Since state legislators chose this session not to provide funding for a statewide voice-based suicide prevention phone line or increase funding for a similar text-based service, expansion of statewide suicide-prevention text services is unlikely to happen in the next two years, and the voice-based service has been put at risk, said Matt Eastwood, CEO of Canvas Health, the parent company of the services, known as Crisis Connection and tx4life.
“We’re not at a point of being able to publicly announce what we are doing,” Eastwood said. “We haven’t met with staff yet. We haven’t met with payers or contributors. We haven’t yet had a chance to finalize our plans.” The organization’s fate is up in the air.
In 2016 and 2017, Canvas Health sought state funding for the crisis lines, which had been running at an annual deficit of between $200,000 and $300,000. Legislative response was largely positive during the public testimony process, Eastwood reported, but when the final budget was announced, Crisis Connection’s phone line received none of the $1.3 million the organization had requested for operational support. And when the bills went back to a conference committee before the special session, further funding for txt4life was also eliminated.
“That all happened at the very end,” Eastwood said. “Our primary authors seemed a little confused about what happened.” The funding shutout, he added, felt like an about-face from a Legislature with a recent history of strong support for mental health initiatives, especially in a session that ended with a budget surplus: “What we were asking for was about 35 cents per Minnesota resident per year. It’s not a lot of money. That’s what we were asking for to have at least this sort of safety net available for yourself or your family or your friends.”
Shannah Mulvihill, Mental Health Minnesota executive director, said letting the suicide prevention lines languish seems to run counter to other statewide mental health proposals.
“When they met last fall, the Governor’s Task Force on Mental Health made recommendations that promoted more upstream support for mental health,” she said. “I take that to mean that they think we need to invest in services like Crisis Connection and txt4life.” If legislators want to fully address the state’s mental health crisis, she said, “We can’t just invest in hospitals. We need to have the range of mental health services available to people when and where they need it.”
If Crisis Connection’s phone line were to shut down, Sue Adberhholden, NAMI Minnesota‘s executive director, said, “It will certainly be a loss to our mental health system.” But she added that she hopes Canvas Health will be able to find a way to keep the service going until they can renew their legislative request next session.
“There isn’t any way to get any money now from the state this year,” Abderholden said. “Hopefully some foundation will come around and help them out. Then they can try again with the state next year.”
Because the legislative response had seemed so positive early on, Canvas Health officials felt surprised when their funding request was denied this session. Eastwood explained that the organization’s leaders are regrouping, trying to come up with ways to keep both lines up and running.
“We’re working out various contingency programs, talking with those folks who have been supportive of us and seeing what we can work out,” Eastwood said. “We’re hoping to preserve some of what we currently offer.”
What could happen
Eastwood said he worries that there could be a potentially deadly impact if the voice line were shut down.
“If we are not able to maintain these services, what will happen to the people who call in?” he asked. Both lines routinely deal with life-and-death situations. “Four hundred times last year, our staff requested first responders to assist callers. These were people who were actively in the process of completing a suicide. It was not something that could be handled on the phone, and we needed to bring in help.”
Without the phone line, Eastwood said, “Our greatest fear is that the rate of suicide completion in the state will jump. My greatest hope is somehow we’re completely wrong about that.”
If Canvas Health stops operating the Crisis Connection phone line out of its Richfield office, only about a third of calls to the service’s 800 number will be automatically forwarded to another suicide prevention line.
“Those calls will then roll to some other call center somewhere in the country and hopefully get picked up by them,” Eastwood said. “Those centers are all busy, too.” Crisis Connection staff isn’t always able to pick up every call that comes in now, he explained. If the local staff goes away, he wonders, “Will someone actually be there somewhere else to pick up those calls?”
If the Crisis Connection voice line shuts down, Abderholden said, “We don’t know if people will go to other types of mental health support lines like Minnesota Warmline or to the national suicide prevention number. It could be that more people end up calling 911 or will learn their county crisis number.”
Eastwood said he hopes that if the phone line shuts down, people who are considering suicide will think about the other options that exist.
“The hope will be that people will call 911 or they’ll go to the hospital ER and get service that way, or, if they know the number, they will call their local mobile crisis team and hopefully there will be somebody there to pick up the phone and respond to that,” he said.
Mulvihill’s organization runs Minnesota Warmline. She said the service is preparing for increased call volumes: “I would expect that some of the Crisis Connection callers will reach out to the Warmline. Our service has grown so much already. We’re taking twice as many calls as we were two years ago.” The Warmline has also recently added texting services.
Until Canvas learns if it can cobble together other funding sources, the organization and its employees and volunteers have to live day by day, Eastwood admitted. This makes for a stressful environment.
“We’re working feverishly to shore up our plans and see what we can do so we can responsibly and respectfully deal with our employees and volunteers. The worst part of my job is having to let people go. These are very dedicated people who do really good work. We’re doing everything we can to avoid that.”
Mulvihill said she hopes that Canvas is able to secure funding so Eastwood doesn’t have to take on that burden.
Crisis Connection and txt4life are key, life-saving pieces of Minnesota’s mental health network, she believes. When she was completing her graduate degree, Mulvilhill worked as an intern handling calls through Crisis Connection’s phone line.
One story from that time sticks out in her mind.
“I spent an hour and a half speaking with a young man in Duluth who was standing on the lift bridge thinking about jumping,” she said. “We were able to get him down. I’m concerned about what happens in the state without a valuable service like that.”