Spike in Suicide Calls Challenges Hotlines

Sept. 17, 2009— -- A groundbreaking new government study reveals more than eight million American adults seriously considered suicide in 2008 – a number much larger than the roughly 33,000 Americans who die by their own hand every year.

The report – the first of its size and scope – sheds light on what government officials call a serious, growing public health crisis.

"This study offers a far greater understanding of just how pervasive the risk of suicide is in our nation," said Eric Broderick, the acting Substance Abuse and Mental Health Services Administration administrator.

Among the findings: 2.3 million adults made a suicide plan and 1.1 million adults actually attempted suicide last year.

Young adults 18 to 25, long known to be the most likely to consider suicide, were three times more likely than those age 50 or older to be suicidal.

While the study did not report on why so many Americans consider suicide, mental health experts say the emotional impact of the recession is very likely a factor.

Last month, the Department of Health and Human Services provided a cash infusion to dozens of crisis call centers that operate as part of the National Suicide Prevention Lifeline.

The centers have been inundated with distress calls since the recession began.

The National Suicide Prevention Lifeline can be reached at 1-800-273-TALK.

In July alone, the nationwide Lifeline network of 140 local call centers answered 57,000 calls -- more than it's ever received in one single month. Roughly a quarter of those calls were directly related to economic distress, including unemployment, home foreclosure and personal debt, according to Lifeline spokeswoman Lidia Bernik.

"If these economic trends continue, call volume will continue to increase," she said. "The economic crisis is a problem for a lot of American crisis centers, and we simply need more funding."

The influx of calls has left many centers short-staffed and unable to handle the increased workload.

"It's been a struggle for us to recruit and train additional staff, pay the additional overnight crisis workers," said Marshall Ellis, director of development for Virginia-based CrisisLink, one of the centers participating in the Lifeline.

Ellis says the number of calls at his center spiked 140 percent in October 2008, just as the economic and home foreclosure tidal wave was sweeping the country.

"It's been a constant year-over-year increase every month since the start of the recession," he said.

Inside Look at Crisis Center Under Pressure

Inside Crisis Link's third floor Arlington, Va., office suite, volunteers -- so-called "listeners" -- sit in cubicles taking notes as distressed callers divulge their woes. The center averages 90 calls per day.

"So you just wanted to escape from everything, and you felt that was the only way to do it?" asks one volunteer of a caller. "And you said you've been drinking a lot of wine today?"

On another line, a volunteer gives a pep talk for persevering in tough times: "So in the past you said you've tried therapy, and what you've realized is that you really need to change your attitude about the situation."

Laura Renenger, a call volunteer at CrisisLink for the past year-and-a-half, says centers like hers provide a valuable social service that's often overlooked because tracking "success rates" can be difficult.

"We always hope that when the call ends they chose to move forward with life rather than not," she said. "But ultimately, we don't always know as listeners. That can be extremely draining on us, not knowing what decision was made after we end the calls."

Crisis Centers Lobby for Funds, Assert Their Value

Mental health experts believe crisis hotlines are an essential part of the nation's health care system.

"The only options to accessing help would be to walk in to the emergency room or pick up the phone," said Dr. Richard McKeon, SAMHSA's lead public health provider on suicide prevention.

McKeon says the hotlines often take pressure off hospital emergency rooms, many of which are already struggling to meet the demand for care. Many of the centers also perform multiple roles, some answering substance abuse, homelessness and child abuse hotlines.

"I'm so glad there's a place where people can go to talk with a sense of safety and anonymity," said Mary Azoy, a licensed therapist and director of CrisisLink crisis response. "It does help to have someone listen -- even if we can't offer them advice, which we don't, or specifically solutions, we can help them brainstorm ways of coping."

But CrisisLink and dozens of other call centers in the National Suicide Prevention Lifeline network say they are under pressure to meet the growing demand while facing the threat posed by shrinking state and local social service budgets.

The Lifeline network saw a 46 percent increase in call volume over January 2008, when the system fielded 39,000 calls, according to McKeon.

"This is a situation we've been monitoring carefully," he said. "Many crisis centers are feeling pressures from state and local cutbacks, and it's important that calls are able to get answered and answered quickly. People who call are at very acute and imminent risk of suicide."

Recession's Impact on Suicide Rate Untold

According to the Centers for Disease Control, suicide is among the top three leading causes of death for Americans ages 10 to 34. It's the second leading cause of death for young adults ages 25 to 34.

The National Center for Health Statistics reports that more than 33,000 people in the United States die by suicide every year.

"Suicide prevention is an urgent public health priority, and [these centers] are a critical part of the national public health safety net," said McKeon.

The federal government had allocated $2.9 million for the Lifeline network for fiscal year 2009 and provided an additional $1 million in August.

McKeon says the money is a "significant increase" and expects it will "help bolster the ability of our existing crisis centers" by allowing them to add phone lines, hire more staff and expand outreach to people at risk for suicide.

"We're not seeing a [suicide] epidemic per se," said Bernik. "But we really have yet to see the full impact of this crisis."

The National Suicide Prevention Lifeline can be reached at 1-800-273-TALK.