Iowa’s response time to 988 crisis calls is good, but staffing a concern

Nearly six months after the national suicide prevention crisis number was shortened to the three-digit 988 in July, the two nonprofits that answer the line in Iowa have been keeping up with big increases in demand despite high staff turnover.

Foundation 2, in Cedar Rapids, is the primary recipient for 988 calls, with any missed calls being picked up by CommUnity in Iowa City, or sent to a backup call center out of state. CommUnity also primarily handles 988’s chat and text features in Iowa.

Emily Blomme, executive director of Foundation 2, said the lifeline is receiving about 1,450 calls every month, which is more than double the average calls received before the phone number was shortened. Foundation 2 is picking up 91 percent of those calls within the first 12 seconds of the phone ringing.

“Making sure that Iowans are served by Iowans is really important to us. We’re doing well with that stuff. I think, because we’ve done crisis line work for so long, we have a really deep understanding of what it takes from an onboarding perspective and a training perspective. A lot of those very tangible things didn’t change from doing other lines that we’ve done as we transition to 988,” Blomme said.

Iowa was well situated to respond to the increase in calls that came with the 988 rollout because both Foundation 2 and CommUnity had already been doing similar work with the national suicide prevention lifeline and with YourLifeIowa, a statewide crisis line, for several years.

“Iowa was fortunate because we have two crisis centers that have tremendous amounts of experience in crisis services, where in other states there were really attempts to build the infrastructure. We’re lucky that we had some of it already in place prior, and so it just made it smoother — not smooth — but it made it smoother to transition to 988,” said Drew Martel, the chief clinical and training officer for Foundation 2.

An emotionally draining job

Both nonprofits increased their staffs significantly before the 988 rollout to prepare for increased call volume — an increase seen nationwide. Nonprofit leaders say that while they’ve been able to keep up with demand, there has been a lot of turnover because of burnout and other factors.

“Crisis work is niche and so some people get into this profession and then realize it’s just not a good fit for them for one reason or another, but we are really well staffed. Over the last six months a lot of the work that we’ve been doing is looking at the volume of chats and texts and calls we’re getting to see, are we still appropriately staffed? Do we need to add more staff? And what kind of support do we need to also add in for those staff to be able to do the work?” said Adrianne Korbakes, chief operating officer of CommUnity.

Being a phone counselor is often an entry-level job in crisis work, so it’s not uncommon for employees simply to move on to new opportunities, Blomme said. It’s also an emotionally draining job, without many follow-up opportunities.

“If you imagine, for eight to 10 hours a day, having the phone ring, picking it up, not knowing what’s on the other end of the line. There’s some natural difficulty that comes with that,” Blomme said. “And we don’t always have opportunities to close the loop. Rarely, in fact. They know the calls that were really difficult, but they don’t know the calls where they were really transformative in someone’s life, and really did give them the tools they needed to feel better or to do better. So, I think that’s a really hard part of the job.”

Both centers are consistently hiring counselors across the state. Remote work options are available as well as in-office work.

Since 988 is often an entry point for other social services, the increase in calls also has strained other community crisis services, Blomme said.

“In all honestly, we don’t have enough bodies to actually cover 100 percent of our mobile crisis needs, or 100 percent of our crisis phone needs. The timing is really bad that as more people are needing mental health support, staffing woes prevent us from actually being able to have all of the people we need to meet the demand,” Blomme said.

“We know that crisis services across the entire state are strained. 988 is an entry point, but we’re also referring people to mobile crisis in other service areas and they have staffing issues as well. 988 in theory is great. It’s just trying to fit it all together is complicated.“

Ongoing funding

Funding for 988 was approved nationally for the first two years of the rollout, giving states time to establish a more permanent funding stream. So far, Iowa has not introduced a plan for permanent funding, partially because officials are waiting to collect more data before deciding how much funding the service actually requires, Korbakes said.

“I’m really hopeful that we’ll be able to collect enough data to make more informed decisions,” Korbakes said. “So far, I think we’ve just been so focused on getting things up and running and operational as is, it’s hard … to think about things down the line.”

When lawmakers do eventually approve a funding plan, Blomme and Korbakes said they hope it includes enough money to not only keep the service running as is but to increase infrastructure to strengthen the service and its connection with other services, like in-person crisis response.

“We have asked specifically for funding related to mobile crisis dispatching software, where we would be able to see on a system where mobile crisis teams are in the state, see who’s on, be able to send them, via text or an app, the information they need about the address they’re going to, what the situation is about, that kind of stuff. That would be really, really great.” Blomme said.

Comments: (319) 398-8328; emily.andersen@thegazette.com