Crisis counsellors at 988 call centers provide empathy while juggling limited resources

At a contact centre in southeast Pennsylvania on a Friday night, Michael Colluccio stirred his hot tea before putting on his headset and turning on his computer. The suicide prevention lifeline was receiving calls from all throughout the state, as seen on the screen.
38-year-old Colluccio claimed to understand what it’s like to get one of those calls.

So, Colluccio replied, “I attempted suicide when I was about 10, 11 years old. And we do receive calls from people who are around that age or pretty young who are experiencing comparable stressors.

Making the 988 call when in a mental health emergency can save a person’s life. But depending on where they are, different things happen once they call. Midway through July, the new 988 system went live, and according to an early estimate, calls increased by 45% nationwide in the first week.

Some contact centres claimed they can only do so much without increasing local resources, with calls likely to rise as more people learn about the helpline.

In comparison to many other regions of Pennsylvania, Colluccio claimed that callers in his service area—Bucks County, to the north of Philadelphia—have access to more services. His duties at the local hotline’s operator, the Family Service Association of Bucks County, occasionally entail putting callers in touch with homeless shelters, therapists, or drug and alcohol counsellors.

His primary responsibility is to listen.

The first phone Colluccio received that night was from a woman who sounded distressed. Her spouse had been abusing narcotics when he started threatening to harm her.

Colluccio listened far more often than he spoke. He said that by carefully hearing what a caller has to say, he can provide comfort, validation, and a sense of personal connection.

When he does speak, he frequently engages in gentle questioning while looking for concrete ways to assist. In this instance, his inquiries prompted him to put the caller in touch with a social worker and local domestic abuse services.

He rarely uses 911 as a service. The concept behind 988 is to provide a substitute for calling the police or an ambulance in a mental health emergency. Colluccio claimed that he would typically only dial 911 in cases where a person posed a direct threat to themselves or others. Some individuals who have had negative interactions with the mental health system have expressed their concerns and cautioned others against calling 988 for fear of coming into contact with law enforcement.

Colluccio spoke with the woman for a half-hour and then probed her with a series of pertinent questions to ascertain whether she felt suicidal. He asserted that it is crucial to check on each caller after they hang up to ensure their safety.

The woman seemed to be on the phone to ask for assistance for her spouse at first. However, when Colluccio directly questioned her about her suicidal tendencies on a scale of 1 to 5, she replied that she was probably a 2 or a 3, and that she had made previous suicide attempts.

Colluccio asked her if she wanted a call back the next day before they hung up. He scheduled one after she replied “yes.”

Before receiving another call, Colluccio had barely enough time to take a quick sip of tea. It was a stressed-out young college student. For more than an hour, they spoke.

He claimed that this evening was quite normal.

Because some people phone with pills in hand and are contemplating suicide, Colluccio noted that sometimes the intervention is more urgent. There are those who have called and threatened to commit suicide if you hadn’t answered.

There are more than 200 call centres like this one across the country. Area codes are connected to calls. If no one answers locally, the call is transferred elsewhere. The guarantee is that a live person will always answer the phone.

In some areas, such as Bucks County, callers who require more assistance than counsellors can provide over the phone can access additional resources. A mobile team of mental health professionals can be sent by Colluccio to visit a patient at home. However, the 988 call centre in Hanover, Pennsylvania, a town a few hours to the west, does not offer that choice.

The center’s manager, Jayne Wildasin, said staff members occasionally have to put their headsets down, get in their cars, and drive to a caller’s home, who might be up to an hour away.

So, Wildasin explained, “if there’s a crisis at someone’s house right now, we could possibly go there.”

The local 988 call centre in rural Centre County, another area of the state, relies on volunteers, most of whom are Penn State university students. The business is led by Denise Herr McCann, who stated that although her staff has access to mobile mental health professionals, more are required.

Additionally, there is a need for more mental health specialists who can offer assistance once a crisis has passed.

Other counselling services occasionally fall short of capacity, according to Herr McCann. “People are phoning, and if they’re lucky, providers won’t be available for six weeks. That’s not good at all.

Suicide prevention call centres have been operating on a shoestring budget from local, state, and federal sources for many years. According to Julie Dees, who is in charge of the call centre in Bucks County, they now have to adhere to additional federal laws as a result of the changeover to 988, such as data collection and licencing requirements. All of that is costly.

There are more obligations placed on the call centres, but Dees noted that there isn’t actually any additional funding allocated for that.

According to a recent study from the Pew Charitable Trusts, it is a problem all over the United States. The polling and research firm pointed out that many of the crisis centres performing the service have been underfunded for years, and states are mostly left to foot the bill for the switch to 988. It was advised that state policymakers assess the financial requirements to guarantee the continuity and sustainability of the 988-connected crisis services.

The local and backup call centres’ capacity was increased, and related services were offered, thanks to a $432 million investment by the Biden administration. However, it is anticipated that governments will come up with the major financial sources.

The statute establishing the 988 number in 2020 also gives states the option to draught legislation imposing a levy on mobile bills as a long-term funding source for the 988 number and related mental health services.

The departing Democratic governor of Pennsylvania put out a funding fee concept, but it hasn’t yet found support in the Republican-led legislature. Kevin Boozel, president of the County Commissioners Association of Pennsylvania, expresses concern about the lack of a funding mechanism.

Boozel declared, “This is life or death.” “And you can’t do it halfway.”

Pennsylvania has opted to wait until next year to publicly announce the new 988 number due to concerns that an excessive amount of calls could overwhelm the system. Counties require more time to get funds, employ personnel, and develop the necessary capability for initiatives like those mobile crisis teams.

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