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The national 988 hotline is up and running but local centers need workers, funding

RACHEL MARTIN, HOST:

For people in crisis, calling 988 can be a lifesaving decision. As of this summer, the new three-digit suicide and crisis lifeline offers a single gateway to hundreds of call centers around the U.S. Brett Sholtis at member station WITF visited two call centers in Pennsylvania and brings us this story.

BRETT SHOLTIS, BYLINE: It's Friday evening, and this suburban office outside Philadelphia is still open. Unused headsets are scattered among empty cubicles. But Michael Colluccio is working tonight. He turns on his computer, puts on his own headset, stirs his hot tea one more time, and his screen shows incoming 988 calls from all around Pennsylvania.

MICHAEL COLLUCCIO: So I had a suicide attempt when I was about 10, 11 years old. And we do get callers who are about that age or quite young, and they're going through similar stressors.

SHOLTIS: Pluto goes by Tom when answering the phone. A lot of call center workers use pseudonyms like this - keeps work life separate from private life.

COLLUCCIO: Suicide Prevention Lifeline. This is Tom speaking.

SHOLTIS: It's a woman. She starts off kind of panicked. And she's not calling about herself. Her partner is using drugs and has started making violent threats.

COLLUCCIO: Do you know if there's been a change that precipitated the threats and the change of behavior? It sounds like there's been a health care change.

SHOLTIS: Colluccio doesn't really commiserate with her as much as you might think. He says listening is the work. For the caller, it offers relief, validation, human connection. He also asks questions, gently searching for specific ways to help.

COLLUCCIO: Would you want a number for a local domestic abuse prevention service?

SHOLTIS: One number he rarely calls is 911. The idea behind 988 is that it's an alternative to involving police or an ambulance for a mental health crisis. At the end of every call, Colluccio asks a few key questions to determine whether the person feels suicidal.

COLLUCCIO: Upon calling here, were you thinking about ending your life, considering suicide at all?

SHOLTIS: What happens next is surprisingly common. At the start of this call, it seemed like the woman wanted help for her partner, but when he asks her directly, on a scale of 1 to 5, how suicidal she is, she says she's a two or maybe a three, and she's attempted suicide before.

COLLUCCIO: You don't have to discuss the past attempts in detail if you prefer not to. Do you mind if I ask when the last attempt was and how?

SHOLTIS: Before they end the call, Colluccio asks her if she would like a call back tomorrow. She says yes, so he schedules one. And he has just about enough time for a sip of tea when another call comes in. It's a young man in college. He's overwhelmed by stress, unable to eat, says he feels like a failure.

COLLUCCIO: I don't consider you a failure. You seem to be working hard. You seem to have lofty goals.

SHOLTIS: Colluccio spends over an hour with the young man - again, mostly just letting him talk. Afterwards, he says this is a pretty typical evening.

COLLUCCIO: Sometimes it's more of an immediate intervention because sometimes people call with pills in hand and are actively considering ending their lives. There are people who have called and said, if you did not pick up, I'd have killed myself.

SHOLTIS: He says that's why having a national network of call centers works so well. There are more than 200 places like this one across the country. Calls are tied to area codes, so if nobody picks up locally, the call gets kicked to somewhere else. The promise is to always have someone pick up the phone. And Colluccio has options. He can even dispatch a mobile crew of mental health workers to go to someone's house. But it's not that way everywhere. In Hanover, a small town a few hours west, the 988 call center doesn't have that option. Here, call center workers sometimes have to put down their headsets and go meet with people themselves.

JAYNE WILDASIN: So right now, you know, if there's a crisis at somebody's house, we could potentially go there.

SHOLTIS: Jayne Wildasin runs the center and has been trying to ramp up hiring to deal with more 988 calls.

WILDASIN: We have seven full-time staff instead of 14, and we're still maintaining 24/7 coverage.

SHOLTIS: For decades, call centers had to scrape together funding from local, state and federal resources. Now with the big switch to 988 these centers have to take on more responsibility while funding remains uneven and unpredictable. There are some federal grants, but the expectation is that states will come up with the main funding streams, and like many other states, Pennsylvania hasn't done that yet. This concerns Kevin Boozel, who represents county commissioners across the state.

KEVIN BOOZEL: This is life or death, and you can't halfway do it.

SHOLTIS: Pennsylvania has actually decided to hold back on publicizing the new 988 number until next year. The fear is that too many calls could flood the system, and counties need more time to set up funding, hire workers and build capacity for things like those mobile crisis teams. Those challenges aside, Wildasin says the hotline works. In most cases, just talking with someone is enough to defuse a crisis.

WILDASIN: I can't tell you how many times I have, you know, sat with somebody and said, are you thinking about suicide? And they're like, whew, I'm so glad you asked because nobody has asked me that.

SHOLTIS: She emphasizes that anyone can call 988. It's anonymous, safe, free, and someone will be there ready to listen.

For NPR News, I'm Brett Sholtis in Bucks County, Pa.

(SOUNDBITE OF BRUNO PERNADAS' "WALTZ")

MARTIN: This story comes from NPR's partnership with WITF and Kaiser Health News. If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline.

(SOUNDBITE OF BRUNO PERNADAS' "WALTZ") Transcript provided by NPR, Copyright NPR.

Brett Sholtis