OSAGE COUNTY  —  988. Remember that number because it could be the difference between life and death, especially during Suicide Prevention Awareness Month in September.

Compass 988’s Suicide and Crisis Lifeline is a nationwide network with trained crisis professionals available to provide support via call, text, or chat. Missouri also has a Deaf Lead for those communicating using ASL.

Locally, the Osage County Anti-Drug Community Action Team (OC-ADCAT) is promoting 988 as a preventive measure.

“I think when we first started, it was more that mental health wasn’t really into prevention as much,” said OC-ADCAT Executive Director Lorie Winslow. “Now, we’ve realized that our mental health is a big part of what we do in prevention. If we don’t have positive mental health, a positive attitude about ourselves, and good self-confidence, we’re going to struggle, and one of those things that we look to is substances, and misuse is a huge part of that. Most of the work we do is mental health and trying to help kids in our ‘Too Good for Drugs’ program. Goals and decision-making are the first two lessons, and that’s a big part of your mental health. If you can set your goals and have something you look forward to, it’s going to help everyone’s mental health.”

OC-ADCAT is partnering with Compass Health to provide support and information to students at all three public schools and State Tech.

“I’m amazed at how many times we are in a classroom or a room with others that people still don’t know about 988, so I want just to keep spreading that awareness,” said OC-ADCAT Education/Project Coordinator Jill Schaefer, who provided State Tech students with a “Lunch and Learn” presentation on Sept. 8 (9/8) to begin the awareness campaign in earnest.

After a slide show and details about 988, Schaefer placed a live call to the hotline to demonstrate its ease of use.

“I practiced that morning before I even started speaking,” said Schaefer, adding that call center managers welcome test calls, particularly in a demonstration. “I told them I would be in front of a room full of students, and I just wanted to try it out. I tried out the 988 chat and saved it. I also made a live call in front of the students and faculty in attendance. And so I just held the phone there, and they’re so helpful. They just went through the thing, this is what it might sound like. And they said, we’ll ask you these questions, and then we’ll go with these questions, depending on what you say.”

It’s a small world. Schaefer told of a positive outcome following the presentation. She noted that an instructor aware of 988 encountered a student who indicated they had a friend threatening suicide. The instructor realized the student before him had not seen Schaefer’s presentation and relayed the information.

The student left class to help their friend but was told to call 988 on the way to get help.

“You don’t have to be the person struggling,” said Schaefer. “You can be the person trying to support that person, and 988 can help you through those steps as well. A lot of people don’t know how to help someone who is struggling. They’re worried about not knowing the right words to say or even the resources to give him for that. It was an amazing part of the story that he literally just had that talk, and then he was there to support his friend. It really is a small world.”

The Sept. 8 Lunch and Learn was packed, with more than 50 students in attendance.

“We were pleased that so many students came in and heard it that day because Jill did a great job presenting the information, and I think we made a difference for some of them,” said Winslow. “We’d already been on campus on Aug. 12 and did a Mental Health First Aid class for resident assistants and student government. We talked about 988 with them, too, and hopefully, we’ll get to talk to more groups.”

988 is not just for suicidal ideation or people at their breaking point and contemplating an end to it all. Schaefer and Winslow want everyone to understand this service is for mental health, suicide, or substance use crises, 24/7.

In 2020, Congress designated the new 988 dialing code to be operated through the existing National Suicide Prevention Lifeline.

The Substance Abuse and Mental Health Services Administration (SAMHSA) sees 988 as a first step toward transforming the crisis care system in America. It went live in July 2022, and Missouri’s 988 Task Force continues to develop plans for 988 and the Missouri Crisis Care Continuum. The Show-Me State has seven providers for 988, with six answering calls and one interacting via texts and chats.

Sadly, an individual dies by suicide every 11 minutes in the USA. In 2022, over 950,000 youth (12-17) and 1.6 million adults attempted suicide.

Suicide rates increased from 2021 to 2022 for nearly all populations, including frightful numbers among children, with 15.2% of multiracial, 12.6% of Latino, 12.2% of black, and 2.3% of Asian youth attempting it.

