Mental health problems possibly leading to suicide are a major crisis requiring emergency counseling — but unfortunately, those in need too often have been unable to get through to a counselor at a state-run hotline. The state Health Department has recognized the problem, but needs to treat it as an emergency in order to repair a last line of defense that hasn’t worked as it should.
Records show that in September alone, more than 1,200 of the 9,631 calls that were made to the Hawaii Access Hotline were abandoned by the caller after an average of 16 rings, listened to a recording announcement and then were often asked to leave a message, which took as long as a half hour for someone to call them back.
Hundreds more callers hung up before ever getting to the recording. The problem has grown over the past five years, as the percentage of dropped calls has more than doubled. That’s alarming.
Such 24-hours-a-day phone lines are set up to provide help to those suffering from severe depression and considering suicide, and the seriousness is real. In Hawaii, more than 200 suicides were reported in 2010, 16th highest in the nation based on population, according to the most recent figures from the Centers for Disease Control.
Dr. William Sheehan, chief of the state Health Department’s Adult Mental Health Division, has said his office is "getting permission and approval to make things better," but how and when is not clear.
His hope of coming up with solutions by June — a full half-year away — is woeful and unduly sluggish, considering the possible life-or-death consequences in some cases.
One big problem cited by mental health advocates is the mixed pool of calls coming into the hotline: from true crisis calls, to referral requests for services.
Surely a more brisk protocol can be employed for hotline screeners to triage calls — much like the police’s 911 opening question, "what is the nature of your emergency" — in order to take the most severe calls first and get back later to those with questions.
Perhaps, too, a secondary, fall-back line should be established to deflect less-urgent calls away from the suicide hotline number.
The Hawaii Access Hotline now has 13 full-time staffers taking calls, two more than last year, and will soon hire a 14th.
The state spends $788,000 a year on the hotline, all but $36,000 for salaries, overtime costs and overnight rates. That is not much when compared with the alternative. For example, the combined annual budget of all accredited crisis hotlines in California was estimated last year at $4.6 million. However, suicide attempts resulting in hospitalization and other medical costs, including the individual’s loss of production, are estimated to cost that state $4.2 billion a year.
"They are able to keep the crisis hotline cost low in part because they rely on volunteers," according to a study by the California Department of Mental Health’s Office of Suicide Prevention.
"Using highly trained unpaid volunteers significantly decreases the cost of providing crisis intervention services."
A hotline "may deter many individuals from attempting suicide and therefore save the cost of treating a suicide attempt in the emergency room."
Since 1958, the National Suicide Prevention Lifeline network was organized to ensure that "all crisis calls to the Lifeline are answered in a timely manner."
Of course, a hotline’s laudable empathy and support in solving problems while treating callers with respect can’t happen unless the caller gets through to a counselor at the other end of the phone.
