Meet some of the Kentuckians answering 988 – These first responders are driven by empathy
by Sarah Ladd, Kentucky Lantern
This story discusses suicide. If you or someone you know is contemplating suicide, please call or text the National Suicide Prevention Lifeline at 988.
LOUISVILLE – When Sunshine Randolph was an undergraduate student, her stepfather died by suicide.
“It really does kind of rock your world,” she said of the experience, which drew her to work in suicide prevention. “I know what it can do to a family.”
Randolph now answers 988, the suicide prevention lifeline in Kentucky, for the Lexington-based New Vista. She draws on her personal experience to help people get through some of their most challenging moments.
“We kind of have these backgrounds in psychology,” said Randolph, whose bachelor degree is in psychology. “We maybe are more familiar with (mental health) – but experiencing it is something a little different.”
Still, she tries to empathize while not projecting her own experiences on others.
“No one death by suicide or or suicidal ideation is the same,” she said.
Calls and texts to the crisis hotline rose after 988 launched in July 2022, replacing a 10-digit number. Experts said the simplification of the lifeline would save more lives.
Gov. Andy Beshear said in January that overall, the state saw a 26% increase in calls to 988 in the second half of 2022, with fewer calls dropped as well.
There were 708 more communications in August that year — the month after the launch — than in June, state data shows.
There were 646 crisis text messages from Kentuckians from January and June of 2022, the Lantern previously reported. Then, after 988 launched, that jumped to 2,286 crisis messages — an increase of 254%.
In February, 727 texts and 634 calls came in, according to a Cabinet for Health and Family Services report. In the past year, there was a 30% increase in Kentucky-based calls overall.
People who answer the line said that since the launch of 988, calls have expanded beyond suicidality. Sometimes, people are calling 988 just to talk and de-stress at the end of the day or middle of the night.
Roughly 138 Kentuckians answer the crisis line at Kentucky’s 13 participating call centers.
In March, there were 112 full-time and 26 part-time employees answering 988, according to estimates from Kentucky’s chapter of Mental Health of America (MHAKY).
Those Kentuckians spend their shifts saving lives behind the scenes. They also, sometimes, just listen.
Marcie Timmerman, the executive director for MHAKY, said the folks who answer 988, which was first proposed in 2019, are “first responders.”
“They’re really the first people who can respond to a mental health crisis,” Timmerman said. “They’re really crucial to the system.”
Driven by empathy
Randolph isn’t alone in pulling from personal experiences to help others who call or text 988.
Her colleague, Abby King, grew up hearing her mother advocate for mental health.
That’s because before she was born, her grandmother died by suicide.
“Suicide” and “mental health” were “vocabulary words that I knew from a very, very young age,” the Bowling Green woman said. “So I think that that may have just made me more compassionate and understanding to the world at a really young age.”
King never got to meet her grandmother, but said she’s always had compassion for her, which she tries to extend to people who call the line.
That’s also made her anxious on some calls.
“I know that suicide is real and does happen,” she said. “No one’s immune to it.”
It’s also difficult, once a call is over, to let go.
Many times, King and Randolph said, they don’t know what happened with a caller once they hang up.
“I definitely think to myself, ‘how did this turn out?’” Randolph said. “You have to have hope and faith in the system … but yeah, I think about certain or really impactful, emotional calls all the time.”
The most important thing when taking a 988 call or text is to make sure the person reaching out is safe and feels heard, answerers say.
“The number one priority is making sure they’re safe in that moment,” said Randolph.
Responders will balance listening to a caller vent while doing a risk assessment to see if the caller has hurt themself or plans to, if they have a suicide plan, and more.
“We have processes and protocols, like the risk assessment and then safety planning,” King explained. “But really, it’s just that natural human interaction that makes the call successful.”
Once the caller is safe and hangs up, responders may need to decompress and process what they’ve just heard.
King keeps her workspace calm, she said, for that reason. She may have essential oils or incense out or keep a virtual fireplace crackling on her TV.
Sometimes, decompressing is as simple as walking outside and feeling cool air on her cheeks.
“It can be as simple as taking a step outside, letting my dogs out,” Randolph added. “Touch the grass so to speak. Just making sure I’m reminding myself that I’m doing good work is really important. And a good face mask never hurt anyone after shift.”
Taking ‘vicarious trauma’ seriously
Holliss Williamson, a triage specialist in River Valley Behavioral Health in Owensboro, said she turns to her coworkers for support after especially difficult calls.
Her team of eight fills in for each other when one needs a mental health day or to just walk away from the desk for a while. They each know the toll crisis response can take on a person.
A self care action plan can also help when dealing with a lot of trauma. That can include asking:
- What brings me joy?
- What helps me reset?
- Am I getting tense?
- Am I having trouble breathing?
