September 25, 2023

988 was launched a year ago. How the Mental Health Hotline Works.

It's been a year since the launch of the 988. How does the hotline work?  (Illustration by Katie Martin for Yahoo / Photo: Getty Images)

It’s been a year since 988 launched. How does the hotline work? (Illustration by Katie Martin for Yahoo / Photo: Getty Images)

Last July, a psychological emergency line was launched with an easy-to-remember number: 988. Calling the 988 Suicide & Crisis Lifeline (formerly the National Suicide Prevention Lifeline) connects people to crisis counselors across the U.S. available 24/7 by calling, text or chat.

It’s not a new lifeline, but the new number makes it easier to connect to the 200 local call centers established in 2005. It differs from 911, which focuses on providing medical assistance, firefighters, and police.

John Draper, executive director of what was then the National Suicide Prevention Lifeline, told Yahoo Life at the time of its launch, “The vast majority of the time, having a thought of suicide in no way means that the person will commit suicide; it means a person is in more pain than they know how to deal with, which is why it’s so important for them to reach out to us – so we can help them deal with that, and we can give them many other options. ‘

Why 988 is now vital

The launch of 988 follows the rise in suicides. According to the Centers for Disease Control and Prevention (CDC), suicide rates rose 37% from 2000 to 2018 and fell 5% from 2018 to 2020, but they almost peaked in 2021.

Rebecca Bernert, the director and founder of the Stanford Suicide Prevention Research Laboratory, calls suicide the “tragic outcome of a medical illness and a complex set of risk factors.”

“COVID has exacerbated many of these risk factors and has challenged an already strained or overburdened healthcare system,” she tells Yahoo Life. “This increased risk in vulnerable individuals and further limited access to care – a central barrier to prevention and our ability to intervene.”

Why not 911?

Draper said of 988, “I hope we will forget 911 altogether as we reflect on mental health and suicidal crisis for generations to come.”

That’s because one problem with calling 911 for mental health emergencies is that it can lead to involuntary mental health care through the emergency room or mental hospital. While the intent in that case is to resolve an emergency, it can backfire: Research shows that suicide rates increase after people are released from mental hospitals, especially those sent there against their will. Those who did receive involuntary treatment were also much less likely to reveal suicidal thoughts in the future.

Ashley Peña, executive director at Mission Connection, says it may be time to reach out to the hotline “if you’re struggling with feeling hopeless, helpless, like a burden, or alone, get in touch.” She recommended that people also contact 988 “immediately” if they have thoughts of hurting themselves.

How is 988 doing in its first year?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “Nearly 98% of people who call, chat or text the 988 Lifeline receive the crisis support they need and do not require any additional services at the time.”

A press release from SAMHSA states that the number of calls to the Lifeline has increased significantly since the launch of 988. The number of SMS contacts via the Lifeline has increased by 1,135%, the number of answered chats has increased by 141% and the number of calls answered has increased by 46%. People were also able to get in touch with a counselor more quickly, with the average response time for contacts decreasing from 2 minutes and 39 seconds to 41 seconds.

One potential problem 988 could run into is funding. According to data from KFF, the Henry J. Kaiser Family Foundation, response rates in the state currently vary widely between states, from 55% to 98%. While the federal government has invested in the launch and implementation of 988, going forward it will be the responsibility of state and local governments to fund local crisis centers. As of June 2023, 26 states have passed legislation to help support 988.

How 988 improves

SAMHSA tries to ensure that 988 is accessible to as many people as possible. In the press release celebrating the first anniversary of 988, Spanish text and chat services were announced as an additional feature.

The 988 lifeline already uses LanguageLine Solutions to provide translation services in over 240 additional languages. There are also plans to add video telephony to better serve the deaf and hard of hearing.

The lifeline also partners with Vibrant Emotional Health, which offers assistance to “LGBTQI+ youth and young adults under the age of 25 who want to connect with a counselor specifically focused on meeting their needs.” During the pilot program, which launched in September 2022, 6% of calls, 11% of chats, and 15% of texts routed to the 988 Lifeline network used Vibrant Emotional Health counselors.

If you or someone you know is having suicidal thoughts, call 988.

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