Staffing Shortages, Unanswered Calls At D.C.’s Crisis Hotline

0:00Today on CityCast, D.C., my CityCast colleague, Elissa Fawars, has done some important reporting about problems at D.C.'s 9-8-Suicide Prevention Call Line. In the spring, nearly half of the calls to D.C.'s hotline went unanswered. They were rooted to a national office. What's going on here? And what does it mean for people in crisis? Elissa is here to talk us through the numbers. Today is Thursday, September 3rd. I'm Michael Schaefer, and here's what D.C.'s talking about. Elissa, welcome. Thank you. Good to be here. So you had a great piece this week about D.C.'s 9-8-Suicide Prevention Hotline. And you reported some pretty jaw-dropping numbers about how often it is un-staffed.

1:03Yeah. So, the 9-8-Suicide and Mental Health Crisis Line, it's a national operation, but when you call, your call is routed to a local call center, ideally. And so, anybody who calls from within the district is going to get routed to the district's call center, which is staffed by the Department of Behavioral Health. And for the last year or so, D.C. has had one of, if not the lowest, call pickup rates in the nation. So, there is always somebody on staff, but that doesn't mean that somebody in D.C. is always going to pick up your call. So, you're saying, if I call and nobody is there, it gets sent to a national backup. Yeah. So, it doesn't just drop. So, if you go to a national backup center, that is, if you stay on the line long enough. So, the numbers I looked at included, you know, the number of calls that were picked up in D.C., the number of calls that were picked up at the sort of national level, and then the number of calls that were abandoned by the person who was calling.

2:03And in July of this year, actually, more people hung up than managed to be connected to a national call center. So, there is a cost to having to wait to be routed to that backup center. And what was D.C.'s pickup rate? So, this spring, it was as low as 56%. That's really low. Yeah. It's actually improved a lot since then. So, there are around 73% in July. It was also around there in June. So, they are addressing some of the problems, but that low call rate persisted for five months. Do we know statistically if, like, you get better outcomes from a call that gets routed to a local help desk then to the national backup? So, we don't have those statistics in part because we have to respect the privacy of the people who call. It's really hard to do those kind of follow-ups. But one of the differences is, if you call locally, they know what's available locally. So, they could tell you about D.C.'s mobile crisis response unit.

3:05They could tell you about the stabilization beds at C-PAP. They could tell you about other numbers you could call other organizations you could get in contact with. And if you get sent to someone at the national backup center, they will still be able to talk to you and help you through whatever the crisis of the moment is. But it is harder to get access to the kind of resources that can help you long-term or to connect you to emergency services, if need be. So, you mentioned that the crisis center that it's supposed to reach in D.C. But it was reaching as little as 56% of the time. That falls under D.C.'s Department of Behavioral Health. Broadly speaking, why are pickup rates so low? Well, it's really hard to staff one of these crisis call centers. And that's not unique to D.C. I found a survey that says something like 70% of crisis call centers in this neighborhood have trouble staffing. But that doesn't mean that the problems are as bad as they are here. And also, like, I'm sorry, but like saying like this is hard, it seems like not a good excuse.

4:07Right. I mean, brain surgery is hard too. Brain surgeons get paid a little more, I think, than people who staffed the 98 call line. But it's really difficult work. It's not paid particularly well. And D.C. Government has in times tried to hire for this and not been able to offer any jobs to anyone who applied. So what happened was multiple staff members, I don't know exactly how many left early in the year. And you saw those call pickup rates drop really dramatically. And then the Department of Behavioral Health hired four more people and they improved again. Like I'm saying they improved. They're still the third lowest in the nation. Right. It's not great, but it's not hanging out in the basement the way it was for much of the year. And the call center operates, supposed to operate 24 seven. What does their staffing situation look like if they have a full complement? So according to a Department of Behavioral Health spokesperson, there are supposed to

5:09be seven people who are taking 98 calls. Currently they have six people in those drops. That's a little confusing because in the written testimony that they gave to the council and the groceries around of oversight hearings, they said they were supposed to be 16. Well, I was going to say like I'm no mathematician, but 24 times seven divided by six or seven people. That seems like not enough. Yeah. So other people at the access helpline, which is DC's other mental helpline, are sort of cross-trained to take over in case there's gaps. So it's never unstaffed with the people who are supposed to be doing it, people who are best trained and able to do it. There are not enough of them. So when a call doesn't get picked up in DC, I guess what happens is it rings the four times in DC and then it starts ringing again because it's ringing at the national backup. So the person on the other end of the line who may be in a really desperate situation is liable to have it ring like eight times before it gets picked up and we can assume that

6:13some of them are going to in that lengthy wait, just hang up. Yeah. I don't actually know how long you have to wait before being transferred to the National Center. So they don't tell me there's supposed to be a set amount of time that's set like at the local level. So DC should have a certain number of seconds and nobody at 98, nobody at the Department of Behavioral Health, nobody who worked for this call center could tell me what that was. So I have no idea how long people have to wait. Did they explain why they couldn't tell you? No. It seems like a thing they ought to know. Yeah. I sent them questions. They gave them a week to respond. I was told on the very last day that the person who's responsible for knowing the stuff was out sick. But these should be knowable numbers. This should not be a mystery. There should not be one person who understands how DC's 98 call center works. So one of the explanations you were given is that 98 calls spiked in November, 2024.

