“Mental health is just as important as physical health,” Governor Mike DeWine said. “988 is a statewide resource that will quickly connect anyone who needs immediate support or crisis treatment to a trained counselor who can listen and connect them with resources. I encourage Ohioans who are in crisis themselves, or helping someone who is, to call 988 for help.”
According to the Centers for Disease Control (CDC), 45,979 Americans died by suicide in 2020. Additionally, the CDC states “an estimated 12.2 million American adults seriously thought about suicide, 3.2 million planned a suicide attempt, and 1.2 million attempted suicide.” Some groups also experience higher rates of suicide, including non-Hispanic American Indian/Alaska Native and non-Hispanic white populations, veterans, people living in rural communities, and the LGBT community.
Suicide rates were also 30% higher in 2020 than in 2000, according to the CDC. Many believe the COVID-19 pandemic exacerbated the mental health crisis.
“Social distancing and everyday pressures have led to greater numbers of people experiencing anxiety, depression and suicidal thoughts,” said Stacey Frohnapfel-Hasson, chief of Ohio Mental Health and Addiction Services’ Office of Prevention and Problem Gambling. “In 2020 alone, the U.S. had one death by suicide about every 11 minutes — and for people aged 10-34 years, suicide is a leading cause of death.”
Building the framework for 988
In 2020, Congress designated the new 988 dialing code to operate through the existing National Suicide Prevention Lifeline’s (NSPL) network of over 200 locally operated and funded crisis centers across the country. The service was established to improve access to crisis services pertaining to suicide and mental health.
The existing 10-digit National Suicide Prevention Lifeline (1-800-273-8255) launched in 2005 and will remain active following the transition to 988, as will local helplines and hotlines, keeping safety nets in place.
Ohio MHAS said the vision behind the 988 transition includes reducing reliance on local law enforcement by linking 988 centers with mobile crisis teams, enabling 988 centers to follow up with those in crisis, relieve emergency room crowding, and better meeting behavioral health needs.
The state has had 18 months to get ready for this move, much of which has been spent building capacity and staff. Lifeline expanded from 12 to 19 call centers, now covering all 88 counties in Ohio. The national service did not include coverage for 22 counties, mostly located in the northwest portion of the state, prior to May 1 of this year.
Ohio MHAS’ phase one priorities for the 988 launch included plans to build system capacity to make sure 90% of Lifeline calls and 50% of Lifeline texts from Ohioans can be answered in the state by this month.
“The 19 Ohio National Suicide Prevention Lifeline/988 call centers have spent the past six months working to staff up for the transition from the 10-digit number to 988,” said Frohnapfel-Hasson.
Lifeline call centers also have a plan in place for wait times, transferring calls to backup providers after 20-30 seconds.
Montgomery County Alcohol, Drug and Mental Health Services (ADAMHS) had a six-month head start on the 988 launch since it began its own crisis hotline called Crisis Now. The number for Crisis Now is 833-580-CALL (2255). RI International is the operating partner for Crisis Now and will be taking the 988 calls that are local to Montgomery County.
While 988 is useful for residents who may not know about Crisis Now, Montgomery County ADAMHS still encourages callers to use the Crisis Now hotline to make sure they get a local person on the other line right away.
“The Montgomery County ADAMHS Board feels like we are better positioned than many other counties across the country for the rollout of 988 because we launched Crisis Now in January,” said Tina Rezash Rogal, ADAMHS director of strategic initiatives and communications.
Ohio anticipates that 80% of calls to 988 from those in crisis will be resolved over the phone with referrals to local resources. In some cases, a mobile team will be sent to the caller’s location, and if necessary, the caller may be taken to a stabilization facility.
Montgomery County ADAMHS has already seen 89% of calls to its Crisis Now hotline being resolved over the phone by connecting callers to local resources. Calls to Crisis Now last, on average, approximately 30 minutes.
Approximately $20 million in federal funding is going to the start-up costs of Ohio’s 988 launch and year one of the implementation through July 2023. Comparatively, the CDC estimates there is a significant financial toll that suicide takes on society with suicide and non-fatal self-harm costing the U.S. “nearly $490 billion in medical costs, work loss costs, value of statistical life, and quality of life costs.”
Is it an emergency or a crisis?
Those experiencing a mental health or addiction emergency, rather than a crisis, should still call 911.
Ohio MHAS defines a mental health and/or addiction emergency as a life-threatening situation where immediate assistance is needed, such as when a person is actively harming themselves or someone else. Examples include: an active suicide threat, threatening harm to self or others, self-injury that needs medical attention, severe intoxication, inability to care for one’s self, and/or an apparent drug overdose.
Examples of a mental health and/or addiction crisis, which are non-life-threatening situations, include: talking about suicide or planning to harm one’s self, talking about harming others, self-injury that doesn’t need medical attention, overuse of alcohol or drugs, and/or extreme depression, anxiety, or other mental illness symptoms.
“Some may struggle with ‘should I call 911 or 988?’ ” Ohio MHAS Director Lori Criss explained, “The 988 number will become well known over time, just like 911. We want people to think about: 1. Is this a fire or police emergency or imminent danger to life? Call 911. 2. Do I need help related to thoughts of suicide, mental health or addiction crisis? Call 988.”
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