Alaska’s suicide prevention hotline and 24/7 crisis call center provide immediate care for mental health emergencies

Presented by the Alaska Mental Health Trust Authority

Part 2 of 4

Every phone call to Alaska’s 988 Suicide and Crisis Lifeline is unique. But callers dialing from a local area code will reach an Alaskan on the other end of the line who is ready to listen.

“We’re here to create a safe space for callers to talk about whatever is going on in their world, at a pace that feels comfortable to them, at a level of disclosure that feels comfortable to them,” said Executive Director of Careline Crisis Services, Susanna Marchuk.

“Our calls are led by the caller,” Marchuk said.

The 24/7 hotline — crucial in Alaska, where the youth and young adult suicide rate (ages 15 to 24) is the highest in the U.S. and roughly four times the national average — is one of the key components of the Crisis Now model

Crisis Now is statewide initiative led by a coalition of behavioral health care advocates to create a better system of mental health care for the state’s residents. Championed by the Alaska Mental Health Trust Authority, in partnership with the State of Alaska and a broad spectrum of organizations, the model focuses on widening the range of options for Alaskans in crisis. After two years, benefits are already being reported.

Alaska’s 988 hotline is one of the first places people can go for help, providing immediate care for a person in crisis. People who call or text 988 are greeted by respectful, professional operators, who listen without judgment. All phone calls are confidential.

“Our primary objective is safety,” Marchuk said of callers. “If there’s not a safety concern, our next goal is to support their wellness.”

Call 988 from a phone with an Alaska area code (907) and it is routed to Alaska Lifeline center at Careline. Phone numbers with a non-Alaska area code can reach the local Careline team at 1-877-266-4357 (HELP). Those with a non-Alaska area code who dial 988 will be routed to the call center nearest their area code.

Careline Alaska has operated a toll-free suicide prevention lifeline since 2005 and is the Alaska member of the 988 Suicide & Crisis Lifeline network. In 2020, Congress designated 988 as the dialing code to operate through the existing National Suicide Prevention Line.

The transition away from an 800 number to the simple, three-digit 988 has been successful due to the multi-stakeholder planning and engagement surrounding this work, said Acting Executive Director for the Alaska Mental Health Board, Advisory Board on Alcoholism and Drug Abuse and the Statewide Suicide Prevention Council, Leah Van Kirk.

Efforts to implement 988 in Alaska began in April 2021, with the Alaska Division of Behavioral Health leading a collaborative statewide planning process. Engagement from stakeholders across the state shaped Alaska’s 988 implementation.

988 is operated by Alaska-based crisis counselors 24/7. Translators and interpreters are available for non-English speakers and those who are deaf or hard of hearing. Alaskans can both call and text 988, or chat at 988lifeline.org for help. Emergency dispatch centers can also connect people to the hotline.

“Our hope is that people will know that they can reach out for support far before they’re in the weeds or when they’re actively contemplating ending their life,” Marchuk said.

For Alaska, the suicide prevention hotline is one of the many “rungs on the ladder” of crisis services needed to help provide a safety net for some of the state’s most vulnerable residents, Alaska Mental Health Trust Authority COO Katie Baldwin-Johnson said.

Thanks to 988, Alaskans can access immediate care, without having to visit an emergency room, or call for a community mobile response team.

‘Walk hand in hand with each patient, in the way that they need’

Experts say having a local voice at the other end of a phone call is important; regional hotlines are a core best practice of the Crisis Now model, according to the federal Substance Abuse and Mental Health Services Administration.

“It’s particularly relevant and important for Alaska,” Marchuk said.

One advantage is Alaskans more deeply understand the nuances and challenges of people in remote communities who call for help, Marchuk said.

“While other states say that they serve rural populations, they don’t do rural like Alaska does rural,” she said. “We really believe that Alaskans are best provided services by other Alaskans.”

Call volume has been steadily increasing since the launch of 988. In March, calls to 988 Suicide and Crisis Lifeline increased 67% compared to the same time last year, said Van Kirk.

Another helpful new feature that rolled out with the launch of the local number was the ability to text 988 or chat online at 988lifeline.org for direct help.

The Careline is responding to text and chat when call volume and staffing allow, Van Kirk said, and is currently focused on recruiting more team members. When local staff are unable to reply to texts and chats they are answered by staff outside of Alaska. Marchuk said Careline is hoping to increase that to a 24/7 local response this year.

“I think about my daughters and how if I call them, they won’t answer, they only respond to texts,” said Alaska’s Chief Medical Officer, Anne Zink. “The fact you can text 988 is a great transition to how people seek care and how they need care. It helps us to walk hand in hand with each patient, in the way that they need.”

