we’re kind of the opposite. In Kentucky, our call centers are mostly paid staff, so we are kind of one of the few in Kentucky that have developed this volunteer program. And it’s it was a lot of work and it’s super exciting because we’ve you know, there aren’t a whole lot of silver linings with COVID.But one of the silver linings is that we’ve been able to do remote work with our call center, and we’ve been able to develop a process based on that, that our volunteers can also volunteer remotely. So you don’t have to come to a bricks and mortar call center. You can be trained, we meet virtually and you can answer calls from the privacy of your own home as a volunteer. It’s a nine month commitment. We allow up to six weeks of training. It’s self-paced. We do have we have some staff. We’ve got three staff that are dedicated to the 988 crisis line, plus a coordinator. So you can work with them. If you’re a volunteer, you’re not going to be out there by yourself if you’re answering calls. There’s always paid staff that are trained that have been doing this for years to help provide supports and leadership beyond that. And I think it is a great way to give back if you’re interested in this field, in psychology, social work, counseling, this is a great way to kind of figure out, you know, is this something that I want to do and have firsthand experience? I’ve seen people volunteer because they’ve had a loved one that has experienced mental health issues, and it’s their way of giving back or retirees or whoever. So it’s a way to give back to our community and answer the call.

 

Nicolas Scott

I imagine a lot of the calls in to the call line deal with heavy topics.

 

Darcy Miller

They can. Not always, but they can.

 

Nicolas Scott

Are the volunteers able to see a difference that they’re making? They may have a five-minute conversation with someone and then they part ways.

 

Darcy Miller

So a volunteer program is still kind of in the beginning stages. I can talk probably more from our call center staff and what they have said. So our call center staff have said it can be it can be a little stressful, right, because you know that this is a crisis line. And if someone is calling this line, they are in distress. We also have our one 800 number, 1.800.928.8000. But a lot of people call that for other things other than just crisis. Of course, 988 people are in some type of crisis or distress, but we have managed that with having office hours, with leadership to kind of process distressing calls­—you can call leadership in the moment­—but it can also be very rewarding because some of our call center staff have said that in the moment, the person they have talked to have said, “I think you saved my life today. I don’t know what I would have done,” like, it makes me tear up to think about, “I don’t know what I would have done if you hadn’t been there,” and that kind of real time, in the moment, saving and supporting somebody’s life is invaluable and so rewarding. And sometimes what’s being shared may be heavier for the person that is sharing it, but not as heavy for you because you’re the helper, right? So you’re helping. But for them, it’s a huge relief. For them, it helps. You have helped them see hope. So you may walk away, and I don’t want volunteers or our crisis line or anyone to think that our crisis line workers or volunteers are walking with this heavy burden on their shoulders. Usually it’s just helping the caller lift their burden. It’s not taking on. It’s just here’s what we can do, here’s how we can help. Here’s how we can help you with recovery. And I think that is very powerful and there are going to be a handful of calls that are really intense and people are really feeling very hopeless. And those can be difficult. But we have supports internally for that that we help those crisis line workers that need that support also, because, you know, helpers need help, too.

Sometimes they need support too.

 

Nicolas Scott

They do. They really do. And it’s encouraging to see the Vista recognize the need to support not just those who call in, but also those who are taking the call. Talk to us about the callers. Who is calling in to 988?

 

Darcy Miller

I would say that most people call in distress, maybe not immediate crisis. They’re having thoughts, but they don’t necessarily have an immediate plan to die by suicide. But they’re just, it’s they’re in a bad way. But it’s better to call than then when you’re at immediate risk. If you’re sitting there and you’re like, “Well, I don’t want to tie up a crisis line. I’m not feeling that bad. And really what I need is therapy and counseling, but I still have hope for tomorrow. And I said, I’m going to be okay, but I know I need supports,” then call and schedule an appointment. Call your wherever you’re at. Your call to Vista at 1.800.928.8000. Call somebody out like call a counseling psychiatric therapy place, right. But if you’re beginning to lose hope, if you’re beginning to feel overwhelmed and helpless and you can’t see tomorrow or you can’t see the future, or you’re like, “I don’t know how I’m going to function anymore,” that’s when you need to call. Don’t be afraid to call 988.

 

Tara Starwalt

Wow. Nicolas, I have to say, you know, as a mental health professional myself, I knew of 988. But now, after talking to Darcy, there’s so many more details that I understand better and that I think can bring much more hope to people who are feeling this stress during the holidays that we’re talking about. For me, one of the big things is that it’s answered regionally by local, regional mental health professionals in your area, trying to help everyone through situations and that they can provide local resources for our 17 central Kentucky counties. What I’m wondering now, however, is what happens when you actually call 988?

 

Nicolas Scott

Well, I also sat down with Cory Hudnall, the 988 coordinator for New Vista, and talked to him about the lifeline, what it’s like to call in and what it’s like to answer the call. But that’s our next episode. Join us next time as we talk more about the reality of calling into the line and answering the call. See you next time.

 

This is the Good Ahead podcast, brought to you by New Vista, the Certified Community Behavioral Health Clinic, serving 17 Central Kentucky counties.

 

Tara Starwalt

We provide resources to individuals and families in the areas of mental health, substance use, developmental and primary care services to help each person see the good ahead.

 

Nicolas Scott

Find out more by calling our 24-hour helpline at 1.800.928.8000 or find us online at newvista.org. Thanks for listening.

 

Tara Starwalt

We’ll see you next time.