Karen Duran answered the crisis line at Integral Care, the mental health authority for Austin and Travis County, for four years. A year ago, the National Suicide & Prevention Hotline became more integrated nationwide to connect these regional centers by introducing the 988 crisis number. It’s very similar to the 911 number for police, fire, and emergency medical services.
Since the 988 system went online on July 16, 2022, Duran said: ‘we’ve just had a lot more calls. … We’re getting everything from someone who needs someone to talk to, to having an emotionally difficult day , are having a panic or anxiety attack, breakups and job loss.”
Typically, on a 10-hour shift, he’ll take 20 to 30 calls.
For her, the hardest calls are the kids who call with suicidal thoughts. “Not many people get to see that,” Duran said. “We have to help them see the light. … We are always here for someone.”
On Wednesday, leaders from state, federal and local mental health organizations traveled to a crisis call center at Integral Care for an early anniversary celebration and to raise what’s working locally.
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See increasing numbers of 988 calls
Since the launch of 988, Integral Care’s call center has seen a 50 percent increase in calls, said Integral Care chief operations officer Dawn Handley. The center covers 76 Texas counties with a crisis line that operates 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 received an average of 371 calls per day in May, or more than 11,500 calls. Nationwide, 988 has had more than 4 million calls since it was launched.
Handley attributes the increase in calls to both an increase in needs and an easy-to-remember number that reduced the stigma of seeking mental health help. Now that’s just like you would ask for emergency medical services, firefighters, or the police.
Once someone places a call, the staff member refers more services including setting up an outpatient appointment at a mental health clinic for the caller, or the staff member can send them a mobile health team mental health or link them to urgent clinical mental health care. Handley said that 97% of calls resolve a person’s needs within the time of the call.
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Wendy Salazar called the crisis line several times from 2020 to 2022 to get help for herself in supporting a loved one in a mental health crisis and to help her loved one get help.
During that time, the helpline connected her to resources, as well as sending a mental health team to where her loved one was. Sometimes that meant deciding that hospitalization was necessary during a period of suicidal thoughts. Sometimes she was a reminder of an upcoming mental health appointment and that you have someone to talk to about next steps.
“It was so customer-centric,” Salazar said. “It was a very warm shell of wholehearted support.”
Salazar, a licensed professional counselor herself, has since recommended Integral Care as someone with lived experience using the crisis line. She has also recommended it to clients.
Before it became 988, Salazar said, he could see with customers that “I’m not going to remember this number or you’re giving it on a piece of paper and I’m going to lose it.” Now, it’s “only being able to remember three digits”.
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 have collaborated to increase access to care and work together.
“The collaborations and partnerships here…it’s phenomenal,” Johnson said. “You don’t often see this level of collaboration getting the results it seems to be getting 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 not wrong door concept and made it operational,” Johnson said. “No wrong doors” means that no matter how a person walks through the door to get mental health (police, EMS, justice system, hospital), they get help.
“The great thing about us is that you have your local mental health authority at the table with 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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There is always a need for more expansion
Right now, 84% of calls in Integral Care’s crisis calls are answered. The goal is 100%, which will require more staff. To get more staff, Integral Care added a 10% crisis salary to the salary of crisis line workers.
Handley said it’s not only important to add more crisis line staff; it is important to expand all local mental health services to include more psychiatrists and psychologists. That means catching people before they have a hospital stay, she said.
“We want to work to develop outpatient services so people stay stable and don’t need to use crisis services,” Handley said.
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