Voices For Suicide Prevention
Voices For Suicide Prevention
988 Suicide & Crisis Lifeline: Saving Lives One Call at a Time
The lifesaving work happening behind the scenes at Ohio's 988 Suicide and Crisis Lifeline is both humbling and extraordinary. With over 592,000 contacts in just three years—approximately 700-800 daily—the service has become a critical resource for Ohioans experiencing mental health crises.
What makes this number even more remarkable is the human connection happening with each call. As 988 specialist Pru Hudson shares, "Somebody's having their worst day ever so what could be more important than being able to hold space with them?" This philosophy drives the dedicated professionals who answer these calls within an average of just 23 seconds—significantly faster than the national average of 34 seconds.
The podcast reveals the deeply personal motivations behind those who staff the crisis line. Doug Jackson, who administers the 988 system, found his way to this work after hiking the entire Appalachian Trail, an experience that gave him "a different life perspective."
Hudson, with decades of experience in social work, describes the profound impact of simply being present for someone in crisis: "The loudest message you can send to another person is I'm here, I'm waiting, whatever your crisis is, we're in this together."
Perhaps most powerful is the understanding that 988 serves as a judgment-free space where callers define what constitutes a crisis for them. No identification is required, no time limits imposed. The vision for 988's future includes expanding awareness beyond the current 36-50% of Ohioans who know about the service and developing additional resources like mobile crisis units to create a comprehensive mental health emergency response system. The ultimate goal? As Jackson puts it, ensuring that "mental health resources would be on an equal level of physical health needs."
Whether you're personally struggling or concerned about someone else, 988 is waiting to help and so is the entire team at OSPF.
Welcome to our September episode of Voices for Suicide Prevention, and here at OSPF there is an especially special month September is National Suicide Prevention Month, and in just a second we'll introduce you to two people who are helping save lives. Hello everyone, I'm Stephanie Bucher.
Speaker 2:And I'm Scott Light. As we like to say, our podcast is real talk, real honest, real life. So, Stephanie, as you said, our guests today, they're lifesavers pure and simple. So let's introduce you to them. Prue Hudson has worked in social work and healthcare going back to the late 80s and not aging you, Prue, but again, you are an expert. She is a 988 specialist today with NetCare Services. Doug Jackson is the 988 system administrator. He's worked a long time as well in healthcare, including his stint as state superintendent of the Department of Developmental Disabilities. Welcome to you both. Thank you. It's great to be here with you, the state, Doug, let's start off with you. The state just put out stats on the three-year record of our 988 suicide and crisis lifeline. Going to start with a pretty dramatic number here. Over three years we're going to get really specific out of the gate 592,294 contacts. Can you help us kind of understand the volume of that number and what that encompasses?
Speaker 3:Yeah, you have to let that number really sink in when you're talking about hundreds of thousands of contacts. If you were to divide that out into a daily average right now we're seeing about 700 to 800 contacts a day by Ohioans to 988 through either calls, chats or texts. So that is that many people who are experiencing some sort of crisis in their life, and we let the help seeker define what that crisis is. If it's a crisis to them, it is a crisis to us. So there are all types of life situations that 988 is responding to, but the sheer number of people in crisis is reflected by that overall number that you just reported.
Speaker 1:It's a big number and, as you say, when we're looking at that here in Ohio, how do we compare with other Midwestern states or other states across the country?
Speaker 3:Yeah, so there has been some reporting that shows that regionally, within all of the states, that there's some states that are higher than other states. You have to look at the variables of that. Ohio has really embraced 988, and we've tried to make people aware that it exists and that's not just through Ohio Department of Mental Health and Addiction Services, that's stakeholders across the state, it's mental health professionals, it's the public saying that we realize that there is a mental health crisis in America, in Ohio, and so 988 as a resource is important for people to know that it exists.
Speaker 2:There's another national number out there and, pru, why don't you jump in on this one, if you would, out of the gate? The average speed to answer calls is 34 seconds, however is 34 seconds. However, ohio's average is 23.
