California answers 988 calls more than most states

Why it matters: The three-digit hotline was developed to make it easier for people to seek mental health help.

What's happening: In San Diego County, when someone with a local area code calls 988, they are automatically transferred to the local Access and Crisis Line to be connected with a trained counselor and services near them or someone they know who needs help.

• The county answered about 20,500 calls that came through the 988 hotline in its first year, data provided by the county shows.

Zoom out: Nearly 10% of the more than 58,000 made from California residents to the national 988 suicide prevention and mental health hotline went unanswered by in-state counselors between April and May, per an analysis from health research outlet KFF.

• That's the highest number of calls and the 14th lowest rate in the U.S.

Between the lines: These missed calls are happening at a time when most Americans remain unaware the 988 national suicide prevention and mental health hotline exists.

• And at the service's one-year mark, few states had established long-term funding commitments to sustain it, Axios' Sabrina Moreno reports.

By the numbers: Last year, 360 people died by suicide in San Diego County, per a report this month by the county's Suicide Prevention Council.

• That's a slight increase from the 358 recorded in 2021 — the lowest number in 10 years.
• While suicides declined overall between 2012 and 2021, death rates increased 7% for youth and young adults between ages 10 and 24.

Context: San Diego County's 10.9 suicides per 100,000 residents in 2022 is below the 2021 national suicide rate (14.1) but higher than California's (10.1), per the latest data from the CDC.

Of note: In June, the county approved $4.1 million to join a state youth suicide-focused pilot program to develop new prevention efforts.

The big picture: Since the National Suicide Prevention Lifeline was replaced last year with an easier-to-remember number, 988 has been contacted nearly 5 million times nationwide.

• Yes, but: Plans to use some of the nearly $1 billion in federal funding for a nationwide public service campaign haven't materialized, partly due to early concerns that marketing 988 could overwhelm the lifeline past capacity.
• Ahead of its launch, fewer than half of public health officials charged with deploying 988 said they were confident they had the necessary staff to field the expected surge in calls.

Zoom in: San Diego County allocated $1.5 million of its fiscal 2022-23 budget to update telephone infrastructure and double its on-call workforce with a plan to hire 20 counselors, the Union-Tribune reported.

• Staffing levels "will be enhanced based on call volume and need," a county spokesperson told Axios Tuesday.

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

• And funding remains uncertain — only California and five other states have enacted legislation to create monthly phone line fees to support the system, similar to how communities fund 911.

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.

• "It's taken 15 years for 911 to evolve to the kind of system that it is today. We're just one year in."

If you or someone you know may be considering suicide, call or text the National Suicide Prevention Lifeline at 988. Ayuda disponible en español.