ATHENS COUNTY, Ohio — Rollout of a nationwide “988” mental health emergency number has been hampered by lack of both funding and public awareness — both around the country and in Athens County.
After years of advocacy from groups working to reduce law enforcement involvement in mental health crises and make mental health care more accessible, Congress passed a law in 2020 creating the mental health emergency number. The hotline launched on July 16, 2022.
Since then, it’s been up to each state to decide how to implement the program. Ohio designated 19 local crisis centers to receive and respond to the calls, most of which were already operating local suicide prevention hotlines. In Athens, Hocking, Vinton, Meigs, Jackson and Gallia counties, Athens-based Hopewell Health Centers was selected as the provider. Hopewell also is the local provider of the National Suicide Prevention Hotline.
Rollout of the program across the U.S. has been rocky, in part because the bill creating it left funding and implementation largely up to each state. To date, 25 states have passed new legislation supporting the program, but only 13 have appropriated general funds or imposed a new surcharge to support it, according to research by the National Academy for State Health Policy.
Ohio is among the half of states that have not passed legislation to support 988. Mental health advocates have called for a 50-cent monthly fee on cellular bills, similar to how the state funds 911. However, no bills have been filed along those lines. A bill proposed by state Rep. Gail Pavliga (R-Portage County) that would have created a fund dedicated to the program — but not actually appropriate state money to the fund — died in the state senate last May. A new version of the bill is currently pending in the state senate. Federal funds are expected to run out in June.
Local calls up
Calls to Hopewell through 988 have increased every month since the program launched, said Nicholas Walters, a mental health counselor at Hopewell. However, because neither Ohio nor Athens County have conducted public awareness campaigns, Hopewell still fields more mental health crisis calls through the National Suicide Prevention Hotline than through 988, he said. For example, Hopewell fielded 361 crisis calls in October 2022, but only 176 came through 988, he said — just under half.
Callers seem to differentiate between the suicide prevention hotline and 988, Walters said.
“What we’re seeing with the 988 calls is that these are people that need that immediate relief,” he said. Crisis counselors then “create a safety plan, create an outlet or create the next step referral program for them, whether that be making arrangements for them getting themselves to safety, [or] having a family member or close friend get them to a place that’s a little more safe such as a hospital or an outpatient clinic.”
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Hopewell also has a mobile Crisis Response Team for Athens County that can be dispatched if needed.
The 988 program was created in part because of concerns about law enforcement responding to mental health crises. The approach seems to be working: Very few 988 calls in Southeast Ohio have resulted in police response, Walters said. In January 2022, just one 988 call resulted in a law enforcement rescue response, and six calls to the suicide prevention hotline did — out of 316 total.
However, “I don’t want to say that [a police response isn’t] going to happen,” he said. Counselors refer to law enforcement only after an “in-depth exploration and filtering for suicidality, and a lot of other factors,” he said, such as immediate risk or danger.
Unlike 911 calls, the location of a caller to 988 cannot be pinpointed. That information has to be provided by the caller.
“So if you’re not describing any locational information, nobody’s showing up,” he said. “We’re not just sending police. If we can minimize and mitigate risk without involving [police], that’s really the plan.”
Walters said he wants to learn more about how people are contacting the program so Hopewell can see whose needs aren’t being met. He also hopes that state and local marketing and public awareness campaigns can start soon to combat misinformation being published about contacting 988 immediately resulting in a police presence.
“At this point, it’s about marketing so that people are fully aware [and have] true, transparent definitions of what it is and what it is not,” he said.
Some states have dedicated significant funding to increase public awareness of their programs. Wisconsin even bought local ads during the Super Bowl. However, the state has not created a surcharge or appropriated general funds to implement the program.
Ohio has not made a statewide marketing push, but data released by the national program show Ohio is among states with the highest in-state answer rates, with 90% of calls to 988 being answered. Gov. Mike DeWine’s office included some $46.5 million for the program in his 2024/2025 budget proposal to the General Assembly, which will be finalized this summer.
The Ohio Department of Mental Health and Addiction Services “will continue to monitor call volumes and system needs moving forward to inform any funding decisions,” Eric Wandersleben, MHAS’s director of media relations, wrote in an email to the Independent. He said a statewide public awareness campaign is in the works.
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