Speaker 4:Can you both talk about how seconds in a crisis absolutely matter? Yes, I think our goal at 988 is to answer on the first or second ring. We're waiting for the call, we're waiting to hold space, so the last thing we want to begin the conversation with is a long pause, while the person seeking help has been waiting or feels like they're in a queue or there's been a lot of rings, so we try and jump on it first or second ring.
Speaker 3:Yeah, I like that. Prue went to rings because as a caller that's what we experience is how many rings does it take for somebody to pick up? And what we see in a call is, for every ring that happens, the person's despair grows. So we know in Ohio that having the fastest speed to answer is a very important metric for us to follow. We certainly want to be as fast as possible, but not just for the sake of holding a record, but because somebody on the other end of the line their despair could be growing with the next ring. So, as Prue pointed out, when you look at it by rings, the average seconds that we have to answer right now is about three rings, three telephone rings. A ring takes about six seconds between rings. So we've actually kind of timed this out how many rings does it take, not just how many seconds, and that's what it equals for us.
Speaker 1:We have a lot more numbers that we'll get to here in a little bit, but I'd kind of like to spend a little bit more time on your respective backgrounds. Prue, you've dedicated your career to social work and access to care, going back those decades we won't say how many again what propelled you to major in psychology and then you went on to get your master's in health care and counseling?
Speaker 4:It was a fit, I think anybody who has a leaning towards helping others or reaching out to others. I had some great internships and different from the judicial system to different from the judicial system, to substance abuse, different opportunities. Starting out, it was a fit and I just seemed to go towards crisis and there wasn't a lot of time spent on what was a crisis. It was truly as it is today. Whatever you define that you need help with.
Speaker 1:And why did you want to become a 988 specialist? What did that mean for you? To go from that career that you had into to what you're doing currently?
Speaker 4:The big conversations. There's nothing more important than being available to somebody. The loudest message you can send, I think, to another person is I'm here, I'm waiting, whatever your crisis is, we're in this together. So I think it's the most valuable thing I can reach out and provide for somebody. Is that voice, is that space on the other side of the phone?
Speaker 2:Let me follow up with that, with kind of a a way back machine kind of question. If you go back to thinking about breaking stigmas, stereotypes around mental health, what was it like in the? I can remember, by the way, I can remember what it was like in the eighties and nineties, but I'm not an expert like both of you. Give us a little comparison, walk us through that arc of time a little bit.
Speaker 4:Huge difference. So we didn't talk about, we didn't label those specifically big things in our lives that were difficult. We danced around them either in our family or in company or in school. And lo and behold, when you just talked to the elephant in the room as crisis workers, you found you're already halfway into hearing the client like just putting the label out there, and it was immediate feedback, a little bit of relief right away. So you just started I think that's how we understood being very honest and open and dealing with exactly what we needed to deal with to get them through this.
Speaker 3:Well, I think that releasing the stigma is a big part of it, but it really is at a personal level, because when people are asked how are you doing, the common response is still I'm doing, okay, I'm doing fine. And it really takes that space as Prue said, the intentional space to say how are you really doing, To go a little bit deeper, because even when somebody contacts 988, the first words out of their mouth probably aren't the biggest challenge that they're faced with. There's probably a lot more behind it. So as we work with 988 in training, we often get asked the question well, what training do you provide to a 988 specialist? It's hard to train in some of the soft skills that really make a 988 specialist the best that they can be, and those soft skills are listening and being empathetic. Those are really the top two skills. Of course, having all the knowledge of crisis and the response to it those are all very, very important, but the best skill is listening and having empathy.
Speaker 1:So, doug your resume combining the business side of healthcare and nonprofit management, your under degree work and then an MBA. You worked at the local board level, then at the State Department of Development, developmental disabilities and now 988. Was that what you had had been planning all along, or how has your career path been taking you?
Speaker 3:Yeah, no, there were absolutely no plans for that. Long story short, I, after graduating high school, hiked the Appalachian Trail. Oh, wow, and the whole thing eight months hiking 2,200 miles. But what that gave was a different life perspective, and so when I came back from the Appalachian Trail, I still had no clue what I wanted to do for a career. How do you mesh those two worlds together? And it was actually my dad that said get a business degree. You can apply at any place. God has opened the door since then, and I've continued to walk through the doors of social services and really helping staff like crew have the resources that they need to do the job Well.
