The phone rings at the 988 call center, and a woman sitting at a desk ready to answer anyone who calls picks up the phone. There is no script for her job, but as is often the case, the operator begins with a simple sentence:
“Thank you for calling 988. How can I help you?”
“This year has sucked,” the 29-year-old caller replies. “I’ve been unemployed since October of last year. I thought things would get better, but they haven’t. I honestly don’t believe in anything anymore,” he said. “Sometimes I think it would be better not to be here than to deal with this shit.”
The caller said he owes over $10,000 in rent and $30,000 in student loans. He’s drained his 401k to make ends meet. His bank account balance? $78.
“What is really worth living for?”
Hamilton County’s 988 call center staff are trained to handle such calls, ranging from people who may be suicidal or experiencing a mental health crisis to people who simply need someone to listen. 988, a national suicide and crisis call service, has been available to Ohioans for two years, and recently released data shows that people in Hamilton County and Ohio depend on the service.
988 calls, SMS and chats are received on the non-profit organization’s line
988 operates over 200 call centers across the United States. Talbert House, a Cincinnati-based nonprofit, operates the line for Hamilton County. Records show that the nonprofit’s staff made 14,950 contacts with people seeking help in Hamilton County in two years.
In addition to operating Hamilton County’s dedicated line, Talbert House also acts as a backup for the state, meaning calls are routed to the company from other call centers in Ohio when needed.
The records provide a 2-year overview of the 988 service here in Ohio
The 988 service was launched on July 16, 2022, and has seen a steady increase in contacts in the two years since then, according to the Ohio Department of Mental Health and Addiction Services.
Ohio has 19 call centers – more than any other state. Data shows that nearly 340,000 contacts were made with 988 telephone service representatives across the state. A “contact” is any call, chat or text sent to the hotline. The total number of contacts includes repeat callers.
In Hamilton County, 254 of the nearly 15,000 contacts resulted in emergency response by police, fire department or emergency medical services.
According to the records, 41 callers actively attempted suicide.
The number of lifeline contacts statewide was 153,329 in the first year and 186,061 in the second year, an increase of 21%. In Hamilton County, the total number of contacts increased by 16% to 6,905 in the first year and 8,045 in the second year.
While exposure is increasing, data from the Kaiser Family Foundation shows that only 18% of adults know what 988 is. And while only a small percentage of people know 988, data from the CDC says that more than one in five adults, or 20% of U.S. residents, have a mental illness and may need help.
988 helps, say mental health experts
The increase in calls and the nearly 15,000 contacts in Hamilton County were no surprise to Michael Madigan, a UC Health social worker and associate professor at the University of Cincinnati School of Social Work. He said he has seen 988 help some of his patients, and he believes more people will call the hotline as it becomes more well-known.
“There are a lot of people with mental illness who have burned all their bridges and have no connection with anyone,” Madigan said. “So it’s really important to be able to reach out to someone.”
Calls to 988 often come from people who need to connect with other community resources, but some just need someone to talk to. Many of the callers are having suicidal thoughts, says James Reeves, director of quality assurance at Talbert House.
Reeves said he is good at handling emergency situations, but still finds them stressful.
He once had a three-and-a-half-hour phone conversation with an engineer who told him he had been fired. The caller was behind the wheel and screamed that he wanted to drive his car into people and “kill everyone and himself.”
“There’s no script that can prepare you for this,” Reeves said. “We’re given skills. We’re trained. But if you’re not the right person for the job, then you’re not the right person for the job.”
The training includes earning an Ohio Certified Prevention Specialist Assistant certificate, which requires 45 hours of prevention-specific training in addition to general lifeline training. The operators also shadow other callers for a month before they are allowed to take calls themselves, said Rebecca Jones, assistant director of Talbert House.
988 operators connect Hamilton County callers with regional assistance
The 988 hotline is connected to Hamilton County’s other mental health and emergency response resources. A partner agency is the UC Health Mobile Crisis Team, which responds to mental health crises in the community. Talbert House hotline 988 operators have been able to deescalate 80% of their calls, but for the remaining 20%, they often turn to the Mobile Crisis Team or 911, said Mobile Crisis Team Director Katherine Cannon.
There used to be a stigma around calling for help, and people feared the police would automatically be sent, Jones said. But with 988, calling 911 is a last resort for operators, Jones said. Instead, they create a safety plan over the phone, connect callers to other resources and teach people coping skills.
What happens after the call ends?
The 988 operators are not allowed to call anyone back unless they request a follow-up call. It’s hard not knowing what will happen when a caller hangs up, they say. But there are also calls that make their work worthwhile, Reeves says, like when people thank him for taking their call.
In the case of the fired engineer, after more than three hours on the phone, he cried and thanked Reeves for his help.
The man, who was having suicidal thoughts because of his financial difficulties, ended the conversation after about 20 minutes with the words: “You know what, I’m done talking. Have a nice day.”
“You too,” the operator replied. “We are here for you if you need anything – 24 hours a day.”
