'Lives will be at stake': SC lawmakers failed to fully fund 988 suicide hotline

Apr. 17—CHARLESTON, S.C. — South Carolina had nearly two years to prepare for the national roll out of 988, a new three-digit number that people will soon be able to call during a mental health emergency.

But as Jennifer Piver looked out at the empty workstations inside South Carolina's only local call center for the 24/7 National Suicide Prevention Lifeline, she worried about all the calls that will go unanswered when that new number goes live on July 16.

Piver worries mainly because state leaders have declined to fully fund the resources needed to successfully implement the new hotline, leaving her organization unable to hire and train the staff needed for the anticipated uptick in demand as a result of this reimagined Lifeline.

"There's a lot of hope in those empty seats," said Piver, the executive director of the Greenville nonprofit that, until recently, was so cash-strapped that it didn't have a dedicated call space of its own and, instead, took calls from inside a church basement. "If we can just fill them up, that hope can be extended to the people who are calling us, to the people who are in need."

Right now, when someone in South Carolina calls the 11-digit Lifeline number (1-800-273-8255), the phones ring at Mental Health America of Greenville County. About eight out of every 10 calls were answered here last month.

And in 2020, about 41% of the 29,856 calls made to the Lifeline from South Carolina were answered by an operator in-state.

But without additional state funding for this call center, Piver predicts about eight out of 10 calls from South Carolinians in crisis will go unanswered by someone in their home state.

The local calls that don't get answered here, Piver said, will be rerouted to backup call centers in other states, where South Carolinians could have to wait longer to feel heard and get the help they are seeking during an emergency.

That matters because the trained volunteers and staff who answer the phones at the South Carolina call center not only know the region where people are calling from, but they also know the resources available to them, like mobile crisis teams. Advocates say those crisis teams can help end a reliance on emergency rooms and reduce the number of interventions by armed law enforcement officials when someone is experiencing a mental health crisis.

South Carolina mental health officials predict the new easy-to-remember number, which is being pitched as the 911 for mental health emergencies, will only drive more callers to the Lifeline.

Matt Taylor, the director of network development for the Greenville-based call center, said call-takers there are expecting to receive anywhere between 6 million and 12 million calls, chats and texts within the first year of the 988 transition.

"But resources are only as good as how well they're funded and how often they're able to be used," said Jennifer Butler, a program manager at the Office of Suicide Prevention for the S.C. Department Mental Health.

"I think there's a misconception that 988 is funded by the federal government, or that this entire time that our one call center has stable funding, and they haven't," Butler said.

'Seconds, minutes, everything counts'

Conservative estimates project the South Carolina call center could see anywhere from four to 10 times more calls as a result of the Lifeline's new 988 number.

While the call center — located on the ground floor of a new building off Greenville'sIndustrial Drive — is equipped to handle some 200,000 calls a year, Piver said the nonprofit lacks the funding it needs to hire and train additional crisis intervention specialists who take the calls.

Right now, Mental Health America of Greenville County has just shy of 22 employees, Piver said.

To meet the moderate uptick in call, chat and text volume of 49,000 more calls and 33,000 chats and texts, Piver said she's going to need 105.5 full-time employees.

And based on recent public health data, South Carolina's needs when it comes to suicide prevention are especially great.

"In South Carolina in 2020, every 23 minutes someone walked into a South Carolina emergency room and reported having mental health trauma. Every 22 minutes that year, someone was brought to the emergency room with suicidal ideation," Butler said. "Every 77 minutes in 2020, an individual came into the emergency room after an attempt. And those numbers actually were down."

"South Carolina's suicide death numbers went up in 2020, whereas across our country they went down," Butler said.

And last year, more than 26,000 calls from the suicide crisis hotline were routed to Mental Health America of Greenville County.

"Lives will be at stake," said Dennis Gillian, the executive director of Half a Sorrow Foundation who also used to work as a liaison for the Office of Suicide Prevention at the South Carolina Department of Mental Health. "For someone in crisis, you know, seconds, minutes, everything counts."

Further exacerbating concerns about the state's preparedness for this shift is a piece of legislation that will take effect in South Carolina exactly 15 days before the roll out of the new 988 number.

"The need is just tremendous," said Bill Lindsey, the executive director of the National Alliance on Mental Illness in South Carolina. "Even as a nonprofit, at my organization, our phone's been ringing off the hook the past two years. It's just gone up with the need for not only suicide prevention, but mental health assistance."