Speaker 2:I want to follow up. I'm going to go off script here just a little bit. But we have to ask more about that eight months. But but also we now clinically know that when people are out in green space or blue space around, water brings a heart rate down, brings blood pressure down, it helps people to just slow down. That was physically and mentally challenging, but did you find being out again in that green space rewarding, I guess, mentally Absolutely.
Speaker 3:Yeah, it gives you a perspective on life that you can truly slow down and take in what is around you, especially in the natural environment, and so I'm a big proponent of encouraging others to do the same thing. Whether it's a 988 specialist encouraging somebody in crisis to get outside, have some activity, absorb some sunshine, get some fresh air, those things do matter in mental health.
Speaker 4:Somebody asked me once how could you do this for so many years? And I have horses at home. The minute I put my foot in the stirrup and I'm on that big animal, I don't know what I do for living or what day it is, and my family will always tell you she's on barn time, it's just getting out, it's getting synchronistic with another being without your voice for me, and all that's done outside. So I have to say kudos, because that Appalachian Trail is after. I've done a lot of marathons Again, looking for that answer out there for my next step, or what can I give here? So I think there's a huge amount of good that comes for every soul to get outside.
Speaker 2:They also say horses are very intuitive to a human's mental state.
Speaker 4:Yeah, the no words just touch and letting them trust you. I volunteer at a couple agencies around town and I take one of my horses and it's that trust. It's being outdoors, it's lowering all your breath, work, getting down into your belly and letting the animal feel it. It's just awesome.
Speaker 1:So Prue. We want to delve a little bit more into your moments of your professional career. What are some of the things that really stand out for you in your time with social work and that kind of thing for highlighting the need for care, elevated care for Ohioans? What are some of those key moments for you?
Speaker 4:Being an advocate for somebody who comes into your environment, either somebody that comes on the phone that's seeking help, or I worked in the medical situation. They came in to the trauma bay and I need to find out who's important to them, what's important to them, and I have moments before they're going to go to surgery or be intubated. So having those big conversations, making them as poignant and specific as possible, and touching I don't do that on the phone, but learning to touch just enough to let that person sort of understand that this I got you here, we'll get through this. It's the same on 988. There is no touch, but you can do it with your voice and your breath.
Speaker 2:What are your jobs? Like Doug, day to day, describe your job.
Speaker 3:Yeah, I mean there's an administrative side to a state program and so that's always there as part of what we do. But also you have to be around the work that's happening. 988 centers that are throughout Ohio is really my favorite part of the job because there's never a time when I'm there that I'm not reminded of the importance of the work that's happening. To sit with staff in that moment of taking the next call, to debrief with them afterwards to ask a question like what can I do as a 988 administrator for the state to make your work better, easier, you know, better able to accomplish helping the person on the other end and those are great conversations to have, being willing to be vulnerable with them about the limitations that are in any program, but also listening to where there's opportunity to improve it.
Speaker 2:Wow, prue, can you talk about your day?
Speaker 4:I begin taking calls as soon as my shift begins. I am never without backup. I work remotely, but I have a team leader or somebody always available to me, which I find so comforting, and I was one of those people that had all my resources lined up at my desk. I'm going to be at home on my own and truly. It's just holding space for that person. If I need someone, there are team leads available every shift, so I feel like there's always someone with me, but my job is to center on that person, get through this day, have a safety plan and move on to the next call.
Speaker 2:Doug, you've been with 988 from the start. Yes, kind of a two-parter here. Biggest challenges and biggest rewards for you over these last three years.
