Wyoming’s 988 journey of going from a zero percent in-state answer rate for National Suicide Prevention Lifeline (now 988 Suicide & Crisis Lifeline) calls to over 90 percent within a few years of 988’s launch illustrates the tireless work of advocates and state decision-makers. Prior to 2020, Wyomingites calling the National Suicide Prevention Lifeline were routed out of state and answered by Lifeline’s national backup centers, resulting in Wyoming Lifeline callers not receiving a localized response. “There weren’t any call centers in the state and the State was definitely interested in having something connected to the [988] hotline. Because Wyoming people really understand Wyoming, whereas [contact centers in] other states may struggle to do so,” reflects Alicia Johnson, Wyoming’s 988 and crisis program manager with the Wyoming Department of Health, on their 988 journey.
Wyoming’s ten year absence of a Lifeline contact center all changed when suicide prevention advocates, the Governor’s Office, policymakers and the Wyoming Department of Health started planning and designing a 988 system that worked for the Cowboy State in preparation for the launch of 988 that occurred in July 2022. State general funds provided by the state’s policymakers allowed the Central Wyoming Counseling Center, located in Casper, and Wyoming LifeLine, based in Greybull, to join the National Suicide Prevention Lifeline network in August 2020. However, the initially available funding was only enough for part-time services rather than 24/7 statewide coverage. During the COVID-19 pandemic, additional federal dollars became available for the centers to expand toward 24/7 statewide services in tandem with 988 being launched nationally.
When discussing the importance of Wyoming crisis counselors answering Wyoming’s 988 calls, Ralph Nieder-Westermann, executive director of Wyoming LifeLine, recounts a recent 988 call he answered from a woman who was having a hard time. “While I could not see her, I could sense in her tone of voice the relief she felt that she was talking to somebody who knew what it was like to live in a small town.” Karen Sylvester, assistant executive director at Wyoming LifeLine, further shared that 988 counselors “have seen how they [callers to 988] respond when you say ‘Yes, I’m from Wyoming, and I know exactly what you’re talking about. I know, I hear you.’”
The Wyoming Department of Health and the two 988 contact centers worked together to develop a unique plan to ensure 24/7 statewide 988 coverage. With Wyoming’s vast geographic area and sporadic population density, the centers came up with the creative solution to split their 988 calls into 12-hour shifts instead of splitting coverage geographically like the rest of the 988 center network. Both centers connected with their staff to gather feedback on their contact centers’ operating hours. After thoughtful consideration, both 988 centers’ staff agreed that an early-morning transition time would ensure the smoothest continuity of 988 services for Wyomingites while also ensuring a positive work-life balance for staff.
Each center operates seven days a week with Wyoming LifeLine answering calls from 2 a.m. to 2 p.m. and the Central Wyoming Counseling Center covering between 2 pm and 2 am, together providing 24/7 in-state coverage for 988 services. The centers have developed memorandums of understanding to collaborate and streamline operations, such as ensuring both centers are providing consistent services to familiar callers.
Another benefit to the 12-hour operational structure is that the two 988 centers are responding statewide to 988 callers in Wyoming, thereby ensuring anonymity and confidentiality to 988 callers. Given Wyoming’s vast rural and low population density, the centers were concerned that providing anonymity and confidentiality would be difficult if they limited their 988 coverage geographically.
Suicide prevention advocates and state policymakers also recognized that 988 was a pivotal opportunity to address the state’s high suicide rates. Wyoming has historically had one of the highest suicide rates in the nation. Coupled by rural mental health disparities, such as stigma and limited availability to behavioral health services, and access to lethal means contribute to the state’s high rates. According to the Centers for Disease Control and Prevention, 75% of suicide deaths in Wyoming were by firearms, which is higher than the national average of approximately 50%. “I knew that the only way we’re going get the suicide rate down was to get our own [24/7] in-state 988 call center,” reflected Sylvester.
Securing 988 sustainable funding is a main hurdle many states, including Wyoming, are facing. Although nine states have passed a 988 fee, similar to the existing 911 telecommunications fees, Wyoming suicide prevention advocates and policymakers are hesitant to implement a 988 fee because Wyoming’s low population would not guarantee adequate funding for 988. Sylvester noted that Wyoming’s 911 services operate at a deficit, even with a 911 telephone fee of $0.75 a month per telephone subscriber.
When asked about sustainable funding, Johnson commented, “The intent for the Substance Abuse and Mental Health Services Administration’s original plan for 988 was for each state to support the day-to-day operations, and that’s Wyoming’s hope for the future.” Nieder-Westermann elaborated that securing sufficient 988 funds to meet Wyoming’s growing 988 demand was a high priority for suicide prevention advocates and policymakers.
During this legislative session, a new biennium state budget was approved and includes funding to cover 988 operations and some service enhancements for the effort through at least June 2026. The program was also added to what’s known as the state’s standard budget, which means special appropriations won’t be necessary in future years for ongoing 988 operations.
To help ensure long-term 988 funding, advocates have been seeking dollars for a 988 state trust fund. The trust fund was established in 2023 but without funding. While some legislators sought $40 million during Wyoming’s most recent budget session for this fund, $10 million was approved as part of the budget process.
Wyoming is starting to see some dividends of its investments in its 988 and crisis services systems. Based on preliminary data from the CDC’s Quarterly Provisional Statistics, Wyoming’s crude death rate for suicide slightly decreased from 32.3 deaths per 100,000 in 2022 for Quarter one (three-month period) to 26.3 deaths in 2023 for the same quarter. “We may never be able to fully quantify the impact of 988. But [by] pairing it with other prevention measures statewide, I think we’re seeing an overall positive impact and people are clearly using the service. The number of 988 users is increasing,” shares Johnson. The state experienced a 62% increase in 988 call volume from 2022 to 2023. Nieder-Westermann and the Wyoming LifeLine team are projecting around a 30% increase for 2024; he indicated that the downside to the call volume growth is the potential negative impact on their average speed of answer — currently hovering around 15 seconds, according to Vibrant Emotional Health, administrator of the 988 Suicide and Crisis Lifeline.
When asked about workforce challenges, Nieder-Westermann expressed that the key concern is securing additional funding to expand their staff, noting that finding staff isn’t a problem. “Wyomingites know that this [suicide] is an issue, and they want to help,” he said. Sylvester further elaborates, “The people we have filling the roles of crisis counselors are so dedicated. They themselves see how badly the State needs this.”
This article is reported and written in collaboration with the National Association of State Mental Health Program Directors (NASMHPD) and Vibrant Emotional Health—the nonprofit that operates the SAMHSA-funded 988 Suicide & Crisis Lifeline.