Since launching in 2022, 988 has received over 9.5 million contacts (calls, texts, and chats), and the national answer rates have increased. People get support from a counselor far faster than before, in part due to enhanced state-level coordination of local 988 centers.

According to data from Vibrant, from July 2022 to June 2023, 988 interacted with 76,817 contacts, including 64,791 calls, 4,953 texts, and 7,073 chats, with an average call answer rate of 91%.

Compare that to one year later, when from July 2023 to June 2024, 988 interacted with 116,299 contacts, including 95,050 calls, 15,367 texts, and 5,882 chats, with an average call answer rate of 94%.

States, territories, and Tribal nations are discussing the steps they are taking to enhance their local crisis care continuum. To date, about 50% of states have passed appropriations to fund 988 related services.

Enhanced technology across the 988 Lifeline system, bolstered cybersecurity, and a new learning management system for crisis counselors highlight improvements.

Winslow and Schaefer agree that people are reaching out to peers and friends to say they’re upset about something or even struggling with decisions. “They might downplay it a little bit, but if our friends or peers can start recognizing signs, that’s a positive,” said Winslow. “That’s why we’re so passionate about teaching Mental Health First Aid, then we know how to help someone.”

As noted previously, 988 welcomes calls from peers or friends and provides talking points. There is also a third-party contact option for high-risk individuals.

Ideally, the friend would hand the phone to the person in crisis because warm hand-offs are more productive. However, whether that occurs or not, 988 will contact the individual needing help. “They don’t have to stay on the phone,” Schaefer said. “They can hang up if they don’t want to talk to someone at 988, but hopefully, they will listen and get the help they need.”

Winslow and Schaefer plan to visit students at the high schools. “We want to go to their lunch period, pass out 988 materials, let them win prizes, and maybe ask them some trivia questions and stuff,” she said.

Schaefer, who teaches Too Good for Drugs at St. George in Linn, said she mentioned 988 to students there. “Our middle-schoolers need to know it, too,” she said. “They all have cell phones, so they can text or call.”

Helping middle schoolers deal with stress is a big part of the training. “If they know how to deal with their stress as a middle school student, it might not manifest itself so much when they’re in high school,” said Winslow.

When students graduate from high school and leave for college, Winslow said challenges can be overwhelming. “They don’t have the tools sometimes to know what to do without a support system,” she explained. “That scares me as a mom with two kids in college right now, knowing they’re alone a lot, and they’ve never been alone like that, or they’re in a dorm full of kids. Hopefully, getting that word out to them will help some of our kids because we have had some suicide deaths in Osage County of 20-year-olds in the last couple of years. Maybe we can prevent those because I think after they go off to college, or they’re living on their own, they don’t know how to handle things so well. They’re still just kids dealing with adult problems, even at 18. No one is providing them meals every day at school, and there’s a lot of stress between being away from family and trying to maintain good grades.”

OC-ADCAT will present the documentary movie “Suicide: The Ripple Effect” on Oct. 26 at 4:30 p.m. at the State Tech Welcome Center for tech students. The film features Kevin Hines, who, at age 19, attempted to take his life by jumping from the Golden Gate Bridge. The movie chronicles the impact of his suicide attempt on others and his work as a mental health advocate since that time.

“If it goes well, we might try to do it again for the community because that movie is still relevant, and he’s coming out with another movie about changes that have happened at the Golden Gate Bridge since that movie came out,” said Winslow.

Schaefer said the most important aspects of suicide prevention are breaking the stigma and providing hope for people who are struggling. “I think we have to really talk about mental health and talk about when people are struggling, or how to support people when they’re struggling, so that we can break that stigma and that we can have no more deaths by suicide,” she noted.

Winslow added that the best part about 988 is that it’s accessible to everyone regardless of location. “It’s on our phone,” she said. It’s everywhere you are, no matter what time because they can connect you with resources.”

State Tech students have access to free counseling on campus to talk about various stressors.

Additionally, Compass Health has an office in Linn, right next to Thriftway, where anyone can visit counselors five days a week. Telehealth is another good option.