Speaker 3:I think the biggest challenge. It was probably the most emotional day that I've had as the 988 administrator. I came home from work and our daughter, who was in junior high at the time, had a classmate whose brother took his life by suicide and to ask myself the question did he know that 988 existed and if he did know, would he have used it and how would that have impacted the outcome of that situation? So we're still in the early years of 988. I mean, three years is a long time over. You know over 600,000 contacts now, but the question still exists of does everybody know that it is a resource for them, because we never plan a mental health crisis Like I don't think well, tomorrow I'll probably have a crisis right. Better know what number to contact.
Speaker 3:It happens unexpectedly almost every single time, just like a heart attack would be unexpected in a physical health emergency. So do people know is the biggest challenge that we've really faced so far. Of course, there's the operational side of it too making sure that the resources are in place, that staff are trained, that they have what they need. But you can work through those, probably on a management level of operations. But awareness affects every Ohioan in the state, and so, until we are at 100% awareness, that mission is not accomplished. The most satisfying, though, is truly to be in a 988 center when the call comes in and to hear it go from crisis, the person's darkest day, to seeing a light at the end of the tunnel where they can leave the call, they can hang up, they can end the chat or text knowing that there's hope, and that's the most rewarding side of it.
Speaker 1:I see, prue, your head is bobbing up and down, in agreement with that.
Speaker 4:Yeah, there's just some great moments, the ones where the person that you called, that you were most worried about, maybe you didn't even hear their voice for a few moments on the phone and your heart rate's starting to go up. You get sweaty. What's going on? And you get through that phone call and at the end of it they're thanking you Like. There's so much relief and just so much connection right there in that moment.
Speaker 1:Well, maybe going back to a few more numbers just really quickly here, the average number of 988 contacts per month, about 16,000.
Speaker 3:That's over the three-year average Over three years.
Speaker 1:Okay, yeah.
Speaker 3:And every month since the launch we've continued to increase in the monthly numbers. So our average currently if you're just looking at this calendar year of 2025, is over 20,000 contacts per month.
Speaker 2:Wow, you mentioned the awareness Doug a minute or so ago. How many people are aware of?
Speaker 3:988?. So we've been doing an awareness campaign. That's been part of the work is helping people to understand that it exists. When we started the awareness campaign, we did a pre-awareness campaign survey and it said that about 36% of Ohioans knew that it existed. Of course, that's miserably low. So when I was asked well, what do you want that number to be? Of course the answer is 100 percent, as I said just a few moments ago. But we had to look realistically at what you can accomplish in a specific period of time. So our goal was to get to 50 percent and we are currently doing the post-campaign survey. The initial part of the campaign ended in June of 2025. So we're looking at what we've accomplished and increasing from 36%. But, again, until every Ohioan is aware, we won't reach our goal.
Speaker 1:Looking at some of the specific groups that are reaching out the veteran population, spanish speaking callers that are routed to specialized centers, on average, again over the three years, about 11,000. And when we're looking at these numbers, I mean Doug, what does this mean for you?
Speaker 3:I mean, there are specific populations, as you referenced the veterans and there's resources that we provide through 988 to specific populations. So we try to understand who's contacting 988 and how we can best support them. But we don't always know either, because it's confidential and we don't require people to submit information or tell us information that they don't want to tell us. Veterans are a great example. We have some veterans that contact 988 and they use the press one option that would get them specific veterans crisis line services that are trained specifically in the resources for veterans and to help them as a unique population. But we also have veterans that call 988 and they don't press one intentionally because they don't want veteran specific supports. They just want to be a person that needs to be heard and needs to be helped through a crisis, so they don't want the label of being a veteran at that moment.
Speaker 2:I bet this is a number I'm sure that makes both of you smile. I mean, this is a low number 1.5% the average percentage of calls that are rolled over to a backup center.
Speaker 3:Oh, that's great. Yeah, so a backup center, when we refer to that as a national backup center. So 988 is a federal mandate. Every state in the country has it, every state, territory and tribe. But in Ohio we've prided ourselves in the availability of an Ohio 988 specialist taking that call, chat and because we want a local response to be provided. Uh, if the help seeker needs additional resources, we want the the Ohio nine, eight, eight specialists like Prue to be able to access local services to support that person. So we believe that the best response is by a local response and we've been able to maintain a very high rate of in-state answer. So that's a metric that we follow. We take it very seriously and it's our goal to answer them in the state of Ohio.
