FALMOUTH—An expanded staff is answering local calls to the 988 Suicide and Crisis Lifeline a year since its implementation.
The Samaritans on Cape Cod and the Islands manages one of the country's independent crisis centers working to end suicide. The nonprofit was volunteer-driven until this year when increased caller demand meant offering crisis-line associates up to $20 an hour to answer calls remotely.
"We now have enough people on each shift to answer just about any call that comes in," Stephanie Kelly, executive director of The Samaritans, told Morning Edition host Patrick Flanary.
Congress three years ago established 988 to improve access to mental-health services and connect calls and texts to the National Suicide Prevention Lifeline. The crisis line was implemented last July.
"I work on the assumption of hope," Kelly said. "We can ask each other 'How are you doing today?' in a way that encourages you to tell me how you're really doing."
Patrick Flanary Are more people dialing 988 to speak to someone than they were before the number changed to three digits?
Stephanie Kelly I think it's likely due to the easier dialing code, but also the promotion. I think that more people are aware that anyone can call who's struggling or lonely or isolated, that it's not necessarily a line for only people who are feeling suicidal.
Patrick Flanary Local callers are routed to your crisis center, which is in Falmouth, one of about 200 centers in the country. What happens when a caller is connected to one of your workers?
Stephanie Kelly Calls that originate from Plymouth, Barnstable, Nantucket, and Dukes Counties are routed to our center. And there are five centers across the state that cover different areas. They are answered by a trained crisis-line associate. Primarily what we try to do is provide a safe place for people to talk about whatever issues they are facing, whatever is bothering them at that moment in time, if they're feeling suicidal.
Patrick Flanary And about how many people are answering the phones at the Falmouth center?
Stephanie Kelly This is something that I'm so proud of. We've gone from about 20 volunteers to approximately 50 paid staff to answer calls, and another 20 volunteers. We had never paid anyone ever to answer calls. It was always volunteer-based and volunteer-driven, but we found that with the volume of calls that are coming in, in order to accommodate that need we have to be ready to respond. So we have about 50 people now that we pay to answer calls. Because of COVID, we had to implement a new mode of operation. Our folks don't go into the center anymore. They work remotely. And that opened up our geography for volunteers and for paid staff.
Patrick Flanary And I don't need a medical background to answer calls, right?
Stephanie Kelly No. The idea is that it's still based on our old foundation for the organization: befriending. Befriending isn't about providing licensed clinical work or being a licensed psychologist. It's about people listening to each other and providing support that way. It's worked for 46 years, and it's just an unbelievably powerful thing.
Patrick Flanary ABC News reported that the call-answer rate in Massachusetts in April was 88 percent, so that means 12 percent of calls went unanswered. Was this a reflection of staffing?
Stephanie Kelly I can't speak to the state, but I can speak to our center. We have enough people on each shift to really answer just about any call that comes in. And in April, we were at 90 percent, which is great. Most of it is about abandoned calls. People who dial want to talk. But we know from past experience that sometimes it takes two or three calls for people to build up the courage to actually begin the conversation.
Patrick Flanary There's something very special to knowing that if I dial 9-8-8 and I'm in Falmouth, I'm speaking to somebody who's also in Falmouth or on the Cape.
Stephanie Kelly Absolutely. And the whole design of that is so that we in Falmouth know what kind of supports are available for you. We're not really a referral agency. But if somebody calls us and we think that they could benefit from some information, we know what's available here.
Patrick Flanary What is the length of one of these exchanges when someone calls?
Stephanie Kelly That's a really good question. Our call-takers pretty quickly do a risk assessment with the caller to see whether they are, in fact, suicidal or thinking about suicide. I would say that the majority of our calls are not people who are necessarily in that place. They're thinking about it, but they want to talk about it. They don't have an active plan. So they're not really what you would call an imminent risk right at that moment. Depending on how many calls are coming in at any given time, we try to give as much time as we can to each caller. If we are on an imminent-risk call, we're going to stay on that call for as long as it takes.
Patrick Flanary This week, the Pentagon reported that military deaths by suicide rose in the first quarter of the year compared to the same time last year. And I was reading that the suicide rate is highest among middle-aged white men. Why is that?
Stephanie Kelly I think that middle-aged men are less likely to reach out for help. And I'm not being sexist. I just think that's that's how men are raised, to be strong and hold everything in. And unfortunately, that that's not conducive to maintaining good mental health. The only scientific data that I have on this is that men tend to use more lethal means when they are attempting suicide.
Patrick Flanary The national suicide rate rose last year, yet the rate went down in Massachusetts. I'm curious what that tells us. Are we getting better at reaching out for help?
Stephanie Kelly The reason is because we have a legislature that really understands the importance of addressing this issue and the importance of mental health. It gives us the opportunity to respond in a way that works.
Patrick Flanary We don't often hear about suicide-attempt survivors, but there were 1.7 million attempts in 2021, according to the American Foundation for Suicide Prevention.
Stephanie Kelly I think that it is an incredibly significant problem that we need to address. We at Samaritans have been looking at ways to support attempt survivors for probably the last five or six years, trying to figure out the best way to do that in a way that would be helpful. They say for every person that dies by suicide, about 135 people are affected. Because if you look at our communities on the Cape, there are a lot of people who know each other. It might be somebody you work with, family members, students. And it also tells you that it touches everyone.
Patrick Flanary And it seems we are more conscious of our mental health, but that doesn't mean the stigma is gone.
Stephanie Kelly You put batteries in your smoke detectors, you wear a seatbelt. There are things that we can do to protect and reduce the numbers of suicide. But because it's still stigmatized so much, we don't talk about it. So I guess I would like to see more of a public health perspective and approach. I would like to see more of a public-health perspective and approach to normalize the conversation around it.
Patrick Flanary I'm curious what drives you to pursue efforts to educate the public about dying by suicide?
Stephanie Kelly I work on the assumption of hope. I think that there's hope that we can reduce the rates. We can provide each other hope. We can ask each other 'How are you doing today?' in a way that really encourages you to tell me how you're really doing. I believe what we're doing works. I want it to be better. I want there to be a zero suicide rate.
The Samaritans will recognize World Suicide Prevention Day on Sept. 10 with an event in South Yarmouth.
