Increasing calls to Utah's crisis hotline show Utahns are struggling — but are seeking help

SALT LAKE CITY — Utah's suicide crisis hotline logged the highest yearly call volume in the resource's history, according to an annual report released by the Huntsman Mental Health Institute.

The number of Utahns who called the state's suicide crisis hotline jumped by 32%, bringing the total number of calls to 92,532 for the fiscal year period ending June 2021, the institute reported.

The voluminous call log represents strides in the organizational capacity of prevention efforts even as it simultaneously serves to underscore the formidable mental health landscape in a state whose perennially high suicide rates have been slow to register with the wider public.

"Seeing an increase in calls to our suicide prevention crisis line is always a double-edged sword. It shows us that many people in our community are struggling, but it's also good to see that folks are calling in and accessing services and asking for support," said Rachel Lucynski, operations manager at the Huntsman Mental Health Institute's Community Crisis Intervention team.

The report comes at a moment when experts say the nation's mental health crisis is worsening, captured most vividly in the startling statistics for suicide and recently thrust onto public awareness by a spate of high profile deaths, including admired celebrity chef Anthony Bourdain and fashion entrepreneur Kate Spade.

In Utah, the data paints a grim picture — with suicide the leading cause of death for Utahns ages 10 to 24, and the second leading cause for those ages 45-60. Hence the state's bleak placement as the country's sixth-highest age-adjusted suicide rate, according to the Utah Department of Health.

Moreover, the figures may understate the scale of the problem, as many more are hospitalized or treated in emergency rooms for suicide attempts than are fatally injured. In 2019, for instance, 70 Utahns were treated for self-inflicted injuries every day, as shown in the department's health indicator report.

Responding to the worrisome trends, the Community Crisis Intervention team has created what it says are innovative life-saving services to address crises at different levels of severity and funnel Utahns experiencing mental health disturbances to resources to help prevent further harm.

On the front line are the team's call responders who've been trained to help those in crisis by establishing rapport and together exploring solutions. They might ask how a caller has resolved a previous crisis, or who in their lives might be able to help.

"Our crisis teams are really skilled at listening to what the concerns are with callers, validating those concerns, being solution-focused and empathetic. It helps keep people safe," said Lucynski, the program manager. "In 86% of instances we are able to handle calls over the phone. People feel better by the end of that phone call, and they have a safety plan in place."

The report showed 4% of callers were referred to emergency hospital departments, and 2% of calls entailed imminent risk situations that required law enforcement to perform safety and welfare checks. For 8% of callers, the center dispatched a Mobile Crisis Outreach Team consisting of two intervention workers who arrive in unmarked cars to meet face to face with those at imminent risk. Each team includes a master's-level mental health counselor and certified peer support specialist.

"It's important to have someone there with a lived experience with mental health challenges or substance use disorder because they can share that experience, which provides people with empathy and support," said Lucynski. "It helps make the person feel safe, valued, understood, heard. Sometimes the peer support specialists share their own experiences and say, 'I know what it's like to be in your shoes. There is hope and ways that we can help get you through this because there are really valuable things to live for.'"

The mobile outreach teams deescalate and evaluate suicide risks before coming up with safety plans that Lucynski says resolve 80% of crises on site. Crisis workers intervened to save 1,353 Utahns "at imminent risk of suicide," and believe the efforts are helping correct worrisome trends, based on correlated data from medical examiners and the state's Death Surveillance report.

"We're seeing flattening suicide rates, and in some demographics are even seeing decreasing rates. It's always hard to determine correlation versus causation, but we hear from our partners that these services are highly effective," said Lucynski, whose assumptions are backed up in national studies about the effectiveness of crisis hotlines.

Growing acknowledgment of crisis work influence has spurred action at the national level. The Federal Communications Commission has passed new rules to simplify the prevention process by instituting an easy to recall, nationwide three-digit phone number for suicide hotlines. The number is 988. Under the new FCC rules telecommunication carriers and phone service providers will direct all 988 calls to the existing National Suicide Prevention Lifeline beginning July 16, 2022.

The new phone number will increase prevention service accessibility while also signaling a larger social commitment to a problem that mental health advocates say is past due. Lucynski anticipates the change will encourage more people to utilize the resource at a time when demand is showing no signs of slowing.

"Right now we're seeing 11% to 15% increases in calls every month. We broke the record last year, but we're already on pace to beat it again this year," said Lucynski, who attributes part of the volume increase to situational stress associated with the coronavirus pandemic.

For Utah's Community Crisis Intervention team, the work is not just saving lives — it's also saving dollars. Intervention efforts help keep individuals from high-cost and emotionally burdensome visits to emergency departments or long-term hospitalization. It also helps minimize the overall use of the state's law enforcement and emergency medical services by catching problems before they spiral further.

For crisis workers, mental health is a big picture issue where lasting and comprehensive solutions demand systematic reform. For instance, mental health faces stigmas that make it hard for people to seek help when struggling.

"One of the challenges for people getting help is the stigma and taboo. You hear terms like, 'You're crazy. You're bipolar. You're psycho.' But people don't understand those are real illnesses and ailments," Lucynski said.

Yet even those seeking help face barriers due to the design of health care delivery systems with inflexible co-pays and negligible reimbursements that make critical psychological care cost-prohibitive for large swaths of those in need, as seen in Utah's Mental Health System, according to a 2019 report from Gardner Policy Institute.

The Community Crisis Intervention program seeks to help fill this unmet need by offering resources beyond the crisis call line. It also offers SafeUT, an app designed to provide professional help for students, parents and educators. That's along with a "warm line" and transitional follow-up services that give emotional support to people getting through mental health difficulties.

"Suicide is preventable and even one loss of life in our state is too many," said Lucynski. "There's a lot of great progress to be made, and still a lot of work to be done."

Correction: An earlier version reported many of the Huntsman Institute's call responders are volunteers. Though other crisis lines are operated by volunteers, responders at Huntsman Institute are all paid professionals.

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