Calls to state’s crisis hotline for children increase

More kids in need or rising awareness of line?

Children threatening suicide or in emotional distress have triggered more calls to Tennessee’s crisis hotline in recent months than ever before.

Yet what’s causing the increase in crisis calls, which often prompt counselors to visit homes, schools or hospitals, remains unclear.

More calls could mean more children are in need — perhaps because of economic pressures on families — or simply that more people have learned about the hotline and decided to call, officials said.

“Holidays — middle of the night — we’re available,” said Dawn Puster, crisis services director for Youth Villages, the Memphis-based nonprofit agency that Tennessee pays to run the statewide response program.

The statewide phone line and team of counselors have been in place for 10 years. In that time, almost 100,000 calls have come for issues ranging from angry outbursts to medication problems to life-threatening emergencies, prompting more than 68,000 home visits.

Anyone can call the hotline for help. Often, it’s parents, teachers or hospital staff, but sometimes children and teens call, too.

Trained counselors take calls at offices across the state. After gathering information and determining whether a child faces an emergency, a responder may be sent to the child. Responders almost always arrive within two hours. The state requires that speedy responses happen 90 percent of the time, a benchmark that is almost always maintained and often exceeded, state data show.

Counselors stick with the family until the child is safe. About one-third of calls lead to the child being taken to a psychiatric

center, but most are cared for at home or through connections to local services, Puster said.

“We are de-escalating that crisis situation and then passing the baton to someone who is going to provide long-term services to the family,” she said.

Despite the emotional, stressful or dangerous particulars of each case, counselors try to use their relatively brief encounters to do some good.

“What comes with a crisis is an opportunity to change things because maybe the family has tried things that haven’t worked,” Puster said.

Counselors can recommend techniques for staying calm or changes in household behavior or even different medical treatments.

When triage counselor VeRonika Tubbs answers the crisis phone in her Nashville office, a wide range of emergencies could be playing out on the other end of the line.

“I’m trying to figure out what’s going on, especially if I hear screaming or chaos in the background,” Tubbs said.

She might hear about a fussy child, a teenager refusing to take medication or, often, a child threatening to attack someone or commit suicide.

In Tubbs’ six years, calls have rarely been simple and hardly ever pleasant. Last year, 43 percent of all calls involved a child threatening to harm himself.

Through the phone, Tubbs can hear the hardships of the recession playing out on families. Some parents have lost jobs or access to services, and counselors have heard children who suggest one awful way to make things less costly for their families.

“Children are picking up that their parents are losing their jobs. They’re feeling like if they kill themselves, their parents won’t have to provide for them and they’ll have extra money,” Tubbs said.

Tubbs spends a lot of time listening and then explaining options.

“A lot of parents get our number and aren’t sure what services we have,” she said. “Some people are nervous to give a lot of details, fearing that we could potentially take their child from them. I just let them know what services we provide and that we’re not coming out to remove the child.”

Dozens of Youth Villages responders wait across the state for cases.

Before closing a case, the counselor works with the family to write a safety plan. Together, they determine ways to protect the child, what household changes might help and who will be responsible for making improvements.

For example, a plan might include a promise to lock up weapons or medications.

“It definitely needs to be a realistic plan,” Puster said. “If it’s not specific to what they’re going to be willing to follow, it’s not really worth anything.”

Although crisis interventions typically conclude within a few hours, serious situations will lead to follow-up calls.

The state Department of Mental Health and TennCare — which combined pay Youth Villages about $6.5 million a year to run the program — monitor call volumes and trends to adjust services.

“We’re working on, on a state level and a national level in all aspects of behavioral health to determine what is a success,” said Mental Health Department spokesman Michael Rabkin. “If more phone calls are coming in, does that mean it’s getting better or getting worse? It’s very difficult to say what is a success.