“Nearly everyone has been touched by suicide is some way. And every day, signs for help were missed, and lives are lost,” said state Rep. Gail K. Pavliga, R-Portage County in her submitted testimony on H.B. 231. “That is why Congress created the 988 program.”
Pavliga is one of the primary sponsors of the bill, along with state Rep. Adam C. Miller, D-Columbus.
Suicide rates increased approximately 36% between 2000–2021, according to the Centers for Disease Control, accounting for 48,183 deaths in 2021. In 2021, suicide was among the top nine leading causes of death for people ages 10-64. Suicide was the second leading cause of death for people ages 10-14 and 20-34, according to the most recent available data.
The 988 hotline is what was previously known as the National Suicide Prevention Lifeline, which was the 1-800-273-8255 number that launched in 2005. The state expanded its call center capacity in to cover all 88 counties in Ohio. Previously, the national service did not include coverage for 22 counties, mostly located in the northwest portion of the state, prior to May 1, 2022.
The state received approximately $20 million in federal funding for the start-up costs of Ohio’s 988 launch and year one of the implementation through July 2023.
Ohio’s state budget set $20.7 million in fiscal year 2024 and $25.8 million in fiscal year 2025 for the 988 program.
H.B. 231 establishes ongoing funding for the 988 hotline, but mental health advocates say it is not enough to fund the entire program.
“We don’t want legislators and the public to think if you pass this piece of legislation it’s going to pay for 988, because it’s not,” said Luke Russell, executive director of the Ohio division of National Alliance on Mental Illness (NAMI).
The proposed legislation creates a monthly 988 charge of 10 cents to be imposed on:
- Each subscriber of wireless service or voice over internet protocol service who has a billing address in Ohio;
- Each wireline service customer; and,
- Each retail sale of a prepaid wireless calling service occurring in Ohio.
Cellphone users already pay a 25-cent monthly surcharge for 911, which appears on people’s phone bills. H.B. 231 establishes that funding for 988 and 911 would remain separate.
The 10-cent fee probably wouldn’t cover even half the cost to operate 988, Russell said. NAMI Ohio is neutral on H.B. 231, adding they are not against it, but they want to learn more about the full cost of 988 and consider funding sources for it.
“What we’d like to see is for them to add a study group before the next budget to look at what is the actual cost to run 988 in Ohio,” Russell said. He added the study should also look at if state should fund the full cost of 988 through the state budget or new legislation.
H.B. 231 was referred to the finance committee and is currently still in committee.
Growing local use
Crisis hotlines have been seeing increasing use, though NAMI Ohio says the recognition in the general public of what 988 is still at around 15%.
“The bigger challenge is just getting information out to people to use it,” Russell said.
Local agencies have seen a growing number of callers each month as people seek out support during a mental health crisis or help just trying to navigate available resources.
RI International, a mental health and substance use crisis service provider, operates Montgomery County’s Crisis Now hotline (833-580-CALL or 833-580-2255), which is funded by Montgomery County Alcohol, Drug Addiction and Mental Health Services (ADAMHS).
Crisis Now is separate from 988 and launched approximately six months ahead of 988. The plan is to continue operating the local hotline, with Montgomery County ADAMHS saying that is due to Crisis Now offering additional resources.
“For us, it is our 988, and so we would continue to have Crisis Now as our ongoing service provider,” said Helen Jones-Kelley, executive director of Montgomery County ADAMHS. “We actually have a little bit more than what the legislation is calling for in that we, early on, established all three aspects of crisis services. We have the call center, we have the mobile crisis services, and now finally we have the crisis center where people can go.”
The Montgomery County Crisis Receiving Center will operate as a “living-room style” emergency facility at 601 S. Edwin C. Moses Blvd. in Dayton. It has had a soft opening as it continues to train staff, Jones-Kelley said.
The Crisis Now hotline operates from 7 a.m. to midnight, with calls after midnight transferring to the 988 call centers. The 988 call center assigned to Montgomery County will also transfer some of its calls to the Crisis Now hotline, according to Montgomery County ADAMHS.
Crisis Now has seen an increasing number of calls over the last four to five months, said Joy Brunson-Nsubuga, chief operating officer for RI International. They receive approximately 1,600 to 1,800 calls a month, and they dispatch their mobile unit between 100 and 140 times a month.
Help for abuse survivors
Though currently separate, Crisis Now’s progress shows how a service like 988 can help get resources to people in non-life-threatening, but still serious situations. Those types of situations can include suicidal ideation, thoughts or talking of self harm or harming others, overuse of alcohol or drugs, extreme depression and/or anxiety, or more.
YWCA Dayton, which is Montgomery County’s domestic violence shelter, utilizes Crisis Now to help its residents in its 65 apartments and other domestic violence survivors when they are experiencing a mental health crisis.
“We try to serve our clients with our resources first before we call them, but it’s not always possible because we are not a mental health provider in the sense of being able to provide hospital stays or any medication that may be necessary to help someone through whatever they’re struggling with,” said Kaitlyn Olsen, clinical manager at YWCA Dayton.
Many times when someone from YWCA Dayton calls Crisis Now, it is due to someone experiencing thoughts of suicide, Olsen said, so the mobile unit from Crisis Now will respond. She said this happens about one or two times a month.
“They can get the services and obtain the supervision and safety that they need to prevent themselves from committing suicide or killing themselves by suicide until they’re stable enough to return to their home,” Olsen said.
Crisis Now can also help provide YWCA Dayton care managers with a second opinion on a situation someone may be going through, taking some of the pressure off of the care managers. Mental health care providers also have been struggling with staffing concerns, so Crisis Now helps provide YWCA’s clients with additional support.
“It is difficult to provide what our clients and residents need at all times without that additional support from Crisis Now,” Olsen said.