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As Iowa prepares to launch 988, some question if the state is ready

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Petr Macháček
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On July 16, the new 988 service will launch nationwide, but some mental health advocates are concerned Iowa isn't ready.

Starting July 16, Iowans needing help for mental health will have a new number to dial – 988.

The idea is that Iowans will have an easy number to remember when they need immediate mental health support – that will divert them away from law enforcement.

The new number started in 2020, when President Donald Trump signed a bipartisan bill into law that would change the National Suicide Prevention Lifeline’s 10-digit number into a new three-digit number that’s much easier to remember – 988.

The concept is simple. People experiencing a mental health emergency or in need of resources can call this line to get connected to help – whether that’s a trained counselor to talk to or local crisis intervention services.

The launch of 988 is something that’s been celebrated as a long-term need by mental health advocates and law enforcement agents.

"It helps divert a significant portion of the people that otherwise might end up in the criminal justice system for no other reason than the fact that they are mentally ill," said Tony Thompson, the Black Hawk County sheriff.

But rolling out the service is proving to be complicated.

'We're building a massive infrastructure'

The federal legislation left 988 up to states to implement with a hard start date of July 16.

The mandated service comes with federal funding, but it also allows states to impose a new tax on phone lines to fund call centers and even crisis services. Many states, including Iowa, use this kind of tax to help fund 911 services.

Iowa is one of many states that has not introduced any legislation to fund 988.

The state is relying on federal funding to see what real-time demand for it will look like after it launches, said Marissa Eyanson, the division administrator of mental health and disability services at the Iowa Department of Human Services.

"We're accounting for what we know today to be additional funding available from the federal level," she said. "But we're also looking to detect what that means going forward because there's ongoing conversation at the federal level for how the effort will be supported. It is a nationwide effort, and it's important."

Eyanson said it’s unlikely that DHS will have enough data available to review in time to come up with a legislative plan by the next session.

But the two organizations contracted by the state to set up the statewide 988 call centers have concerns about this.

"We're building a massive infrastructure to do this and without knowing if there's sustainable funding moving forward," said Sarah Nelson, the CEO of CommUnity in Iowa City.

Emily Blomme, the CEO of Foundation 2 Crisis Services in Cedar Rapids, said it’s been challenging to recruit the extra crisis counselors they need with the funding she has.

"It's really hard to say, ‘Hi, you need to have a bachelor's degree and two years of experience, and I'm going to pay you $17 an hour,'" she said.

Both organizations currently run call centers for the National Suicide Prevention Lifeline.

Blomme said estimates provided by Vibrant, which runs the National Suicide Prevention Lifeline, projects calls to jump significantly under 988.

According to the estimate, Iowa is expected to have 71,800 "contacts" for 988 services the first year. Contacts refer to calls along with texts and online chats, which are new services that will be offered at a local level.

National Suicide Prevention Lifeline data show Iowa had 19,476 calls in 2020.

So far, Blomme said she's hired less than half the additional staff she would like to have in place by the launch date.

"I can tell you what keeps me up at night. The idea that someone's going to call, and no one's going to answer, and it's going to bounce around until it lands somewhere where someone in another state tries to provide quality services," she said.

Blomme said the goal is for Iowa 988 centers to answer 90 percent of calls by 988's second year.

Recent data from the National Suicide Lifeline suggests that could be a challenging goal.

For the first three months of this year, National Suicide Lifeline call centers in Iowa answered 69 percent of calls. Calls that are not answered in Iowa are redirected to call centers in other states or to a national back-up center.

'We're sufficiently funded to start'

An estimate by Vibrant, which runs the national lifeline, projected 988 in Iowa would cost $4.4 million its first year.

But the state allocated just under $3 million to CommUnity and Foundation 2 for 988’s first year.

DHS has worked with Vibrant to review that estimate and provide its contractors with enough funding for the first two years, Eyanson said.

"What we've told them is that we think we're sufficiently funded to start," she said. "But if their experience tells us otherwise, we will shift. And that's a promise that we'll make real."

This uncertainty has made mental health advocates like Peggy Huppert, the executive director of NAMI Iowa, nervous.

"The advocate in me wants to [say] we need to have billboards. We need to have this everywhere that people can call 988," she said. "But I also understand the sense of caution, you know, that maybe we don't want to blast it all out because we want to make sure that we can handle what comes in."

However, Huppert, like other advocates, says despite her reservations, Iowans who need help should not hesitate to call 988 starting July 16.

If you are in need of help, you can contact the Iowa Warm line at 1-844-775-9276, the Iowa Concern hotline at 800-447-1985, or Your Life Iowa at (855) 581-8111 (call) or (855) 895-8398 (text).

Para obtener ayuda en español, llame al 531-800-3687.

Starting July 16, Iowans can call 988.

Natalie Krebs is IPR's Health Reporter