Youth suicide rate lower than projected after launch of 988 suicide hotline, study shows

NINA MOINI: New data is offering a look at how the National 988 Suicide and Crisis Lifeline may be making a difference, especially for young people. An analysis published by the Journal of the American Medical Association found that the youth suicide rate was 11% less than predicted in the 2 and 1/2 years following the launch of the hotline, which was in 2022. Those numbers raise hope that easier access to immediate mental health support saves lives.

Here in Minnesota, regional call centers make up part of that nationwide network, answering calls and texts from people in crisis every day. Carolina De Los Rios is the director of 988 at greater Twin Cities United Way and joins me now. Carolina, thank you so much for your time.

CAROLINA DE LOS RIOS: Thank you, Nina, for having me.

NINA MOINI: It's very encouraging to hear about this. What reaction did you have once you started to see this data? Did you have a hunch that this is what it would show? Were you feeling success?

CAROLINA DE LOS RIOS: Absolutely. We were very thrilled to read actually this research. As we were hoping that this was going to be the outcome of so much effort at a national level. So we are definitely welcoming the news. I'm very, very thrilled to see that so much effort and hard work is starting to show and is starting to help people to stay safer, particularly young people.

NINA MOINI: So there was a National Suicide and Crisis Hotline years before 988 launched in 2022. But would you explain, for people who may be unfamiliar, more about how 988 is different from the prior crisis line options, or how it can be a more effective or helpful resource, and just how it works?

CAROLINA DE LOS RIOS: Yeah. So definitely it works because it's a simple number. Something 988, something that every one of us can remember. It's simple. So people are able to reach out to that three-digit number much, much easier than when we used to be an 800 number. In reality, the service is the same. But I think the strategy here is that immediate access, I can remember 911. I can remember 988. So it's that immediate access at the point of crisis.

Let's say someone is having suicidal thoughts. So in that moment, it's an easier-- in a moment of crisis, really, we tend not to remember a lot of things. But 988, those three digits, are really easy to remember. So even in a moment of crisis, people remember that simple number, 988, which kind of lowers that barrier to reaching for help in that exact moment of the crisis. So I think that is the key in these moments of crisis, that we are lowering that barrier with a very, very simple number to remember.

NINA MOINI: Do you think that's part of the reason why we're seeing particularly help for younger people? Or can you talk a little bit about when we say it's particularly helpful for young people what that means or looks like for you?

CAROLINA DE LOS RIOS: Right, do I think, yes. On one hand, definitely having a three-digit number is helpful. Like all of us will remember, even like young people will reach out for help either, calling or texting. So it's easier, definitely super easy access. And I think part of also the success, obviously is how easy it is to remember, but also is once you call, we have trained counselors, crisis counselors, that are really trained in de-escalation. So we use crisis intervention techniques that are really aiming for anyone, in particular, young people, to feel comfortable, like someone who is active listening, someone who is able to reach out, someone who is able to actually connect, help the person to safety plan when no one else is able to actually listen through a crisis.

So many callers are moving from that acute crisis, that moment of acute distress, to a more stable stage where you are able actually to interact and to actually think of options, to actually think about maybe I am open to explore other alternatives. So that itself is reducing that immediate risk.

NINA MOINI: Can you give us a sense, Carolina, about just the demand and what it looks like maybe at your call center throughout the day? Do you feel like there is enough staff to be able to help everybody in need?

CAROLINA DE LOS RIOS: Yeah. So definitely we receive roughly 150 calls a day. So that will make up to 4,500 calls per month. We get the peaks for us are in the evening around 9:00 PM. Normally, like Mondays or Tuesdays are the busiest days that we have. And so that's just more from that operational perspective. That's how it shows in a day to day.

Definitely we could always have more people. We are really well-staffed right now. We have between eight to nine people per shift. And we identified that there are hours that are busier. We try to have more people. However, there is always this conversation about we can always have a bigger team, especially because we're seeing the increasing demand. We're seeing how people are able to be more aware about the 988, and are able to call.