Speaker 4:I'm just ecstatic that we're keeping so many within the state because it feels like there's always better service to the person in crisis. If you are in that state and you know those resources like the back of your hand, you can tell them the bus number that they could get in some cases. So that just feels really personal and connected to me. I'm always happy that we can serve our population first. There's out-of-state people, for sure, but much I didn't realize it was that low. We are given information. We know that the numbers you get a feeling but we'll get a broadcast about. Our goal is always 11 seconds or under to get that phone, but we'll get a broadcast about how many might have gone over that and it might have been this reason or we had six simultaneously or whatever. But yeah, I think it's just an intuitive sense that we have that it's busy.
Speaker 1:What motivates you, Prue, to keep doing this, being able to answer those calls, whether it's someone who is in crisis or it's someone who is looking for help for someone that they know who might be in crisis.
Speaker 4:Somebody's having their worst day ever and if they've probably worked through all their family and friends or whatever and nobody comes to mind in their calling, what could be more important than being able to hold space with them, like I get to sit and hold a space with them and say, okay, like, let's breathe together, let's figure this out. There's no judgment, there's no time frame at all. We're just going to suspend here until we get through this together, and I can't think of anything more important to do with my time.
Speaker 2:It's got to make you feel good to hear one of your specialists get emotional and to be that connected to the cause, Doug.
Speaker 3:Yeah, it was bringing tears to my eyes, and that is the joy of the job that you have is interacting with those who are taking the calls. I've never taken a call personally, so to be alongside those that are, that's where I can feel the impact of the work.
Speaker 2:Can we ask one more data question, and this is fairly topical with where we are in the calendar. This is our September episode. Governor signed the state budget into law a couple months ago. Where are we on funding for 988?
Speaker 3:Yeah, that's a great question. You have to ask it because 988 is not free. We have to pay Prue and the others who are taking these contacts. There is an administrative cost to it.
Speaker 3:Governor DeWine has been fantastic in supporting mental health across the board. 988 has been a part of that and his advocacy for that has been very important to the success that Ohio has seen in 988. In the state of Ohio We've continued to operate with funding from the General Revenue Fund GRF we call it and that funding has continued to support the ongoing efforts. Of course, we would love to see a dedicated funding source, something that wasn't subject to change. We know that the General Assembly is looking at what options are available to continue that. Some states have been able to accomplish that. It's a very sensitive topic when you're talking about paying for additional public services. We want to work within the resources that are available to the state to fund programs like this. So it's always a push and pull balance that we find to support the highest priority services in the state of Ohio. But we're happy that 988 has continued to receive funding so that we can do the work that we're doing.
Speaker 1:What else do you need for 988? Obviously more specialists, more advocacy, more education. I mean, what else do we need to continue to make 988 available and a ready service for an Ohioan who might need it?
Speaker 4:I think just to know that, no matter what it is, it's not too small to call. Call, Reach out, Make that call. If it's a friend of yours and you're worried about them, make that call. I want everyone to know that we are the resource for that, no matter how small you think it is, you don't know what it's leading to and hopefully every single one and I feel like they are are answered completely compassionately, nonjudgmentally and welcomed Like. The first thing I say is thank you so much for calling us.
Speaker 3:Yeah, I think having staff that are dedicated to it as Prue has been a great example on today's podcast that staff do this because they have a passion for it. If you don't have a passion for it, you're probably not going to last as a 988 staff person. It If you don't have a passion for it, you're probably not going to last as a 988 staff person, because the space that you do hold for the help seeker is a space where you're taking on a burden yourself. You're taking on their burden because you're listening, you're interacting, you know that somebody else that you're interacting with is feeling that burden. So it is a job that you have to be cut out to do. And, of course, we're always looking for additional staff to join into the call centers throughout the state of Ohio and become a part of that workforce to do that.
