Minnesota joined the nation in introducing the phone number 988 as a mental health crisis hotline one year ago, localizing and easing access to the service that was before only reachable at 1-800-273-TALK (8255).

While the longer number still functions, call center operators said state support for raising awareness of the shorter line contributed to an increase in engagement over the past year. According to most recent data from the Minnesota Department of Health, or MDH, the month of May saw a 74 percent increase in calls statewide compared to the year before.

Carolina De Los Rios is senior program officer of mental health and suicide prevention at Greater Twin Cities United Way, which operates the call center that serves fourteen counties around the Twin Cities metro. She said she began to notice call increases in the region after efforts began to promote the shortened hotline.

“The main change with the transition to become a 988 center is there was the visibility and the accessibility,” De Los Rios said. “People will remember this and will pass it along easier than what used to be a 1-800 number.”

According to data from the National Academy of State Health Policy, Minnesota is one of 26 states that have passed legislation preparing funding for implementation of 988. Most in-state calls are now routed to one of four centers operated by different organizations regionally rather than anywhere nationwide.

De Los Rios said keeping calls local means operators are often more equipped to connect callers to nearby mental health resources and personally relate to them on the phone.

“Building that trust or rapport with the callers is crucial,” De Los Rios said. “If you’re from the community and you know the struggles, that translates into better rapport and more ability to de-escalate a crisis.”

But De Los Rios said understanding how call increases impact the state suicide rate is difficult. MDH data is only available up to the end of 2022, showing a steady increase in suicides since 2001. At least 835 people died by suicide in 2022, a 68 percent increase from two decades prior.

She added call centers are working to learn the impacts of using the mental health crisis line on callers’ mental health by asking optional questions about their experience with the service and providing an opportunity for the call centers to follow up with them. But due to the sensitivity of those interactions, asking for caller feedback is not a top priority.

“Some of them don’t want to talk any more about what was going on in that first interaction because they feel that the crisis is over,” De Los Rios said. “They don’t just don’t want to be in that space anymore.”

While 988 was introduced as a hotline in Minnesota last July, text support wasn’t provided by in-state operators until April of this year.

Ashley Ladbury-Hrichena of FirstLink, a call and text center that serves the northwestern corner of the state, said text services act as an alternative communication tool for those who feel less comfortable talking on the phone.

However, she added the text line put more pressure on call centers, which have struggled with hiring enough operators to meet the demand coming out of the COVID-19 pandemic. She said while FirstLink is now above minimum staffing levels, providing text support adds an extra strain on resources.

“They are longer conversations or longer interactions than phone calls. So, you know, if we only have minimum people and we’re taking somebody off for an hour to chat or text, that’s one person that would’ve been taking the remainder of the calls,” Ladbury-Hrichena said.

Still, calling 988 for mental health support remains more popular than texting. According to the MDH, operators respond to about 3,600 calls and 970 texts per month.

Online chat, which is the least commonly used platform, is also available at 988lifeline.org/chat/.

But even when staffing is unstable, no one will be left hanging, Ladbury-Hrichena said. National backup centers are in place to continue supporting anyone who reaches out for help.

De Los Rios added her team hopes to receive additional funding to continue bolstering staff.

The state Legislature signed off on a telecom fee for 988 last session that further draws similarities to 911’s functioning. An extra 25 cents will be tacked on to monthly phone bills to help keep 988 calls in-state. The surcharge for 911 services varies nationwide.

According to De Los Rios, boosting collaboration between 988 and 911 services could create a smoother system for all of Minnesota.

“One of the focuses for all of us here is to be able to get to that level of very uniform approach to emergencies for callers and to collaborate,” De Los Rios said. “We reach out to 911 quite often depending on what the situation is, and the idea is that in the future it could also be the case for 911 to reach out to us if they are able to identify that we will be able to respond to that need in a more appropriate way.”

The 988 line is open to offer mental health crisis support 24 hours a day, seven days a week, year-round. More information is available on the MDH website.