‘911 for the brain’: Tarrant County call center prepares for 3-digit suicide lifeline
If you or a loved one is experiencing a crisis or suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-8255. The 988 lifeline discussed in this article is unavailable until it launches July 16.
There are not enough people like Brittney Henry in Texas.
Henry spends her days answering calls from the National Suicide Prevention Lifeline. She talks to people who are often in extreme pain, including some who are thinking about or planning to hurt themselves.
The job requires her to stay calm, and to respond to strangers’ distress with patience.
“When somebody is in a crisis, or calls in and says, ‘I’m standing at the top of a parking garage,’ if their voice is on (a level) 10, I have to make sure that my voice is on two,” she said.
Henry is a senior crisis interventionist with My Health My Resources of Tarrant County, the public entity that provides treatment and support for people with mental and behavioral health issues and intellectual and developmental disabilities. MHMR also operates a call center for its crisis line and calls made to the suicide prevention lifeline.
Finding people like Henry, who have the skills and temperament to do a critical and taxing job, was never easy. But the workforce shortages roiling industries across the U.S. are also affecting crisis response workers. MHMR’s call center has a budget for 45 full-time employees; only about half of those positions are filled, said Mark J. Ware, MHMR’s senior director of crisis services.
Hiring becomes increasingly urgent as July approaches, when a new, three-digit lifeline number – 988 – will debut in the U.S. The telephonic shortcut will make it easier for people seeking help to remember and dial. Eventually, suicide prevention experts hope that 988 will become as familiar as 911. But as the lifeline becomes easier to access, experts also expect that call volumes will increase dramatically, meaning finding more people like Henry will be essential to support a nation still grappling with the mental health impacts of the COVID-19 pandemic.
“I think if we can get the vacancies filled … within the next couple of months, we will manage what we have,” Ware said. “I think come July and beyond, (the call volume) could double, they could triple, nobody really knows.”
How the National Suicide Prevention Lifeline works
The lifeline, which was created about 20 years ago, is a network of about 180 call centers throughout the U.S., including the one at MHMR. Together, these centers provide some of the most immediate responses to people in crisis, especially people who are thinking of killing themselves or, in some cases, are ready to do so and have the tools at hand.
The lifeline is not a permanent solution to people’s mental distress. But researchers like Madelyn Gould, a professor at Columbia University and expert in psychiatry, have regularly found that people who call the lifeline report that the call was helpful — and sometimes life-saving.
“They really will report to us that,for the vast majority of them, that it stopped them from killing themselves,” Gould said. “In times of distress, it really makes the difference between them perhaps killing themselves and not.”
Only a small number of people who call the lifeline are at immediate risk of suicide. Many others are in the midst of other crises, or might just need someone to talk. For almost all callers, the lifeline has proven to be an effective entryway to get people access to mental health services. Callers can get information on where to get treatment in their community and can get a follow up call from a few days later.
The transition to 988
Suicide prevention experts have heralded the 988 shortcut, which was approved in 2020, as a major step that could be the first in a series of transformations in the country’s mental health crisis system. Some early advocates of creating a lifeline have termed 988 a “911 for the brain” by launching a uniform way to get professional help in crisis.
Years from now, people like Hannah Wesolowski, the chief advocacy officer for the National Alliance on Mental Illness, hope that 988 might be the first call someone makes during a mental health crisis.
“We want 988 to be as commonplace in American households as 911,” Wesolowski said. “Right now if you have a heart attack and you call 911, you have a good expectation of what you’re going to receive.”
Wesolowski said 988 should prompt a similarly uniform response: You or a loved one will be able to talk someone locally, and if more help is needed, it’s going to be a behavioral crisis team that can de-escalate the situation.
“There are some people who are fearful of calling 911 when they’re in a mental health crisis, because right now so much of the response that is available is law enforcement,” Wesolowski said.
As police officers have increasingly been asked to respond to mental health crises, for which they often aren’t trained, the results have sometimes been deadly. A 2021 Star-Telegram investigation that examined 150 police killings in 11 North Texas counties found 54 cases in which mental health was a factor.
Police across the country are used as front-line emergency mental health providers, but many departments, including those in North Texas, lack the specialized training to properly handle the situations, the Star-Telegram found. Experts told the newspaper that teams with medics and mental health professionals — not armed, uniformed officers — should be the first to respond when no crime has been reported. But in Dallas-Fort Worth, police officers are the first to respond, which experts said can aggravate already stressful situations.
Preparation for the 988 shortcut, which is scheduled to go live July 16, will vary by communities and states.
In Texas, preparing for the shift has meant developing a plan so that as many calls from Texas area codes as possible are going to one of the five centers in the state that are part of the lifeline.
MHMR’s center, known as the iCare Call Center, will provide coverage for 71 counties. Anyone who calls from a local area code will automatically be directed to the local center first. If MHMR’s center is overwhelmed, calls will go to a backup center elsewhere in the country. Eventually, the goal is to have as many local calls answered locally as possible.
At MHMR, Ware says the call center has the funding and infrastructure it needs to serve 71 counties. But what’s still being worked out across the state is how to help the small number of people who need more than a phone call.
“Now, the lead topic on the 988 conversations is being able to expand mobile services,” like crisis response teams, Ware said. If people who need face-to-face support don’t get it quickly, they could be at immediate risk or continue to remain stranded searching for support in the fragmented U.S. mental health system.
“A lot of the discussion right now is really focusing on how to find and ramp up mobile dispatch across the country,” Ware said.
But for now, call centers are working on the first step of the crisis process: Having someone to answer the phones.
Henry, the crisis interventionist, said the job isn’t for everyone. She has worked at MHMR for about two years and has learned how to grapple with the immense stress of the job.
After a particularly difficult call, she might have a snack — her favorite is a Snickers — or take some time in the center’s self-care room, where counselors can rest or meditate in reclining chairs. When she leaves for the day, Henry usually takes the long way home. While driving, she’ll listen to jazz or something similarly instrumental, so she can leave behind some of the suffering and pain she witnesses every day. On the toughest calls, Henry said, sometimes she’ll have to press the mute button so she can collect herself and keep the caller from hearing her crying. But even during the hardest days, Henry said, there are calls that give her hope.
“Maybe they were crying at the beginning. And maybe now, the panic attack has come down, you feel the shift in the conversation,” Henry said. The best moments for her are when the caller is willing to get more help.
“For me, it’s when the caller says ‘I didn’t know that this was available. I didn’t know that this was an option.’”
How to get help
There are multiple places to turn if you or a loved one is experiencing a crisis or suicidal thoughts.
- Call the National Suicide Prevention Lifeline at 800-273-825. If you press “1,” you will be routed to the Veterans Crisis Line. You can also text 741741 or reach the online chat at suicidepreventionlifeline.org/chat. If you are calling from a local area code, your call will likely be routed to MHMR’s call center.
- Reach MHMR’s call center directly by calling or texting 800-866-2465. If you have an out-of-town area code, or want to learn more about local mental health providers, calling this number directly will ensure you reach MHMR of Tarrant County.
All services are available 24/7 and are free and confidential. Live translation is available for people who do not speak English.
This story was originally published April 10, 2022 at 6:00 AM.
