Indiana's mental health progress — and pitfalls

Why it matters: Over half a million lives were lost to suicide between 2010 to 2021 nationwide.

• Indiana's suicide rate climbed by 25% during that same time.

How it works: The "in-state answer rate" is a measure of the percentage of calls answered within state borders.

• 988 uses the caller's area code to route the call to the closest crisis center.
• If local centers don't answer calls, they are redirected to out-of-state overflow facilities staffed by counselors who may be unfamiliar with the area and struggle to connect callers with local resources.

State of play: Indiana's 988 answer rate is high, but some advocates are concerned about the state's long-term commitment to providing access. The federal government initially footed the bill to implement 988, but state and local governments are responsible for ongoing funding of area call centers.

• This past legislative session, the Indiana General Assembly opted against instituting a cell phone fee to provide a dedicated funding stream to support 988 in Indiana.
• Six states have already implemented a similar fee.

The big picture: Securing state support for the hotline is just the first step toward building a more robust mental health care system.

• Sen. Mike Crider, R-Greenfield, who advocated for the implementation of the cell phone fee, also sponsored legislation to build upon 988 with mobile crisis response teams and community-based mental health clinics.
• He proposed an annual investment of more than $100 million to improve the state's mental health system, but lawmakers opted to only provide $50 million for each of the next two years.

What they're saying: While advocates were glad for a long overdue focus on mental health in a state that ranks near the bottom nationally, some are still calling for a dedicated funding source for 988, like the cell phone fee.

• "We need some kind of ongoing funding," said Stephen McCaffrey, president and CEO of Mental Health America of Indiana. "There needs to be something so that we're not faced with a question literally every budget cycle as to whether we're going to fund 988."

Zoom out: Plans to use some of the nearly $1 billion in federal funding for a nationwide public service campaign haven't materialized, partly due to a fear that marketing 988 could overwhelm the lifeline beyond capacity.

• Since the National Suicide Prevention Lifeline was replaced last year with the easier-to-remember number, 988 has been contacted nearly 5 million times nationwide.
• Officials, mental health advocates and call center leaders say they’re pleased with that number.

Yes, but: More than 80% of Americans still aren't familiar with the new hotline, according to a recent National Alliance on Mental Illness survey.

Meanwhile, Crider told Axios he'll continue working on the issue with the goal of building out a statewide network of mental health resources for every Hoosier who needs them — not just those with serious mental illness or who are already in crisis.

The bottom line: "The goal is you keep people from reaching that crisis point," he said.

If you or someone you know is currently experiencing thoughts of suicide, or a mental health or substance use crisis, please call 988 to reach Suicide & Crisis Lifeline and speak with a trained crisis specialist 24/7.