The funding gap

Lawmakers recognized the importance of the National Suicide Prevention Lifeline when it passed the Student Identification Card Suicide Prevention Act last year.

The legislation, which goes into effect July 1, will require public and charter schools that serve students from grades seven through 12, as well public and private colleges and universities, to print the National Suicide Prevention Lifeline and other crisis resources on student identification cards this upcoming academic year.

Butler said it was only the second piece of legislation South Carolina has ever passed to specifically address suicide prevention.

In October, the American Academy of Pediatrics declared a national emergency in child and adolescent mental health, saying its members were "caring for young people with soaring rates of depression, anxiety, trauma, loneliness, and suicidality that will have lasting impacts on them, their families, their communities, and all of our futures."

Already, Butler confirmed, some schools in South Carolina have gone ahead and printed the 10-digit Lifeline number on their student ID cards because, "they saw the need."

Piver said one of those schools was in Greenville County.

"And within 24 hours of the first day of school, we rescued a middle school student from suicide," she said.

The impact that this legislation could have on the 988 number was not factored into the estimates provided by Vibrant, the administrator of the National Suicide Prevention Lifeline, but it is weighing heavily on the minds of mental health professionals who applaud the legislation but worry about not being able to deliver for adolescents in crisis.

Repeated attempts to reach Lexington County Republican Sen. Katrina Shealy for comment for this story, given her role as the bill's lead sponsor and a key member of the Senate finance committee, were not successful by press deadline.

Additionally, in his executive budget, South Carolina Gov. Henry McMaster urged lawmakers to spend $5.5 million for the S.C. Department of Mental Health to establish a second suicide crisis hotline , citing the roll out of the new 988 number by name.

The funding also would support 50 mobile crisis clinicians who would cover all 46 counties in South Carolina along with call center staffing, infrastructure for the crisis center and other recurring operating expenses.

Lawmakers didn't do it.

And when mental health officials appeared before a Senate Finance subcommittee hearing earlier this month to ask for a budget proviso — a one-year law included in the state's budget — that would provide $1.5 million to Mental Health America of Greenville County, they were unsuccessful.

Earlier this week, Sen. Thomas Alexander, R-Oconee, the president of the Senate who sits on the Senate Finance Committee, announced that lawmakers would be recommending $1.3 million to be spent for the establishment of a second call center.

When asked why the committee's request did not include the full $5.5 million, Alexander said it's because it will probably take multiple years to build out the facility.

"It's going to take more than one year to do what needs to be done from that standpoint. But this is a good faith effort for us to move forward in addressing the 988 system," Alexander said.

He continued, "We're doing a lot to help really, with the capacity for mental health and a lot of a lot of different areas of making sure that services are being provided throughout the state. So that will be an initiative that will be a multi-year (effort) as well, too. We're very supportive of what needs to be done but it's just going to take more than one year to get it across."

However, mental health experts say any funding at this point, while welcome, might have come too late for the impending July roll out of the 988 number due to the time needed for development and certification of the center.

Meanwhile, nothing has been allocated for South Carolina's only operational call center, which is part of the National Suicide Prevention Lifeline's network of nearly 200 local and state-funded crisis centers across the country.

"Well, it's my understanding that they need an additional call center," Alexander said when asked why the money wasn't instead shifted to the existing call center that is facing a critical need right now. "So this is for that infrastructure and that additional call center, so this is to complement the work that's already being done at the Greenville center."

Even if she had money to hire staff, Piver noted employees would still need to undergo weeks of training before they can start taking calls. She sighed on the phone when asked about the budget requests that have gone unanswered for the call center in Greenville.

"We've just been duct taping this together for so long," Piver said.

To put an end to short-term funding solutions, Lindsey said he would like to see South Carolina consider charging a small fee on people's phone bills to support 988 similar to the fees charged on phone bills now for 911 services.

But Lindsey said the political will in the State House was just not there this year to even consider such a measure, saying one state senator ended their conversation about the idea by telling him, bluntly, "Don't bring up the word fee."

"This year is an election year. That's another downside to the legislative process, but this needs to happen," he said of the funding for 988 moving forward. "It's not much, it's probably a few pennies on the dollar but, boy, would it sustain what we're doing? Absolutely."

Meanwhile, the phones at the call center in Greenville keep ringing.

Reporter Joe Bustos contributed to this story from Columbia, S.C.

___

(c)2022 The State (Columbia, S.C.)

Visit The State (Columbia, S.C.) at www.thestate.com

Distributed by Tribune Content Agency, LLC.