7:15And they dropped back down to roughly baseline. But after the spike, call pickup rates never recovered. Why do they say that is? So that was something that I found. Not something that they told me. They were very hesitant to tell me literally anything. You know, it's a little bit difficult to know without detailed staff records, but it looks to me like they had this big spike. Maybe some people burned out. Maybe some people left the job. It's sort of stabilized at a lower than regular rate. You know, a little bit more stable. And then it plunged again in the spring. So if I had to guess, I'd say there were multiple points in time where people left, but it's really hard to answer that. So 98 in general for people who aren't familiar with it's pretty new system. It was implemented nationwide back in 2022. I guess it has its flaws, but what do we know about its impact? So it's a really interesting thing to try to figure out. We do know that in places where there's higher usage rates of 98, the number of suicides

8:15of when people aged, I think it's 18 to 35, has not been as high as expected. It's actually fallen. So they had a prediction of how many people would die by suicide in the coming years. The numbers have been well below that, especially in places where 98 is used a lot in places where 98 is not used a lot. Things are a lot closer to that kind of expectation. So there's some evidence that it's helping prevent suicides among younger people, the national alliance and mental illness, did a big survey on this, they do this pretty frequently. And I think the vast majority of people said that 98 helped them to decide not to commit suicide at that time. The numbers are a little bit less rosy on connecting to longer term help, but it is something that does work. And that's something that advocates said to me over and over again when I was doing research for this piece was, you know, 98 has problems, especially in DC, but we don't ever want to

9:16discourage people from calling because it does help. When you were first pitching the story and you're talking about 98, it has not yet sort of seeped into my, like if you said, I'm doing a story about problems at 9-1-1. I would have known exactly what you're talking about, but it sort of took me a beat to know what you were talking about. 98 is another three digit number. And I guess the idea is to have this seeped in to everybody's conscious the same way normal one has. Yeah, it was a, the one that instituted it, it was actually a replacement for a 10-digit suicide hotline number that was national, which seems pretty impossible to remember, especially in a time of crisis. So the idea was that you make it easier to remember, you make it easy to put big on signs. If you go to metro stations, bridges in the district, there are big signs saying, you know, call this number, which is pretty grim, but I'm glad it's there. So the idea was to make it something that people were more aware of, more easily able to

10:19remember, and more able to turn to in a time of crisis. So recruiting people to work there, as you mentioned, doesn't pay that well. What have you heard about, like, how aggressively and how well DC specifically is recruiting? I know that they had a requisition so that DC HR could post the job. I know that they didn't get any responses to that. I know that sometime in the last couple of months, four new people started, but this is something that nobody wants to talk about. I mean, it strikes me that, you know, this is like the second or third time we've said that in this conversation, people not want to talk about it, people giving you the run around, people not really answering questions. This is a government service. It's a very important government service who oversees this agency, the Department of Behavioral Health. Is it in the council or in the mayor's office, either one, and how aggressive has that oversight been? Have there been hearings about this? So there were a lot of questions asked in the most recent round of sort of standard oversight

11:23hearings. I'm not sure that there have been hearings outside of that about this. This is just something that as far as I can tell kind of flies under the radar until once a year, the Department of Behavioral Health comes up in front of the DC council and gets raked over the coals about it. Before we go beyond 988, are there other resources for DC residents in crisis? Yeah. So DC has the access help line. I think that we're going to have these numbers read out at the end of the show, which exists to help connect people to sort of longer term services, but also does crisis line work. There's a national text line. I've been saying call a lot with 98, but you can also text or chat with them online as well. If you're LGBTQ, the Trevor project has a crisis line that you can call, especially after the 988 crisis line for LGBT youth was shut down in this administration. So there are other places to reach out for help. If we heard anything from the new or the mayor to be about this, I mean, I can tell

12:28you that Councilman, Christina Henderson, who heads the committee on health, seemed to think that this, we basically needed a new mayoral administration for this to change, that it was just not a priority of the Bowser administration. And so she seemed to have a lot of hope for a new head of DBHB and able to turn things around a little bit. Alyssa, thank you very much. And thanks for this important reporting. Thank you. If you or someone you know is experiencing suicidal thoughts or a mental health crisis, you can always call our text 988 or you can reach DC's access helpline at 888-793-4357. And that's all for today here on CityCast DC. If you enjoyed this show, why not tell a friend, rate the show, leave us a review and subscribe to our morning newsletter. We will be back tomorrow morning with more news from around the city. Bye.