“The good thing about that is they accept insurance, or they’re on a sliding scale, so if you don’t have insurance, that’s a good resource,” said Winslow, suggesting people check with their workplaces, especially bigger companies. “Some employers offer free services on your health plan, so I recommend everyone look into it and see what your options are through your healthcare provider.”

Schaefer noted that according to the Missouri Office of Administration, state employees are entitled to seven free visits after each incident. “That was really powerful because a lot of people don’t know that,” Schaefer said

Anyone thinking about suicide, experiencing a mental health or substance-use crisis, in emotional distress, worried about a friend or loved one, dealing with trauma, having trouble thinking clearly, experiencing general anxiety or depression, feeling lonely or hopeless, having relationship or family problems, suffering distress about sexual orientation, or suffering financial or job stress is encouraged to contact 988 for help.

When you call 988, you will hear an automated greeting message that will prompt you to make a selection. You can either stay on the line for a crisis specialist, press one for the Veterans’ Crisis Line, press two for the Spanish network, or press three to speak with a gender-affirming crisis specialist.

988 offers crisis support in English and Spanish, as well as translation services in over 250 languages.

After you’ve made your selection, you will hear music while being quickly routed to a trained crisis specialist in Missouri. The crisis specialist will answer the phone, introduce themselves, and listen to understand what you are experiencing and how it’s affecting you. They will work with you to address your immediate needs, offer support, and connect you to local resources.

A similar process occurs when you text 988. When you send a text to 988, you will be asked to complete a short survey to share what you are experiencing. Texting 988 will start a real-time conversation with a local crisis specialist ready to assist you.

Once you are connected, the crisis specialist will work with you to understand what you are going through and how it’s affecting you. They will then work with you to address your immediate needs, offer support, and share helpful resources.

Texting is available in English and Spanish.

Chat is available in English and Spanish through the 988 Suicide & Crisis Lifeline’s website at 988lifeline.org/chat.

When using chat 988, you will be prompted to complete a short survey to share what you are experiencing. You will then be connected to a crisis specialist who will work with you to understand what is affecting you, offer support, and share local resources.

Available 24/7, the 988 videophone allows individuals who identify as deaf, deaf/blind, deaf/disabled, hard of hearing, late-deafened, or any American Sign Language (ASL) user to connect directly to ASL-fluent 988 crisis specialists. You can dial 988 on your videophone.

Once connected, follow the prompts. You will be asked to answer some questions regarding your situation and what you are experiencing. Crisis specialists will work with you to understand what is affecting you, offer support, and share local resources.

The Compass 988 call center will dispatch Mobile Crisis Response when the caller or someone worried about the person requests the unit, the person in crisis requires additional support, and a phone call alone is not enough.

Compass’ Mobile Crisis Response Central Team consists of trained clinicians and covers Osage, Cole, Miller, Camden, and Laclede counties. When activated, a clinician responds and connects with the individual in need of additional support.

Compass 988 helps with medical compliance.

When the Mobile Crisis Response Clinician arrives, they will assess the safety risk for the individual and others and whether the person can stay safe with the support of others.

The MCR clinician also helps the individual in crisis create a plan for safety for now and set up follow-up services to address the issues behind the crisis and more permanent services. The clinician will call for co-response in times of emergency.

It’s important to note that 988 is confidential, with no personal information maintained unless the caller signs up for a follow-up visit. Calls are currently routed via area code, but geo-routing will soon send the call to the tower nearest the caller to determine their exact location.

Additional improvements in FY 2024-25 include better operational response, standardization of contact documentation and reporting, continued expansion of local chat and text, improved transparency of 988 outcomes (including quality of service and suicide behaviors), and raising awareness and building trust in 988.

Winslow noted that drug abuse has also been a focal point, with about 107,000 people dying in the U.S. from drug overdose in 2023, according to SAMSHA. That’s down from approximately 110,000 overdose deaths in 2022.

“Our primary objective at OC-ADCAT is drug prevention and training, but it often goes hand-in-hand with suicidal thoughts and mental health issues,” said Winslow. “We are committed to raising awareness and providing resources to help people.”

For more information, visit https://missouri988.org or call 988 if you need immediate help. Additional resources are available at https://www.ocadcat.org.