And as we are normalizing more and more these conversations, like the one that we're having right now, about it's just if you're feeling in crisis or you're feeling dysregulated, you can call 988, if you're feelings suicidal. So these conversations are helping people to reach out. So the demand is increasing. So we can always have more people and grow the programs. And I'm sure that is the reality for all the centers in Minnesota and in the country.

NINA MOINI: I'm sure. And to your point, I do, since we have you, want to just give everyone more information about what the process may be like, because people can opt in or not to a follow-up plan. Can you just talk a little bit about what happens when somebody does call in?

CAROLINA DE LOS RIOS: Yes, so someone calls in, and let's say they are feeling particularly dysregulated because they are having suicidal thoughts. And so our crisis counselor will basically open the space where a lot of active listening, a lot of emotional support, is happening at that moment. We don't require disclosing. I mean you could be completely anonymous, which is that part of the trust that we're building with our callers. You are not required to disclose where you are or what is your name, if you don't want to share. So it's really the space about you talking about what is going on right now in your life at that particular moment that you're feeling particularly vulnerable, having suicidal thoughts.

For many, let's say if you are having those thoughts, it's not something that you can talk to anyone, even if you have a very close support network. Sometimes it's not easy to talk about this. So this is the space where the person can feel supported. There is a lot of conversation around what kind of alternatives can you have. We focus a lot on safety planning and that's part of how we are able to help that caller to maintain safety. So the safety plan can look into many different ways. It can just be also connecting that caller or providing the resources like for therapy, for other local services.

We also connect, if needed, and this is with the caller consent, with our local mobile crisis teams. In case it's in a collaboration sort of approach, the caller decides that they are OK with someone going in person to connect with them. So that's when we connect with our mobile crisis teams to add more support. So in reality, we connect with a lot of resources. So the caller feels that this is something that is a local effort. As we make a lot of emphasis that when you call us, it is someone in your community answering that call and someone in your community supporting you with those resources.

And tell us, too, about the avenue of texting, because a lot of people may not know or may, may not think they can just text if they don't want to talk. You can also text our center. In particular, we don't answer texts, but we have other centers in Minnesota that also have that ability. So this is a very popular option for anyone in crisis just to text to 988, and you get exactly the same response. You get exactly the same support. It's just through text, which makes it more comfortable for people that are not comfortable actually talking, or they might be in a space where they don't feel that they can actually talk, because maybe some others might listen. And you still get the same support from our crisis counselors that respond to those texts.

NINA MOINI: Carolina, how do you envision continuing to grow upon the effectiveness of 988? I mean, starting to see some of these numbers coming out that look encouraging in terms of suicide rates, but there are obviously many other parts to the puzzle, and many other facets that help people to find help and resources. What do you envision for the next maybe decade or so of 988?

CAROLINA DE LOS RIOS: So I think definitely 988, as crisis center, we cannot do this alone. So we need the support of the community. We need the support of the medical systems in our community. So we need definitely a community effort, a team effort from different institutions. So that's why as a state, with the support of the Minnesota Department of Health, we are part of different groups. We are part of the 911 group, where we are all working together to make sure that there is a response in which we all are in the same page, responding to those who are in crisis.

We are connecting in a working group with the mobile crisis units. We are connecting with mental health providers who are connecting. So basically this requires for all of us that are working with people in general, that connect with the medical system, with the mental health system, for all of us to be on the same page on how to respond to people when they are asking for help. So I see this for us in the future as being part of this system of this care-coordinated system where we are all actually ready to support that one person that is in crisis and doesn't matter if you go first to a particular institution, or if you call 988, or if you call 911, everyone is going to have the same response and the same support for a mental health crisis.

So that's how we envision as 988 the future.

NINA MOINI: Yeah, I see what you're saying. Just coordination and getting people the help that they need on that individual level. Carolina, thank you very much for coming on the show and telling us more about this. Really appreciate your efforts.

CAROLINA DE LOS RIOS: Thank you, Nina, for having me.

NINA MOINI: That was Carolina De Los Rios, Director of 988 at United Way. If you or someone you know is in crisis, you can call or text 988 to reach the Suicide and Crisis Lifeline.