While 988 is making progress toward its goal of strengthening crisis response systems across the U.S., a 2022 survey showed 50% of behavioral health providers experienced symptoms of burnout. Knowing this, Cambia Health Foundation invested in six crisis centers across Idaho, Oregon, Utah and Washington to support their workforce training and resilience. The crisis centers used the funding to invest in training, development and self-care opportunities for their staff. In addition, organizations diversified staffing to strengthen services for those who are historically underserved.
In recognition of the 1-year anniversary of the launch of 988, we’re shining a light on our grantee Volunteers of America Western Washington, whose workforce answers calls for Washingtonians in crisis.
Crisis calls were projected to increase two-fold with the launch of 988, from 3.3 million in 2020 to 7.6 million by the end of July 2023. With the anticipated spike in calls, Volunteers of America Western Washington (VOA) began hiring more trained counselors to answer the calls. By July 1, 2022, VOA had hired 100 additional people to accommodate the anticipated need, nearly doubling its staff.
“We’re still growing,” said Levi Van Dyke, senior director of behavioral health with VOA. “Prior to 988, we were able to transition to a remote model, which is the trend among crisis centers. That allowed us to be well-positioned to scale up to this point. With a remote model, we were able to expand our hiring search nationally – now we have employees in 29 states.”
Text and chat options expand access
Nationally, more than five million calls, chats and texts have been routed to 988 since its launch--a 66% increase from the previous 12 months. Van Dyke and the VOA team have seen an increase of about 40% in crisis phone calls – and a dramatic 130% increase in chat and text services.
Before the National Suicide Prevention Lifeline transformed into 988, many crisis centers across the country lacked the capacity, funds and resources to support chat and text functions. If someone contacted a crisis center through text or chat, messages often went unanswered. With new funding, most crisis centers added the ability to reliably respond to text and chat messages, significantly expanding access to care.
“We’re one of the leading crisis centers in the country regarding our text and chat services, which is partially why we saw such a high increase in text and chat utilization,” said Van Dyke. “We focus on youth as a high-risk population, and they are more likely to use text and chat.”
VOA recognizes the distinct skillset that is needed to answer texts and chats rather than calls. “We assign different counselors to phones versus the text and chat services. We have found that individuals who contact us on chat and text initially present with a higher suicide risk; there are a few different variables for why this is, but we’ve found that an individual is more willing to share the severity of their crisis via chat and text than they are on the phones.”
Innovation in cultural competence
Throughout the year, new options were added in order to provide more culturally competent care. Callers can now choose to speak with a counselor who better reflects their cultural identities, including a newly launched Spanish-language text and chat feature as well as a line dedicated to veterans and military families. In addition, VOA is one of the leading crisis centers, specializing in providing support to:
- American Indian and Alaska Native: The Native and Strong Lifeline is exclusive to Washington State and operated solely by VOA. Launched in November of 2022, it’s the first program of its kind dedicated to serving American Indian and Alaska Native people. Calls are answered by fully trained Native crisis counselors who are Tribal descendants and provide special emphasis on cultural and traditional practices related to healing.
- LGBTQ+: What began as a pilot in the fall of 2022 expanded into a nationally dedicated LGBTQ+ dial pad option in March of 2023 and now includes chat and text. “Four crisis centers across the country were selected to specialize in the LGBTQ+ chat and text line, and we are one of them,” said Van Dyke. “We have proven our ability to expand our hiring to accommodate added volume. We also surveyed our staff to see who would want to participate in this program and the percentage was high, which shows their dedication to helping.”
Helping the helpers
With the grant provided by Cambia Health Foundation for the launch of 988, VOA invested heavily in their employees. They implemented new workforce management software, offered additional training opportunities for their staff and focused on preventing burnout.
“Right now, we’re recruiting for a wellness coordinator, which is a new position for us,” said Van Dyke. “They will address secondary trauma and burnout related to the intensity of this work. We’ve found that big changes like this really make a difference among our staff, but so do the little things.”