“We take secondary traumatic stress, vicarious trauma and burnout very seriously,” said her coworker Gerrimy Keiffer, a social worker at River Valley. “Working a crisis line is incredibly stressful because, in some cases, you don’t know if that person actually got help or if they got better when that phone call ends.”
River Valley crisis workers also have access to an app called Heroes Health, which lets them track their mental health and access resources.
King said she compartmentalizes her feelings while on calls.
“While I’m on the call, my main priority is to make sure that they’re safe. And that’s the perspective I try to keep to keep me calm throughout the call, even if I’m … even relating to some of the pain that they’re talking about,” she said. “It’s just reminding myself that I’m currently in a safe environment, and they’re not. So I have to make sure to provide that safety.”
The effect of COVID-19 and anti-LGBTQ laws
The COVID-19 pandemic, Keiffer said, has “caused a lot of stress and unsurety” among the community, resulting in more calls to crisis lines.
“Combine that with loss of jobs for many, unstable employment, unstable economic environment that we’re entering right now, as well as a lot of the political and cultural strife we’re experiencing,” he said. “Within the last few months, we’ve also seen an uptick in individuals experiencing issues related to gender identity and LGBT concerns.”
He pointed to legislation targeting transgender Kentuckians as being a stressor for many.
River Valley has also seen an uptick in calls from youth, particularly those re-entering a public school setting after learning at home for so long because of the pandemic.
The Centers for Disease Control and Prevention reported in February that more young girls are feeling depressed.
Almost 60% of teenage girls “felt persistently sad or hopeless in 2021,” the CDC said. About 30% of teenage boys felt that way. Teens in the LGBTQ+ community suffered “ongoing and extreme distress.”
The CDC also reported that about 1 in 3 teen girls seriously considered attempting suicide in 2021.
“Add on the stressors that normally would be experienced as a youth like bullying, the anxiety of tests and just your own interpersonal issues, and then we throw on top of that the emotional triggers that you deal with that are exclusive to living during a pandemic, and that kind of unsurety,” Keiffer said. “It’s very difficult for kids, especially because that ability to emotionally regulate hasn’t fully formed. It is absolutely a concern.”
Will the police get involved if I call 988?
Several folks who answer 988 in Kentucky said police would be involved only as a last resort. For example, police may be called if a person admits to having a weapon and wanting to harm others.
Keeping everyone safe can be a balancing act.
“We don’t want to criminalize mental health,” Keiffer said. “If (people are) experiencing a mental health challenge, I want them to feel secure and safe to reach out for help.”
“Involving law enforcement immediately makes that person feel more stressed out,” Keiffer explained. “Having a police officer knock at your door when you’re having, for many, the worst moment in their life … we want to avoid that if we can.”
No wrong door
People who answer 988 aren’t just there to save lives. They provide an anonymous listening ear for people who just need to vent or maybe don’t have a support system.
“You can’t get to the saving,” Randolph explained, “without first listening to the client.”
They’re also focused on getting everyday resources to people in need. They may help a caller find food banks or places that can help with rent or housing. Lacking transportation or internet access, too, can lead to suicidal ideation. For teenagers, it’s often an issue of parents not supporting them or listening to them.
At River Valley in Owensboro, staff can direct callers to gambler’s addiction help, a sexual assault support line and more.
Basically, there is “no wrong door,” Keiffer said.
“I think of 988 as suicide prevention, but also a helping line,” Randolph said. “If you call me I might be able to connect you with several different things all at once or give you resources and advice on where to get those things.”
‘Please don’t prank call 988’
Several 988 responders said they get prank calls, often from kids.
“I kind of just laugh a little bit,” King said, “because it comes from a place of: ‘I’m happy that these resources are available now.’”
Still, experts say mental health should be taken seriously.
“Mental health is not something we joke about,” said Timmerman with Kentucky’s chapter of Mental Health of America.
So: “Please don’t prank call 988.”
Just start with hello
In the 2024 legislative session — a budget year — Kentucky’s chapter of Mental Health of America and the American Foundation for Suicide Prevention will be asking the General Assembly to allocate general fund dollars to 988.
“We need to fund (988),” Timmerman said, “as equally as we do 911.”
Beyond funding, crisis workers say they need more awareness of the 988 number and education surrounding stigma.
“We’ve taken callers who were leery about even calling in,” Williamson said. “even some callers will hang up because … there’s a stigma … or they just don’t feel comfortable and never had to address their issues in that way.”
Some also recommended embedding social workers with police so when they do have to respond, trained mental health professionals are on hand.
Keiffer said if you don’t know where to start when calling 988, just start with hello.
And: “If you don’t feel comfortable calling right away, that’s okay,” he said. “But do try again.”
Top photo: New Vista engagement specialist Sunshine Randolph poses for a portrait on Wednesday, April 12, 2023, at New Vista in Lexington. (Kentucky Lantern photo by Carter Skaggs).
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