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Measures look at state suicide prevention

by Hunter Field | March 13, 2017 at 4:30 a.m.

Until last year, Arkansans had only a slight chance to speak with someone in the state when they called the national suicide hotline.

Now they have no chance.

Dating back to January 2015, the Arkansas Crisis Center in Springdale, the state’s only participant in the National Suicide Prevention Lifeline, only took a small fraction of the state’s crisis calls, according to data from the national hotline. In April 2016, the center quit taking national hotline calls altogether.

That left the state as one of only two without one of the 159 call centers affiliated with the national hotline. The other state, Wyoming, had the most suicides per 100,000 residents in 2015. That same year, Arkansas rose from No. 16 to No. 10 in the latest federal rankings of suicides per capita; 571 people killed themselves, according to the U.S. Centers for Disease Control and Prevention, making suicide the No. 1 injury-related cause of death. Arkansans are twice as likely to kill themselves as they are to be killed by someone else.

Activists attribute this trend, in part, to the lack of an in-state hub for calls to the national suicide hotline.

About 95 percent of Arkansans in crisis have had their calls to the national suicide hotline routed out of state for the past two years.

Suicide prevention advocates agree that’s a problem. Out-of-state call centers don’t know where to refer people in Arkansas for help, said Mary Katherine McKinley, Arkansas Crisis Center’s executive director.

“As a crisis center, you’re only as good as the resources you’re able to connect people to,” McKinley said.

Advocates disagree about how the state should go about getting a call center back on the national network.

One faction wants the state Department of Health to run a 24-hour, accredited call center that would answer Arkansans’ calls to the national hotline. Rep. Bob Johnson’s House Bill 1775 would accomplish this.

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Another group wants the Arkansas Department of Human Services’ Division of Behavior Health Services to take a more holistic approach to suicide prevention, which would also include establishment of a call center. Rep. Tim Lemons’ House Bill 1705 would direct $2.3 million to the agency for this purpose.

Lastly, Arkansas Crisis Center leaders want the state to partner with them to help regain accreditation and connection to the national hotline. McKinley said the state could help the center solve its ongoing staffing and funding shortfalls, which she said led to the center’s removal from the national hotline’s network.

The Crisis Center’s board president on Wednesday sent a letter to Gov. Asa Hutchinson and state representatives in response to an article that appeared in the March 5 edition of the Arkansas Democrat-Gazette.

The letter summarized the Arkansas Crisis Center’s mission, and suggested that the state partner with the center to avoid having to build a call center from the ground up.

“We have already laid the foundation, partner with the Arkansas Crisis Center to continue saving lives,” Jeremy Upton, the board president, urged state leaders. “Together we can battle this epidemic that affects so many in this state.”

In response to Upton’s letter, a coalition of organizations penned one of their own, rebutting some of his claims.

That letter — signed by the American Foundation for Suicide Prevention, the Arkansas Suicide Prevention Network, the Arkansas Veterans Mental Health Council and the Arkansas Veterans Coalition — thanked the Arkansas Crisis Center for it’s dedication to prevent suicide, but it questioned whether the center was up to the task of operating a 24-hour hotline, claiming that callers are often routed to an automated message.

“Mr. Upton’s letter stated that the [Arkansas Crisis Center] is ‘already running an operational hotline,’” the group’s letter said. “We do not believe that callers who are in an active suicidal crisis being directed to an automated message is an effective ‘operational hotline’ which is why HB 1775 is so important.”

The Arkansas Crisis Center runs its own line separate from the national hotline. They assist Arkansans in crisis from 8 a.m. to 11 p.m. A reporter who called the number received an automated message on Friday at about 1 p.m. On Sunday afternoon, a crisis center worker answered a phone call.

McKinley said the center is remedying issues with their phone lines. She’s also actively recruiting volunteers to help staff the lines. It requires 32 hours of training, but she said most volunteers find the work extremely fulfilling.

She hopes to have the center re-accredited later this year once it gains more volunteers and finishes upgrading its phone system.

Meanwhile, supporters of Johnson’s bill hope it sails through committee in the coming days. That call center would cost about $688,100 annually to run and evaluate, which the health department has said it would pay for with a mix of state and federal injury prevention funds.

Lemons’ bill appears to be at odds with Johnson’s legislation because it appropriates suicide prevention dollars to the state Department of Human Services, not the health department.

The lawmakers, who are friends, realized they had filed similar but competing bills within an hour of each other. Lemons, R-Cabot, said in a phone interview last week that he will wait to run his bill until after Johnson’s bill had been acted upon. If Johnson’s bill passes, Lemons said he would amend his bill by decreasing to allocation to DHS by the amount it would cost to run a call center.

“That’s what we all call common sense,” Lemons said. “Some of that is missing in that marble tower over there.”

Lemons filed his bill after being approached by Steven Blackwood, chairman of the Arkansas Suicide Prevention Council. Blackwood said the bill would leverage existing infrastructure within DHS’ Division of Behavioral Health to most effectively combat suicide. The division would most efficiently coordinate and search out available resources.

“Nobody is opposed to suicide prevention,” Blackwood said. “They just don’t know where to go to get it.”

Currently, the health department administers the state’s suicide prevention programs. It has three full-time employees, whose salaries are funded by a federal grant, which targets suicide prevention for people under 25. The state is also seeking an additional grant for those over 25, but that grant requires recipient states to have a call center connected to the national hotline. The two grants would total about $1.4 million, according to the health department.

There’s a third piece of suicide-related legislation pending. Rep. Warwick Sabin’s House Bill 1666 would mandate that colleges provide incoming students with suicide prevention information, like local mental health services and early warning signs.

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