Reflections from a crisis professional

When I tell people I work in crisis services and suicide prevention — always a great conversation starter at a party — I’m often met with sympathetic sighs and remarks like, "That must be rough." Indeed, it can be challenging work, but it's hard for me to imagine doing anything else.

Every day, I go to work on the front lines of combating a complex public health crisis: suicide. I've sat beside individuals during their most vulnerable moments. I've listened to counselors provide lifesaving care to callers contemplating suicide. I've had the privilege of collaborating with some of the most compassionate and dedicated professionals imaginable. It’s demanding but profoundly meaningful.

Most professionals in suicide prevention feel called to this field, often through personal loss. My own journey began before Iowa established its regional mental health system, when funding for suicide prevention was essentially non-existent. Despite suicide being a top-ten cause of death in the United States, it remains one of the lowest-funded public health issues — even as suicide rates have steadily climbed over the past two decades.

Funding increases for crisis services have been hard-won, typically achieved without much political support. A significant milestone came in 2020 when the National Suicide Hotline Designation Act was signed into law, officially designating 988 as the universal suicide prevention and mental health crisis line. This paved the way for increased accessibility, including dedicated support lines for vulnerable populations like veterans and LGBTQ youth. Nearly 20% of LGBTQ youth report attempting suicide — twice the rate of the general youth population.

My employer, CommUnity Crisis Services in Iowa City, is one of just a handful of centers nationally answering the LGBTQ youth crisis line, handling 5,000—7,000 calls per month. We're also one of two centers in Iowa answering the broader 988 Lifeline. Yet, earlier this year, our critical federal funding was abruptly frozen without notice. Our federal contacts stopped responding, and we received vague, contradictory instructions. Data on LGBTQ youth suicide was inexplicably removed from federal websites, and inquiries to representatives went unanswered.

Over subsequent months, we've witnessed intensifying attacks from extremist groups against the LGBTQ youth crisis line. Disinformation spread rapidly, maligning the service and even personally attacking our counselors, who provide compassionate care daily. This culminated in a May budget proposal from the federal Office of Budget and Management, which, among other cuts, explicitly targeted the LGBTQ youth crisis line for defunding.

All this unfolds against Iowa's ongoing mental health system redesign, itself marked by uncertainty. Working in the nonprofit sector, one grows accustomed to shifting priorities, funding reallocation, and service changes. Yet the current situation is unprecedented in its chaos and cruelty. We now face coordinated disinformation campaigns explicitly designed to dismantle critical social services, funding freezes, confusing messaging, and personal attacks.

When did we as a society become so indifferent and harsh? What conceivable justification exists for defunding suicide prevention services — an already severely underfunded system addressing a public health emergency that claims more lives annually than automobile accidents? Do LGBTQ youth not deserve compassionate, lifesaving support?

Every counselor, every crisis worker, and every nonprofit employee in this field carries an unbearable weight of uncertainty — not just about their livelihoods, but about the futures and lives of those we serve. Suicide prevention isn't political; it's a human imperative. We must decide, as a society, whether we are willing to uphold our collective responsibility to protect vulnerable lives, regardless of political currents.

In moments of crisis, clarity sometimes emerges: human life and dignity should always transcend partisan politics. It's time we all recognize and support the essential work being done in crisis intervention and suicide prevention — for everyone, especially our youth. After all, their lives depend on it.

Drew Martel is Chief Clinical Officer at CommUnity Crisis Services and Food Bank in Iowa City