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A sign, visible to drivers on West 84th Avenue in Westminster, points to the 24/7 Walk-in Crisis Center among the other services offered at the Centura Health Complex. (Eric Lubbers, The Colorado Sun)

A year after it went live, the 988 national mental health hotline is still working out some issues — and Colorado needs a huge increase in staff to meet the 24/7 demands. 

For starters, when people dial the three-digit number, their call is routed to the state call center that matches their area code, not their location. This is particularly bad for Colorado, which has a high number of transplants who moved here with out-of-state area codes and a large military population. 

Also, Colorado realized it needs 260 additional employees to answer the calls on top of the 130 it started with if it’s going to meet a federal requirement taking effect in April that call centers must pick up within 20 seconds. The current threshold is 59 seconds. 

And a recent report from Kaiser Family Foundation found that Colorado failed to answer about 22% of calls this spring, though Colorado officials dispute that. The report revealed that state call centers’ ability to answer crisis calls varies widely across the nation, from a low of 55% to a high of 98%. 

Colorado says it managed to answer 88% of calls this spring, while the national data dings the state for answering 78%. Colorado records show they answered 94% of calls in June within the time allowed.

Callers who don’t get an answer at state call centers are still getting help, however. Calls that don’t get picked up within 59 seconds are routed to a national backup call center. 

“They are being answered,” said Kelly Bowman at the state Behavioral Health Administration. “It may not be in the home state, and we understand that’s a challenge. That’s why it’s so important to make sure that we’re answering those calls in under 59 seconds … so that they don’t go to a backup center.” 

A small fraction of calls are dropped in route to state call centers, but national data doesn’t show why. It’s possible the call got dropped, or the caller changed their mind and hung up, Bowman said.

Colorado trying to hire 260 workers across the state

Colorado is in the process of trying to bring on 260 additional workers with a variety of skill levels who can answer the phones at its Denver call center or from their homes across the state. 

The call center is now bringing in 15-20 new employees twice per month to begin their four-week training sessions. The goal is to have enough workers in place by April, when the federal requirements say states must answer calls within 20 seconds. 

The legislature in 2021 created the 988 Crisis Hotline Enterprise, housed within the Colorado Department of Human Services and overseen by a separate board of directors. The enterprise is funded through a surcharge on monthly cell phone bills and is allowed to assess up to 30 cents per bill. 


The enterprise started out with an 18-cent fee and then bumped that to 27 cents this year after realizing how many employees it would take to answer the calls. The Colorado program’s initial annual budget was $14 million, and that increased to $21 million for 2023. 

Colorado also adjusted its supervisor-to-staff ratio, realizing it needed more supervisors to help employees manage the toughest calls and decompress afterward, said Bowman, the state manager of the 988 Enterprise and crisis line. “These calls are very intense and can be really, really challenging,” she said. “There’s a lot of trauma involved in this work.” 

And the call center, run by Rocky Mountain Crisis Partners, realized it needs more people working weekends and the middle of the night. 

“We often see some surges around those times,” Bowman said. “Maybe you don’t want to call your friend at 2 o’clock in the morning or your doctor’s office is not open Saturday, so that makes sense.”

Colorado eventually could phase out state crisis line

Rocky Mountain Crisis Partners took on the 988 calls a year ago in addition to answering the Colorado Crisis Line, 1-844-493-8255. The national number routed nearly 58,000 calls to Colorado in the past year.

The state is hoping to push more callers to 988 and eventually consider phasing out the 10-digit state hotline number. The longer number is harder to remember and has the word “crisis” in its name, which invokes stigma for some people, Bowman said. 

But for now, many people are more comfortable calling the state number because they know it’s connected to Colorado’s network of walk-in crisis centers, overnight stabilization beds and mobile mental health units. 

“We don’t want there to be a lot of different numbers out there, and we don’t want it to be confusing,” she said. 

There’s no rush to move away from the Colorado number, however, since the area code problem still exists. People who live in Colorado but don’t have a Colorado area code are better off calling the Colorado number to get linked to local services. 

It’s unknown when federal regulators will fix that issue. State call centers have been talking to the Federal Communications Commission about the area code problem since before the 988 number went live in July 2022. 

Most calls are not about suicide

Hotlines have historically been for suicide calls, but 988 is broader than that. It’s for any “self-defined crisis,” Bowman said. 

“It can be for emotional distress, substance use,” she said. “It’s for relationship issues. It’s for anxiety. It’s for depression. We see a lot of kids calling in, saying, ‘I’m worried about my mom. She’s drinking too much.’”

There is no age requirement to call 988. No insurance information is requested. And the line is different from 911 in that it’s confidential — there is no mechanism to triangulate the call to determine a caller’s location, Bowman said. If a call is a “suicide in progress,” the responder can’t send help without first getting the caller to give their address. 

Most people just want to talk or get advice. In Colorado, only 0.3% of 988 calls resulted in a call to 911 and 0.5% resulted in a referral to a walk-in crisis center. 

“Folks just want to be heard, and they want to know that the person on the other end of that call or that text is trained and knows how to manage whatever it is they come with that day,” Bowman said. 

Colorado Crisis Line: A statewide hotline. 1-844-493-8255, or text TALK to 38255.

“It’s what has to happen to build hope and connection. It’s not a replacement for therapy, but it is somebody that is there no matter what.” 

In the future, the call center hopes to extrapolate more data so mental health experts can determine what kinds of events are causing distress in different parts of the state. They could see, for example, whether a car crash or a suicide in a rural town caused a spike in calls and how long after the event the calls persisted. 

The suicide rate in Colorado has remained steady since 2017, at around 22 or 23 suicides per 100,000 people, according to the state health department. There were 1,287 suicide deaths last year, including 17 deaths of children ages 10-14 and 39 deaths of teens 15-18. 

Jennifer Brown writes about mental health, the child welfare system, the disability community and homelessness for The Colorado Sun. As a former Montana 4-H kid, she also loves writing about agriculture and ranching. Brown previously...