Advocacy organizations aren’t happy that September, the national Suicide Prevention Month has ended. They don’t want to forget the problems facing thousands of Minnesotans with mental health.
The 988 Suicide & Crisis Lifeline received more calls in the last months due to the change of the hotline number from a longer three-digit number to 988 in mid-July.
Minnesota has four call centres. According to the Minnesota Department of Health, calls rose by 44% compared to July 2022’s call volume.
According to MDH, Minnesota’s call centers received 23,099 calls from January 2022 through August 2022. This is an increase of 16.6% over the 19,796 calls they received in the same period in 2021.
According to Carolina De Los Rios (senior program officer, Mental Health & Suicide Prevention at Greater Twin Cities United Way), the centers are receiving more calls. She said that these callers may call several times per day.
De Los Rios says that the root problem is that many callers don’t have enough resources to pay for long-term care. The hotline is their only option, but it is not sustainable.
For the past twenty years, suicide, also known as intentional self-harm or suicide, has steadily increased in Minnesota. According to the Minnesota Department of Health in 2021, there were 777 deaths by suicide. This makes it the seventh consecutive year that more than 700 Minnesotans have committed suicide.
From where are these calls coming?
De Los Rios stated that when someone calls the Lifeline, the call is routed to the appropriate center based on the caller’s area code. The Minnesota Health Department receives data from the Crisis Lifeline 988 Suicide & Crisis Line, which is then sorted by county. The call centers and health department do not have the ability to determine which communities or populations are calling more frequently, except for information that callers may choose share. De Los Rios stated that if the call centers could seperate the data by ZIP code or demographic information, they could highlight disparities in access to mental health care and the need for it in different communities.
Data tracking and demographic are a top priority in order to identify which communities are not receiving mental health access. This is where the problem lies. De Los Rios stated that people are especially cautious when reaching out to our line.
She said that some people are concerned that the call center could know the caller’s ZIP code or address and police could be involved in an unproductive manner.
Lolita King is a psychologist at NorthPoint Health and Wellness Center. She believes that the 988 Lifeline is a good step in the right direction but trust must be built with underserved areas so that mental health care disparities are reduced.
“I don’t believe it’s going to be the final word. It will take a lot of information to inform the public about how useful it can be. It takes more than a flyer or billboard. She said that it will likely take one-on-one contact with the community, going to their homes and dispelling any concerns they might have.
If they have to contact emergency services, the call center won’t ask for a zip code. In 2020, 988 dispatched police approximately 2%. This happens when the person is unable to keep themselves safe or there is an attempt.
De Los Rios stated that people don’t want to (say much) about themselves. Because it’s a crisis call we prioritize safety and de-escalation over, like gathering demographics.
The centers track the demographic information that callers provide and forward it to the Minnesota Department of Health. However, this data is not complete because the callers are able to choose what information they want.
“Underrepresented groups have a healthy suspicion about how this information might be used and who has access to it.” King said. King asked if this could have a negative impact on their ability to access the courts.
Hennepin County received the most calls in 2021, with 20,749 calls. It was followed by St. Louis County, with 1,328, Stearns County, with 1,101 and Olmstead County, with 934, and Isanti County, with 712.
Hennepin County was home to around 60% of the 33,887 calls that were made to Minnesotan call centres in 2021. However, only 22% of Minnesotans live in Hennepin County.
Call center specific
Minnesota’s call centers have very different experiences with callers. However, one thing is common: Calls have increased since the switch from 988 to 988.
The Greater Twin Cities United Way Lifeline can be reached by texting or calling at any time, and is available seven days per week. De Los Rios stated that it has received more than 4,200 calls over the past two-months.
The company employs 18 suicide prevention specialists, who work remotely. They are looking to hire four additional people due to the increase in calls. The center does not require the specialists to be licensed clinicians. Instead, it aims to recruit people who have inpatient management or case management experience.
De Los Rios estimates that six to nine out of the lifeline’s 2,000 to 2,500 monthly callers are frequent callers.
She stated that there is a clear lack of long-term mental healthcare for these individuals.
De Los Rios stated that there are times when callers cannot find resources in their local communities. In these cases, they use the call center almost as a long-term service. “I am glad that callers feel comfortable and confident reaching out to me. This also shows us that they aren’t able to access resources in their local communities. It’s concerning that they continue to reach out to others and reveal that they don’t feel secure that they are receiving the care they need.
Barriers to long term care
King, who has been working in behavioral health for over 20 years, suggests that call centers create an informed consent. This should be clear about the reasons they are asking for the information, and it should also state that the purpose and use of the data are to reduce disparities.
Access to mental health care is not equal. Despite how necessary it may be, there are many barriers that can prevent people from getting the care they need. King stated that stigmatizing the treatment of mental illness can also prevent people from seeking it out.
She said that there has been a stigma attached to those seeking mental health and behavioral services, especially in the underserved areas. It’s not a fanciful or unfounded truth, because we know there have been atrocious acts against the African American community. Our culture and community continue to reflect that.