U.S. launches 988 hotline for callers with mental health emergencies

suicidehotlineFederal officials have launched a new 988 number for callers with suicidal thoughts or other mental health emergencies, hoping that the public adopts this three-digit alternative and finds it as familiar and useful as 911 has become for medical and other urgent help needs.

The National Suicide Prevention Lifeline, which those in distress could reach by calling 800-273-TALK (8255) or texting HOME to 741741, will keep operating for a time.

But mental health advocates say they hope 988 soon will become embedded in the public consciousness as the line to call 24/7 to tap into resources — many of them which will rely more on individual states — for what have become big needs. Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, a nationwide grass-roots group, told the Washington Post this about the new hotline:

“I look at 988 as a starting place where we can really reimagine mental health care. We’re really looking at a fundamental tide shift in how we respond to people in mental health crisis.”

As the newspaper reported:

“The network of more than 200 local call centers [supporting 988], drastically underfunded throughout its history, fielded 3.6 million calls, chats and texts in the 2021 fiscal year, according to the federal Substance Abuse and Mental Health Services Administration (SAMHSA). Officials expect that to jump to 7.6 million contacts in the coming year.”

The New York Times reported that officials know the changeover to this resource will not be swift and without challenge, even with $400 million in federal funding:

“[T]here are lingering concerns that short-staffed call centers across the country may not be ready to face the surge [of 988 calls]. Many who called the Lifeline in recent months disconnected before they got help. About 18% of the roughly 1 million phone calls placed to the Lifeline in the first half of this year were abandoned, according to a data analysis by The New York Times. An earlier Times analysis in March found similar problems, and the transition to a well-publicized three-digit phone number is expected to strain capacity further.”

Still, officials have expressed guarded optimism about 988, especially with increased public attention during the coronavirus pandemic to mental health issues and the boost in funding this service has received, the New York Times reported:

 “Hundreds of millions in federal dollars have given a major jolt to the Lifeline over the past half-year. The money has helped the chronically underfunded crisis line — long answered by a patchwork of call centers, often nonprofits that juggle several hotlines and rely on both paid counselors and volunteers — to enlist additional phone banks across the country, bringing the total from 180 to more than 200. The funding has also bolstered a Spanish-language network; national backup centers, where counselors can pick up calls that go unanswered locally; and digital messaging services, seen as a crucial tool for reaching younger people who need help. The Lifeline’s texting and chat lines received about 500,000 contacts during the first half of 2022, but only about 42% of those were answered. Still, the data, supplied by the organization that administers the Lifeline, showed steady improvement — the response rate climbed to 74% in June, and the average wait time declined from 16 minutes in January to about three minutes last month. There were no significant gains in response rates for phone calls, though one goal of 988 is to eventually answer 95% of them within 20 seconds. The Lifeline said 80% of callers who disconnected last year did so within two minutes of the automated greeting, and about a quarter of those who hung up tried again within 24 hours and got through.”

The nation has significant need for improved response to callers with urgent need for mental health help, the Washington Post reported:

“The number of suicides in the United States rose steadily from 29,350 in 2000 to 48,344 in 2018, before declining to 45,979 in 2020, according to the National Center on Health Statistics. In the wake of the coronavirus pandemic and other factors, government and health officials agree that the country is in the grip of a mental health crisis, especially among younger people, with sharply rising rates of depression and anxiety.”

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their challenges with accessing and affording mental health care that might help reduce suicide’s terrible toll.

The Obama Administration took steps to boost the nation’s mental health care, calling on practitioners and providers to recognize that it should be held to the same high standards we aspire to in this country with treatments for physical disorders. But let’s face it, whether due to lingering stigma or ignorance about the severity of need, the funding and resources for mental health care in this country still lags from where it needs to be. The problems only worsened during the pandemic, and they also have shown how shortages of trained, skilled, and experienced personnel must be addressed.

Mental illness and suicide can be as devastating, painful, and difficult to deal with as any physical disease or condition, and we must increase our efforts to help those in need. We need to step up our battle against suicide at all ages, including by recognizing that interventions with those in crisis can be significant. This means that we need much more study on controls on guns, a leading way that the desperate take their lives, especially with the proliferation of weapons and too many unsafe ways they are or are not stored. We have much work to do to ensure that those with mental health issues find care that is accessible, affordable, safe, efficient, and excellent.

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