Pandemic fallout: Idaho health department responds to need for depression, anxiety resources

The oldest caller to the Idaho Suicide Prevention Hotline since it launched in 2012 was 92 years old, while the youngest was just 7 years old. And as the COVID-19 pandemic has gripped the state, Idahoans of all ages have needed more mental health resources to get by. 

During the first three months of 2021, the Crisis Call Center for the hotline received 3,919 calls and 253 texts and chat communications, which is an 18% increase over the first quarter of 2020 — just before the pandemic started to affect Idaho residents. According to the Centers for Disease Control and Prevention, suicide was the eighth leading cause of death for Idahoans in 2020.

“What we have noticed is throughout the pandemic, people have really been calling for the same reasons they reached out before the pandemic,” said Lee Flinn, director of the hotline. “It has felt a little more intense, anecdotally, but at the end of the day we’re all human. We’re all highly likely to experience a crisis at some point during our lives.”

The Idaho Department of Health and Welfare confirmed an increase in people across Idaho seeking mental health care services, either from their own providers or from the agency itself. Ross Edmunds, division administrator for the Department of Health and Welfare’s Division of Behavioral Health, said his division is seeing high rates of anxiety and depression among adolescents and younger children in addition to adults. Edmunds attributes the increase in children’s mental health services to isolation during the pandemic.

“When the pandemic first started sending kids home and doing all that, the request for services went quite down,” Edmunds said. “The need reduced for a while, and then kind of toward late summer last year is when we really started seeing the increased needs into the fall. And then that trendline has kind of continued, we’re seeing it ever-increasing now.”

To handle that increase, Edmunds said the Department of Health and Welfare is using part of $8.5 million that was allocated to Idaho through the CARES Act in 2020 for mental health services. Using those funds, Edmunds said his division is working to hire temporary staff who can help with the increased demand for mental health services.

“One of the compounding factors is we’ve seen a reduction in the mental health workforce across this state, so that’s challenging as well,” Edmunds said. “We’re just hearing from many providers about their inability to fill positions with qualified and trained and licensed staff.”

Health and Welfare is still using the CARES funding but has another $8.5 million in grants for mental health care available from the American Rescue Plan Act passed in March. The agency did not request any of that funding during this legislative session because there is enough from the CARES Act for the moment.

“The one thing we don’t want to do is create a cliff, so we don’t want to temporarily just create all these services without the ability to fund them ongoing, so it’s sort of a timing issue,” Edmunds said.

Preparing for 80% higher call volume will require more staff for hotline

In addition to the staffing needs, Edmunds said the funds will be directed to infrastructure for the 988 hotline, which was created by former President Donald Trump under the National Suicide Hotline Designation Act of 2020. The number will be a universal mental health and suicide prevention crisis line, leveraging the existing infrastructure of crisis call centers across the nation.

“988 is just such a win-win in every way; it’s going to be much better for Idahoans no matter where they live,” Flinn said. “And if emergency phone calls can be diverted, if somebody is in a mental health distress and that call can be diverted from 911, it really means that the call gets routed to people working in crisis care.”

Currently, when someone with an Idaho area code calls the National Suicide Prevention Lifeline (1-800-273-TALK), they are routed to the Idaho Suicide Prevention Hotline unless they choose an option specific to veterans or Spanish speakers. If Idaho’s lines are too busy, the caller is rerouted to another call center within the network of 180 centers across the country. By July 16, 2022, that number will be shortened to 988, similar to 911. Any calls made to the longer 1-800 number will automatically be directed to 988.

Flinn and Edmunds expressed excitement about the change, but it will require additional resources — particularly for Flinn’s staff, which is mostly made up of volunteers.

“On the low end, our call volume could increase next year by 84%,” Flinn said. “… So that’s why there was a bit of runway built in (for implementation), and if you’re a call center like us, the runway is pretty short.”

A bill that would have added a $1 surcharge to phone lines in Idaho to help fund the 988 line for the state died in a Senate committee during the 2021 legislative session. Flinn said representatives of telecommunications companies pushed back on the idea and too many questions prevented it from advancing. She expects another version to come back in the next session.

But either way, the hotline is mostly funded by individual donors and fundraising efforts, with the remaining 30% coming from state funds. The Legislature did approve an additional $300,000 for suicide prevention as part of the Division of Public Health Services’ budget.

“We’re going to be working hard to raise all sorts of funds, but this is a change in federal law that impacts us, so we are absolutely looking for and counting on an increased investment on behalf of the state,” Flinn said.