Speaker 3:I think the other big piece is not just awareness We've talked a lot about awareness but understanding what to expect if you were to reach out to 988. So awareness is greater than just knowing that it exists, but knowing what to expect so that you're comfortable reaching out and then trusting that. So we look at awareness on three different levels, the highest level being simply that it exists, then what to expect, and then trusting that that resource will be able to accommodate your needs.
Speaker 1:I feel like this is a good opportunity for us to help educate in that way. I mean, if I call or text or I'm chatting, however, I reach 988,. What can I expect?
Speaker 4:You're going to be welcomed warmly, openheartedly, with whatever your concern is, and you talk when you're ready to talk. There is nobody pushing you, just I'm glad you're here. Sometimes this can be really difficult to start this conversation, but I'm here when you're ready to start it. And I think just some people have a think that they have to call for themselves, but they might have overheard one of their school aged children talking to a friend and then it just wears on them. So call us. Call us, we'll have that, talk with you. We'll give you resources, we'll ask you how you feel about it. Like you may be the third person or once removed, but you've got some strong feelings about it. Let's work through them.
Speaker 1:I've heard from people who have used 988 and they say sometimes I just need someone who's not a family member, who won't be judgmental and who I can just talk like straight out, just talk to them and have an honest conversation with them about what I'm going through.
Speaker 4:I think it's invaluable In my mind's eye. We used to call them, when I was growing up, no-see-um conversations, Like we would walk together somewhere but don't look at me, Like when you have to divulge something to a parent or something. It would be like no-see-ums, don't look at me. Right now, I often think it's so great to not have any idea who you're talking to. You don't have to worry about running into me anywhere. It's just you are totally welcome here. What can we do for you?
Speaker 1:Do I have to tell you who I am, where I am, anything about myself?
Speaker 4:No, if you want to talk about yourself, if you want me to use your name, or if you want me to use some other name, I'm here to meet your needs.
Speaker 2:Wow. We ask you to share some of your thoughts about the previous decades and our kind of walk up to present day. Let's end it this way A crystal ball question for both of you when would you like mental health and access to care to be five or 10 years down the road, and how do we get there?
Speaker 3:988 is the entry point to getting help and many, many contacts about 80% of them are resolved just through the interaction, chat, text or a call with a 988 specialist. But we know that people's needs are greater than that. So being able to have additional resources for the needs that require something more than the conversation, so ongoing therapy, ongoing counseling, an immediate response from a mobile crisis unit Ohio is building those services out as we speak and I can see that in five to 10 years from now that would be the norm, the same as calling 911 and expecting police, fire, ambulance to show up within minutes. That in the future, mental health resources would be on an equal level of physical health needs and that those resources would be much more available in communities much more rapidly, so that the crisis can be addressed at the level that it needs to be addressed.
Speaker 4:I also think that there's something I would hope everybody, including those kids on the school bus, would know hey, did you ever call 988? If you're feeling that way, I would hope that it would be accessible and it would continue to have the respect it has for resources and availability. But the other part of it I think too off of what Doug was saying is I'd like them to know it's not like forever. It could be a short-term thing. It could be my conversation with you or another 988 person. Maybe you're going to make two or three calls, maybe you're going to go see a counselor. It's not a forever thing. Like it's.
Speaker 4:Mental health doesn't have to be stuck in your craw the rest of your life. We can do this. Let's all work together and make better resources. But I just want them to know it's not a forever thing. It doesn't. It can be really fixable. It's something you have to attend to, just like your medical, physical health every day, but you can have moments and periods of time and decades where you feel really good, periods of time and decades where you feel really good.
Speaker 1:Prue Hudson and Doug Jackson, thank you so much for joining us today. We really are very honored to have you with us today and having this conversation about 988.
Speaker 3:Thanks to both of you for joining. Well, we appreciate being able to tell the story.
Speaker 4:Yes, thank you for having us.
Speaker 2:And to our listeners. We always appreciate all of you out there as well, because when you're listening to our episodes, when you're talking about them, you break stigmas, you break barriers and you care about mental health and saving lives. This is Voices for Suicide Prevention, brought to you by the Ohio Suicide Prevention Foundation. Thank you.