“I’m suicidal” are sometimes the first words crisis counselor Susan Rush said she hears when she picks up the phone.
But not just any phone. Rush is referring to her phone at PATH’s 988 call center where she’s been working almost a year. She started around the time 988 — the national emergency mental health line — was implemented throughout the country in July 2022.
From 9 a.m. to 5 p.m. five days throughout the week, she and around 75 other crisis counselors help people in crisis.
“I just look around and just think, ‘How awesome is it to be surrounded by all of these people that are here that are just working to change the lives of other people?’” Rush said about working in the call center. “And it makes me feel very grateful.”
988 services are available via phone call, text, or chat for people who are having some type of mental health need all over the state. This includes a parent or a loved one of someone with a mental health concern, or someone who is having a crisis themselves.
PATH’s Assistant Director of Call Center Operations Adam Carter said it's the largest of six total 988 call centers in Illinois. On average, they get about 9,000 calls per month, and about 500 chat messages and texts.
The average speed at which PATH answers a call is 20-25 seconds, Carter said.
Statewide, the average speed of answer has been between 24 and 33 seconds since 988 went national last July, according todata from 988.
Carter said it’s not uncommon for people who call to be in the process of dying by suicide. In a case like this, he said the crisis counselor can reach out to an emergency response team to take further action.
Mostly, 988 crisis counselors do listen.
“Not everyone needs mobile crisis, not everyone needs emergency medical services,” Carter said. “Our goal is to handle about 80% of our calls, without connecting them with an emergency crisis team.”
Rush said only in very rare instances has she had to do this.
“If you are at a level where you need an ambulance — I don't want to discount the fact that there are times that that does happen — but I have been there over a year or almost a year … as far as times that I have actually reached out and contacted emergency personnel, I can probably count them on one hand,” Rush said.
The goal of any 988 crisis counselor is to “triage,” Rush said. She will assess a caller’s mental state and try to avoid placing people in the hospital who might not really need to be there.
“Are you having suicidal thoughts today? Or have you in the past few days?... Have you done anything to harm yourself today? Have you ever attempted to kill yourself? And are you a veteran?” These are all standard questions Rush said she asks people who call to help assess what any given person might need.
While a crisis counselor’s ability to jump into action may be limited, Rush and Carter said people at PATH have a wealth of resources they can provide.
Unlike emergency first responders, he said PATH counselors can stay on the phone for an hour or longer. They can also call people back to check-in. Whether someone wants a call back in a few days or 15 minutes, he said, PATH is happy to follow up.
“It is not bothersome, it is not something that we begrudge,” he said. “We just want to make sure folks have access to those services.”
Call routing challenges
A complication in the national 988 system is call routing, which can often hinder immediate access to the most relevant services for the individual in crisis. Currently, 988 routes calls based on the area code of the phone number the person is using to make the call.
With this setup, a person calling with a Bloomington phone number living in New York City would likely be connected to PATH. This is a known flaw in the system, though, and Rush said there are ways to work around this.
At PATH, the crisis counselors can look up resources by zip code, so if a caller in New York is talking to Rush in Bloomington, she can still tell them where they can go for help. She can also try to transfer the person to a call center near them.
Another handy feature, Rush said, is the ability to text someone about nearby resources. However, this is a feature special to 988 centers that have text capabilities, like PATH.
Carter said “our goal is to get it as close to where you are. But if not available, we're going to have someone there who can listen and can help support you through the process.”
Rush said she can tell when someone who calls is not doing well by their tone because they are crying. But at the end of the call, sometimes they smile.
A person who calls might not be able to see themselves through Rush’s eyes, which she said can be the hardest part of the job.
“Just in the glimpse that I talked to somebody, I see the good, and I wish that there was a way that people could see that,” she said. “It's just painful to see that somebody is struggling to see their strengths.”
Carter said being a crisis counselor is not easy. There can be high turnover in the position. He said doing the work is a “very unique skill … that can potentially take a toll on folks.”
Despite this, he said the first year of 988 has been successful for PATH, and he’s expecting “exponential growth” in the future. He could not say whether plans included new hires, as call volume informs staff sizing, but he said he hopes there will be an opportunity to bring more people in.
For now, they both said they hope people know or learn that 988 is an option.
“We want them to know that we can help them through these things,” she said. “They can be open and honest with us, and we're going to do our best to make sure that we get them in a better place.”
