Where 988 mental health calls go in Oregon

More than 11% of the 8,600 calls made from Oregon to the year-old national 988 suicide prevention and mental health hotline went unanswered by in-state counselors during April and May, per a new analysis from health research outlet KFF.

Why it matters: When local counselors don't answer, calls are routed to out-of-state crisis centers.

• "The counselors at an overflow facility are less likely to be familiar with local resources and treatment options, including the availability of additional emergency mental health services," KFF study author Heather Saunders tells Axios.
• Plus, these missed calls are happening at a time when most Americans still aren't aware of 988, Axios' Sabrina Moreno reports.

Zoom in: Oregon lawmakers established a 988 system when the national hotline was created last year, and it is one of the few states that have made long-term funding commitments to sustain it.

• Last month, lawmakers approved a 40-cent monthly tax on all phone bills to help expand it. You'll see it on your bill starting in January.

By the numbers: In the year since 988 launched, Oregon's crisis hotline centers answered over 53,000 calls, texts and chats, per Oregon Health Authority data.

• That's a 33% increase over the previous year, when people needed to dial a ten-digit number — a jump of about 500 calls a month.

What they're saying: "It's easier to remember," Oregon Health Authority spokesperson Dean Carson told Axios.

• It's also designed as a resource for people needing a range of mental or emotional support. "There's this vision that 988 will be the front door to the whole behavioral health system," Carson said.

The top three reasons people called over the past year were mental health concerns, family or relationship issues and suicidal thoughts, he said.

Context: The KFF data ranked Oregon 23rd in the nation for the most calls answered locally.

• OHA data shows higher local answer rates, but acknowledges missing at least 7% of calls.
• The new phone bill tax — expected to raise $32 million by 2025 — is slated to expand hotline staff, Carson said, followed by increasing mobile crisis response teams.

Of note: 988 call data is tracked by area code, not physical location.

• If you call from a 503 or 971 cellphone and you're not in the state, your call will still go to Oregon-based crisis counselors.
• 97% of 988 contacts are resolved or "de-escalated" on the phone and don't need further intervention immediately, per OHA.

Zoom out: 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.

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

The bottom line: "We have to remember, we're at the beginning of what's going to be a marathon, not a sprint," said Chuck Ingoglia, CEO of the National Council for Mental Wellbeing.