It’s not always easy for people to admit they’ve been having suicidal thoughts – especially to those closest to them.
“When you mention it to family members they don’t know how to react; they get scared and nervous and worried about saying the wrong thing,” said Tamara Fleury, hotline manager at Headrest, the only 24-hour crisis hotline in New Hampshire. “Sometimes they say nothing and just hope if they ignore it, the problem will go away.”
Talking about it with a stranger, on the other hand, is usually a lot more comfortable, Fleury said. Operators at Headrest, a state-wide crisis line located in Lebanon, are trained to talk callers out of crisis and connect them with mental health resources where they live.
This is a proven method of suicide prevention that mental health experts say is vital to bringing down the state’s suicide rate, now one of the country’s highest. But Headrest has been having trouble accommodating all of the people who want to talk lately, Fleury said. The number of calls Headrest has received has increased by 50 percent or more in the last eight months, Headrest executive director Cameron Ford said.
Between 2016 and 2017, operators answered 882 suicide calls at Headrest, Ford said. From 2017 to 2018, it was 1,218. And so far in the first three months of 2019, there have been 898 suicide calls.
Callers from Concord make up the third-largest group of suicide-related calls Headrest answered in the state behind Manchester and Nashua, Ford said.
“It’s just steadily increasing, it’s going up and up,” he said.
Right now, Headrest is dependent on donations and small amounts of money in federal grants and from local municipalities. Ford said in the last two years Headrest has had to take out more than $100,000 in a line of credit to keep up with all of the calls.
Now, the organization is asking for the state for funding for the first time ever: $200,000 a year. The money is listed as part of the Department of Health and Human Services’s recommended $750,000 for two years toward suicide prevention in its 10-year Mental Health Plan.
However, the governor’s proposed budget does not include specific suicide prevention funding. The state currently spends a little more than $100,000 a year on suicide prevention, said NAMI New Hampshire Executive Director Ken Norton.
Organizations like Headrest are left in limbo, hoping for a transformation in the budget, now in the House Finance Committee.
“It isn’t like we’re looking for a windfall, we are just looking for support,” Ford said.
Headrest Headrest started in Dartmouth College dorm basement in 1971 by a group of people who were concerned about rising drug use on campus.
Now, Headrest has expanded include its hotline, a 14-bed residential facility that offers 90 days of low-intensity recovery, outpatient substance use disorder treatment and workforce training.
The money Headrest is requesting from the state would go specifically toward the hotline. The hotline is part of a network that includes 160 other accredited crisis call centers throughout the country. The hotline – 1-800-273-TALK – is set up to accept any call from a 603 phone number.
Headrest operators are familiar with mental health resources throughout the state and are able to make individual recommendations to callers based on their needs. Each call averages a little over 13 minutes, Ford said.
Although the organization’s focus has shifted to include a broader range of mental health supports, every third or fourth call at the hotline is still from someone who is using substances, Fleury said.
“It’s something that we are dealing with here,” Fleury said. “People are struggling with addiction themselves, they feel like it’s a cycle they can’t get out of and they feel hopeless. That, or they have lost someone they love.”
Another major issue Fleury sees is the use of social media. She said a lot of callers, particularly teenagers, are concerned about bullying online.
There is also usually a spike in calls after a celebrity suicide death, Fleury said. It happened after designer Kate Spade and television personality Anthony Bourdain died last year.
“It’s an increase of people thinking, ‘If he’s got everything and he’s depressed, there’s no hope,” she said. ” ‘He’s got money and fame and power and he can’t get help, I don’t have a chance.’ ”
But Fleury said she sees people every day who are able to find balance in their lives. The people on the other line are always different, Fleury said: it might be a pastor, a mother, a 9-year-old girl.
“People who are in a suicidal state, they want to talk about it. It helps them know that what they’re going through is not unusual, that people can cope with this through medication and therapy,” Fleury said.
“It’s a huge weight lifted off these people,” she added. “We do hear back from people. They’ll call down the road and say, ‘You saved my life.’ ”
Headrest operators are specially trained to make assessments of each caller to determine if he or she is at risk for harming themselves.
They also perform follow up calls after initial conversations and create safety plans with the caller and family members.
Funding Headrest receives by far the most calls from people in New Hampshire, and occasionally Vermont, Maine, as well as other states if their local call centers are busy.
Several local municipalities in Vermont donate annually to Headrest, Ford said. That usually amounts to a few thousand dollars from towns that border New Hampshire.
In New Hampshire, the city of Lebanon and Grafton County contribute annually, Ford said. The organization reached out to the city of Manchester for the first time this year asking for financial support.
Headrest only receives about $3,000 in federal grants annually, Norton aid.
The rest of their work is typically funded by donation, Ford said. Medicaid insurance billing contributes to the cost but doesn’t come close to covering it.
“It’s getting to the point where, we need the state funding to be able to continue doing this work,” Ford said. “We need the funding to continue to grow.”
Norton said they also need the funding to expand. Other hotlines around the country have been experimenting with a crisis text line – something that has been popular, he said.
“It is the preferred mode of communication now for a lot of people, especially young people,” Norton said. “We need to learn how to have the capacity to respond to that, to meet people where they’re at.”
(Leah Willingham can be reached at 369-3322, lwillingham@cmonitor.com or on Twitter @LeahMWillingham.)
If you or someone you know might be at risk for suicide, contact The National Suicide Prevention Lifeline 24/7 at 1-800-273-8255. For additional resources, visit NAMI New Hampshire’s Connect Program at theconnectprogram.org.