Karen Duran has been answering the crisis line at Integral Care, Austin and Travis County’s mental health authority, for four years. A year ago, the National Suicide & Prevention Hotline became more integrated nationally to connect these regional centers by introducing the 988 crisis number. It’s much like the 911 number for police, fire and emergency medical services.
Since the 988 system came online July 16, 2022, Duran said, “we’ve just gotten a lot more calls. … We get everything from someone needing someone to talk to, to they are having an emotionally difficult day, to they are having a panic attack or anxiety, to breakups and job loss.”
Typically, in a 10-hour shift, she’ll take 20 to 30 calls.
Mental health professional supervisor Karen Duran answers calls Wednesday from the 988 crisis hotline in the call center at Integral Care’s Dove Springs Clinic. A year ago, the National Suicide & Prevention Hotline introduced the 988 crisis phone number.
For her, the hardest calls are the children who call with thoughts of suicide. “Not a lot of people get to see this,” Duran said. “We get to help them see the light. … We’re always here for somebody.”
On Wednesday, leaders from the state, federal and local mental health organizations came to a crisis call center at Integral Care for an early celebration of the anniversary and to lift up what is working locally.
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Practice manager Jaime Parker answers calls on the crisis hotline Wednesday.
Seeing the numbers of 988 calls increase
Since launching 988, the Integral Care call center has seen a 50% increase in calls, said Dawn Handley, Integral Care chief operations officer. The center covers 76 Texas counties with a crisis line that runs 24 hours a day, seven days a week. It has 50 crisis line employees, who mostly work remotely.
The 988 service is available in English and Spanish, and via text messaging service in both languages.
Centers in Texas took an average of 371 calls a day in May, or more than 11,500 calls. Nationally, the 988 number has had more than 4 million calls since it launched.
Handley attributes the increase in calls to both an increase in need as well as an easy-to-remember number that has reduced the stigma of asking for help for mental health. It’s now just like you would ask for emergency medical services, fire or police.
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Once someone makes a call, the staff member makes referrals to more services including making an out-patient mental health clinic appointment for the caller, or the staff member can dispatch a mobile mental health team to them or connect them to the mental health urgent care clinic. Handley said 97% of calls get a person’s needs resolved by the time the call ends.
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Wendy Salazar called the crisis line multiple times from 2020 to 2022 to get help for herself in supporting a loved one in a mental health crisis as well as helping her loved one call to get help.
During that time, the help line connected her to resources, as well as sent a mental health team to where her loved one was. Sometimes that meant deciding a hospitalization was necessary during a time of suicidal thoughts. Sometimes it was a reminder of an upcoming mental health appointment and having a person to talk to about next steps.
“It was so client-centered,” Salazar said. “It was a very warm wrapping of unconditional support.”
Salazar, herself a licensed professional counselor, has since advised Integral Care as a person with lived experience in using the crisis line. She also has recommended it to clients.
Before it became 988, Salazar said, she could see with clients that “I’m not going to remember this number or you are giving it on a piece of paper and I’m going to lose this.” Now, it’s “being able to remember just three digits.”
Since launching the 988 hotline, the Integral Care call center has seen a 50% increase in calls, said Dawn Handley, chief operations officer of Integral Care.
What makes Austin unique
Monica Johnson, director of the 988 & Behavioral Health Crisis Coordinating Office for the federal Substance Abuse and Mental Health Services Administration, said Wednesday that what makes Austin unique is that leaders from EMS, police, fire, the justice system and mental health services collaborated to increase access to care and work together.
“The collaborations and the partnerships here … it’s phenomenal,” Johnson said. “You don’t often see this level of collaboration getting the outcomes they seem to get here.”
If you call 911 in Travis County, you get four options, instead of three: police, fire, EMS and mental health.
“They’ve taken the concept of no-wrong door and operationalized it,” Johnson said. “No wrong door” means that no matter how a person enters the door to get mental health (police, EMS, justice system, hospital), they get help.
“What’s neat about us is you have your local mental health authority at the table with the first responders,” Handley said. “We all have electronic health records. We can look into our system. We can see where people have touched the system throughout … and really build a plan to expand our services.”
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Mental health professional supervisors Karen Duran and Yashi Duhon answer calls from the crisis hotline. “We get to help them see the light,” Duran said. “We’re always here for somebody.”
Always a need for more expansion
Right now, 84% of calls into Integral Care’s crisis calls get answered. The goal is 100%, which will require more staffing. To get more staffing, Integral Care has added a crisis stipend of 10% to the pay of the crisis line workers.
Handley said it’s not only important to add more crisis line staff; it’s important to expand all local mental health services, including more psychiatrists and psychologists. That means catching people before they have a hospitalization, she said.
“We want to work toward building out the outpatient services so people stay stable and don’t need to use the crisis services,” Handley said.
This article originally appeared on Austin American-Statesman: Year after 988 suicide, crisis number calls increase in Travis County
