James Donaldson on Mental Health – 988 suicide hotline is getting more calls than ever. Many states have no clear plan to fund it

Editor's note: If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the Suicide & Crisis Lifeline.

Brent Brewer has a passion for helping his fellow farmers and ranchers handle the stress that comes with agricultural work. He's known around Oklahoma as someone you can call if you're struggling with your mental health.

Rural populations, particularly farmers, have a higher suicide rate than the general public. The unique stresses of working in agriculture can exacerbate symptoms of depression and anxiety — particularly when the economic situation is dire for farmers.

Since it started taking calls in 2022, demand has increased for 988 nationwide. 'We have been seeing a month over month increase in utilization of 988. And so we are also working pretty hard to keep up,' said Monica Kurz, chief administrative officer for Health Source Integrated Solutions in Kansas, one of the state's 988 call centers.

The 988 system was designed to give people in crisis an easy-to-remember number that's available 24 hours a day via call, text and chat. Every state has its own set of call centers with trained operators.

The federal government paid for the launch of 988, but states were expected to pick up the tab eventually. The federal bill that established the program recommended that states collect fees on telecommunication products, which is how 911 is largely funded. Only a dozen states have created these fees, though.

'There's no sustainable funding source for 988,' said Jonathan Purtle, an associate professor at the New York University School of Global Public Health who studies 988 funding. 'The federal law kind of suggests, Hey states, here's an idea about how you can fund it. And that idea is 988 telecom fees.'

Purtle is near the end of a five-year study analyzing the funding of 988 systems in all 50 states. So far he's found those with long-term, dedicated funding for staff are generally more efficient. 'The big thing is people, right? The staffing, the people who work in these call centers is the main thing,' he said.