As mental health calls rise in Missouri, supporters worry the state won’t commit to funding. KCUR 89.3

If you’re in eastern Missouri and call 988, you may be able to speak to Crisis Intervention Clinician Jennifer Brown.

Brown responds to requests from Behavioral Health Response, the crisis response line for the St. Louis area and other parts of the state.

“A lot of people just call because they don’t know what to do with the energy they’re feeling outside their bodies. They’re asking for hope and help,” she said.

In July, Missouri officials opened 988. This is an emergency mental health hotline that connects callers to dozens of organizations nationwide based on the caller’s area code. During his first month on the hotline, Calls to Missouri mental health centers increased 30%.

Suicidal thoughts aren’t the only people calling the hotline, Brown said. Sometimes it’s just someone feeling lost or helpless.

“I want them to feel connected when they call,” she said. “It’s a real person on the other end of the phone.”

Proponents of 988 say the easy-to-remember number will help more people connect with professionals like Braun when they need it most. That is, if you or someone you know is having a mental health crisis or is contemplating suicide.

workforce on line

A hotline overhaul means crisis response organizations need more workers and the money to pay them. Advocates are concerned that the state has not committed to funding the hotline for the long term.

The Missouri Department of Mental Health received $16.7 million in state funds and block grants to support the 988 first fiscal year call, agency officials said. However, the Missouri legislature has not enacted legislation to ensure continued funding, and the hotline is not guaranteed a source of funding for years to come.

“That’s my fear,” said Casey Muckler, who heads the department’s 988 systems. “How can we make this a sustainable effort and keep this going long-term? Since I started, I’ve been mostly up late.”

State health officials expect a surge in callers as more people learn about the new number. An official with the Department of Mental Health estimates that the service will receive 172,000 calls in his first year of service alone. This does not include texts, chat messages, or follow-up calls.

That’s more than four times the number of calls made to Missouri’s suicide prevention lifeline network in 2020, Muckler said.

To absorb that new volume, state response organizations will likely need to hire dozens of additional employees.

Despite being a national initiative, the hotline is not fully funded by the federal government, Muckler said.

“Whether or not to fund 988 at the state level is up to the states,” she said. “We’ve been looking for any funds that could be found for over a year.”

Several states have enacted laws imposing surcharges on telephone bills to pay for line charges, but Missouri has not taken that approach.

“I can’t say for sure that I know for sure if this is sustainable in the governor’s office, or even rely on it in any way,” Muckler said. “But we certainly hope so.”

Backers of 988 Line say they will be eager to fund it permanently once state officials see how effective the service is.

“I think after this first year, we can really say, ‘This is working and we need more funding to make sure we can continue this important service,'” Muckler said. said.

special work

Unlike 911 dispatchers, call center workers are also providing care and can stay on the phone for extended periods of time, said Bert Andrews, director of behavioral health response.

“We’re really creating a system that meets people’s needs in the moment, where they are, and lowers the barriers to access to mental health services,” said Andrews.

Andrews said even with the new funding, recruiting and training people for specialized, sometimes traumatic and demanding work is a big undertaking.

Behavioral Health Response plans to use the first year of government funding to hire about 60 staff to handle the new patient numbers, he said.

“There will be a massive recruiting drive all over Missouri,” says Andrews. “Missouri is in great shape for the 988.”

To hire more workers, Missouri and other states changed the qualifications required to work on the line.

“We used to hire only masters-level clinicians. We will never have the capacity we really need, enough masters-level clinicians to handle the volume that is coming in. .”

He says experience and training are more important than education to do the job well. A Behavioral Health Response emergency responder is required to undergo her three-week training before receiving her first practice call.

New (and old) problems

Another way 988 lines differ from 911 is that hotlines route calls based on the phone’s area code rather than the phone’s location.

Andrews said that could create problems connecting people with local services.

“In metropolitan areas, up to about 50% of people have out-of-range cell phones,” he said. “A lot of people have given up landlines. So we have a problem.”

Emergency clinicians say they can route calls to local response centers or dispatch teams to people at risk anywhere in the country, but based on the caller’s location I’m hoping the call will be routed soon.

There is also the issue of after care. 988 clinicians are able to not only listen to someone, but connect those in distress to services and direct help.

“It’s not just the answers that matter,” said Gena Terlizzi, executive director of the National Psychiatric Missouri Alliance. “However, to know how to connect individuals to their immediate needs, referrals to follow-up care they may need.

But it can be expensive or logistically difficult to schedule an appointment with a psychiatrist, for example, depending on where someone lives, she said. In all but two of Missouri’s 114 counties, according to the editorial Rural Health Information Hub, Lack of professional mental healthIt may take longer to get an appointment with a therapist or psychiatrist if someone does not have insurance.

“Even if we achieve that primary goal, even if we can stop the person from doing that behavior, we need to ensure that they get the treatment and services they need in the future.” said Terlizzi. “It’s not a one-time thing. It’s a long-term effort to improve the mental health of our society.”

what the caller wants

According to Andrews, research shows that many people who call Lifeline actually don’t want follow-up service.

“They just want to call the lifeline when they’re in trouble, when they need help, when they need someone to talk to,” he said. We make it easy for you to get the service you want, the way you want it.”

Jennifer Brown, a crisis call worker, said some callers just want to talk.

“Often when people are at their lowest point, what you need is a connection with someone you can trust and feel safe with,” she said.

Follow Sarah on Twitter. @petit_smudge

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