Katelyn Blotsky prepares for work by doing something utterly ordinary: eating a bagel and staring at her cellphone.
Her shifts are usually eight hours long. She wakes up early (4 a.m.), does a workout at the gym, showers, dresses and makes her 15-minute commute from her apartment to the nondescript, two-story office building where she works. It sits glumly, framed by drifts of glaringly bright snow, shoved aside by the plows that keep the roads in Fargo, North Dakota, open and the place habitable. She clocks in. It looks like any other drab call center one could find across the better part of the country. But instead of sitting down and making calls, Blotsky waits for the phone to ring.
Sitting in a 988 crisis hotline center, there’s a small part inside of her that hopes it doesn’t.
The 988 Suicide and Crisis Lifeline is a network of more than 200 local, independent and state-funded crisis hotline centers, available 24/7 for anyone in the U.S., replacing the former 10-digit national suicide prevention hotline number. Utah state Sen. Daniel Thatcher ideated the new hotline, and the late U.S. Sen. Orrin Hatch helped garner wider support. The National Suicide Hotline Designation Act was signed into law following the passage of bipartisan legislation in 2020. After a multiyear effort, the hotline became operational in July for people in need to contact.
A look at the statistics on suicide in America shows just how many people are in need. According to the Centers for Disease Control and Prevention, one American dies by suicide every 11 minutes. Statistics from the nonprofit Mental Health America show that the national rate of suicidal ideation among adults has increased every year since 2011, with an increase of 664,000 Americans reporting suicidal thoughts from 2021 to 2022. The numbers for children who are experiencing mental health crises are equally staggering. According to a report from the National Library of Medicine, the number of adolescents admitted to emergency units with suspected suicide attempts has increased by more than 31 percent between 2019 and 2021. And over 50 percent of adults and 60 percent of children experiencing mental illness don’t receive any treatment, even in states with the greatest access.
So far, 988 is proving useful. Data released in September by the Department of Health and Human Services shows that the crisis hotline experienced a 45 percent increase in the overall volume of calls, texts and chats during the first month of operation compared to August 2021. The number of calls answered increased 50 percent, texts answered increased 1,000 percent, and website chats increased 195 percent. The Substance Abuse and Mental Health Services Administration estimates that contact volume to 988 will more than double before this time next year. Additionally, HHS announced a $35 million grant in support of implementing 988 in tribal communities in September.
“You have to have the ability to know how to finish the call and move on to the next one without it destroying you.”
The rising need for accessible mental health care in times of crisis has led to a growing need for mental health professionals and counselors. At the time of reporting, 196 out of the 200 hotline call centers had job openings needing to be filled.
Inevitably, the phone rings. Blotsky adjusts her headset and answers.
“FirstLink Crisis line.”
That’s where the script begins and ends.
A call can span anywhere from 15 minutes to upward of two hours and, in that period, it’s just her and the voice on the other end of the line. Sometimes there’s background noise, too. Keeping someone on the line can feel like floating in space, with only her training and intuition to try and anchor a soul drifting beyond reach.
So Blotsky comes right out and asks: “Are you having thoughts of suicide? Are you thinking of killing yourself?” Some callers open up right away. Sometimes, they tell her, “I don’t really want to be here anymore.”
“Can I hear a pill bottle? Can I hear a gun cocking back?” she asks. Even if they’re not expressing their intentions, by holding a pill bottle or cocking a gun, they’re saying everything.
Calls are “like peeling back an onion,” Blotsky reflects. “It’s a hard thing to admit that you’re having thoughts of suicide … people think there’s something wrong with them if they are having those thoughts when, in reality, there’s nothing wrong with them. Life is just really hard sometimes and you need a support system.”
Today, that support system, for anyone who calls, is a 23-year-old woman with glasses and light brown hair, and the five or so other counselors who are sitting at their cubicles, spaced neatly between peach-colored walls. It’s an incredible reality that the people sitting on the opposite end of someone’s worst day are — before that call is answered — complete strangers.
Hotline workers’ backgrounds vary significantly. Call one facility and you might get a college student, at another, they hire only trained clinicians. Blotsky is currently somewhere in between. She started at First Link as an intern when she was in college. After finishing her undergraduate degree in social work, psychology and family science, she went on to pursue a master’s degree in social work. When she finishes graduate school, Blotsky hopes to counsel human trafficking victims.
She wants to be there for others, just like someone was there for her when she needed it most.
During her freshman year of high school, Blotsky wrote a note and had a plan. The evening she intended to take her life, her brother invited her to church. There, the pastor spoke about depression and suicidal ideation. It felt like a sign to Blotsky. So, she made the choice to live.
Other hotline workers have loved ones who have attempted or committed suicide. Some have family or friends who haven’t tried to take their own lives but very well could have ended up there.
The weight of the work is a delicate thing to balance. But, it’s scientifically proven to be lifesaving for many who call.
Amanda Bradley, who leads the Community Outreach Psychiatric Emergency Services (COPES for short) division of Family and Children Services in Tulsa, Oklahoma, left corporate accounting for psychology in her 30s, following a family tragedy. “I looked at that trauma, the stress and the lack of resources and what they needed to help that wasn’t necessarily there. I made a decision that I wanted to change things and go into this field,” she says.
That was in 2009. Thirteen years later, she is still answering the phones.
A profession where every day is a crisis — a literal matter of life and death — isn’t usually synonymous with career longevity. The job can take its toll on hotline counselors. “You have to have the ability to know how to finish the call and move on to the next one,” Bradley says, “without it destroying you.”
After a call, Blotsky goes into the bathroom to cry. There are days that are harder than others, and some that haunt her. Once, she counseled a nine-year-old child. She was struck by how the child’s voice kept cracking, a constant reminder of the caller’s young age and fragility. There have been times when she’s out with friends or running errands, and the child’s voice will flood her memory. These flashbacks are a symptom of the trauma that she’s experiencing, so she’s started seeing a therapist.
The weight of the work is a delicate thing to balance. But, it’s scientifically proven to be lifesaving for many who call. One study, published by Wiley, found that the overwhelming majority of crisis hotline callers felt less depressed, less overwhelmed, less suicidal and more hopeful while on the line. On calls deemed as “imminent risk,” 75 percent included the caller themselves agreeing to collaborate on intervention, and 19.1 percent included counselors sending emergency services with the collaboration of the callers.
Here, in this drab office building in Fargo, North Dakota, lives are saved.
Before the sun sets, Blotsky clocks out, leaves the building and drives back to the apartment she shares with a roommate. When she walks in, she puts her keys on the ring by the door — otherwise, she’s prone to losing them — and convinces herself to have a snack.
Tomorrow, she’ll wake up, work out, shower, drive to the office, settle into her cubicle and eat her bagel. The line will ring, and she will answer. And then she’ll do it again and again until it’s time to go home. And although the small part that hopes the phone won’t ring is there, Blotsky will be relieved when it does.
Because when someone calls 988, that means there’s still hope.
This story appears in the December issue of Deseret Magazine. Learn more about how to subscribe.