The highest demographic of callers are people aged 25-44. But in Alaska, people ages 10-24 have been identified as the highest risk group for dying by suicide, Zink said.

One objective of Crisis Now is to “take a really intentional look at how we can increase young people reaching out for help,” Zink said. “And a piece of that is making sure we are using the platforms that are more preferable to young people.”

“People can ask for help 24 hours a day. It’s a system of us supporting each other,” Zink said.

Solutions for emergency dispatchers

One of the benefits of Careline Alaska is that most calls can be resolved over the phone, alleviating the burden on already-strained emergency departments, an important goal of the Crisis Now model.

Results are promising: The local Fairbanks hotline has been able to resolve 99% of all calls without needing additional emergency services, Van Kirk said.

Jacob Butcher, communications manager for the City of Wasilla’s Mat-Com Dispatch, said the crisis line is helping emergency dispatchers, too.

“We have a lot less dispatcher time spent on the phone handling emotional and mental health crises, because we have the resources to transfer them to someone who has the time and energy to focus,” Butcher said.

Dispatchers use their skills and training to discern when to transfer calls to the crisis hotline, Butcher said. They run through a checklist to determine if certain elements have been met, such as if a person is suicidal or a threat to others. If certain criteria are met, dispatchers treat the call as a public safety threat and notify emergency law enforcement. Otherwise, dispatchers utilize the 988 crisis call center.

“Connecting someone to the appropriate care and resources within their home community is essential to prevention,” Marchuk said. “We also provide follow up calls for support, when requested.”

Marchuk said this is especially unique in Alaska, where some people who call 988 might be in remote villages without any peace officers in town to help.

In one example, a person called and consented to an active rescue, but Alaska State Troopers were not able to fly to the community until the next morning, she said. To help this person get through the night, Careline Alaska staff called them every hour, on the hour, until the person was safely contacted by troopers.

“While those instances are rare, they do happen,” Marchuk said. “And those people reaching out for help deserve to access call takers that are ready and prepared to navigate those challenges.”

“The ability to work creatively with our callers has been cultivated out of necessity,” Marchuk said. “It is an asset we hold as a point of pride; it means we can do our job really well.”

Careline also has mental health services available to staff to help keep them healthy and safe after helping people navigate difficult situations. After each shift, call takers are required to process events with a peer or supervisor.

“It’s hard work, and it’s beautiful work, but it’s sometimes heartbreaking work,” Marchuk said.

The center has cultivated a culture where staff know to take measures to support their health and utilize provided resources, such as counseling, she said.

Numerous partners contributed to planning for the transition to 988, said Van Kirk with the Alaska Division of Behavioral Health. These include behavioral health service providers, law enforcement, tribal organizations, telecommunications companies, suicide prevention organizations and advocates, Alaska’s crisis call center, state and local government agencies, and people with lived experience and those who have lost loved ones to suicide.

“Due to the prevalence of suicide in our state, most Alaskans have experienced loss,” Van Kirk said. “When called upon, personally or professionally, we come together, to do our best at reducing the burden of suicide in our state,” Van Kirk said.

A 24/7 crisis and suicide prevention hotline like 988 is a crucial component of the Crisis Now model, proving to have an immediate impact on the wellbeing of Alaskans — but it is just one element in a wider effort to lift communities up through access to mental health care.

In many cases, individuals in crisis can have their needs met by speaking with a counselor on the other end of the line, but in some cases additional supports are needed. That’s where new services for Alaskans that align with the Crisis Now model are most important, such as mobile crisis teams.

NEXT: Mobile crisis teams have made encouraging strides in helping Alaskans who would otherwise be met by police or ambulance.

If you or someone you know is struggling or needs immediate support, contact Careline at 1-877-266-HELP, call or text 988, or chat at 988lifeline.org. You are not alone. Please visit 988.Alaska.gov for additional 988 resources. For more information on the Alaska Suicide Prevention Council and suicide in Alaska, visit https://health.alaska.gov/suicideprevention.

Read the rest of the series: Part 1 - Part 3 - Part 4

The Alaska Mental Health Trust Authority is a state corporation that administers the Alaska Mental Health Trust to improve the lives of beneficiaries. Beneficiaries of the Trust include Alaskans who experience mental illness, developmental disabilities, chronic alcohol or drug addiction, Alzheimer’s disease and related dementia, or traumatic brain injuries. Learn more at AlaskaMentalHealthTrust.org.

This story was produced by the sponsored content department of the Anchorage Daily News in collaboration with the Alaska Mental Health Trust Authority. The ADN newsroom was not involved in its production.