September 25, 2023

What works and what doesn’t with the 988 Suicide & Crisis Lifeline

The mental health center in Houston, Texas is a great example of how the 988 Suicide & Crisis Lifeline is doing nationwide.

Employees like Jennifer Battle and others have responded to more than 52,000 emergency calls from local Texans — in the past 12 months alone. That’s an 80% pick-up rate, compared to 45% under the old system before it was renewed by the federal government in 2022.

It’s not a perfect system, says Battle. But the progress over the past year has been “extraordinary”, especially as the number of calls has grown exponentially. The state has the third highest call volume only to California and New York, she said.

The Biden administration launched the 988 phone number a year ago through the Substance Abuse and Mental Health Services Administration to replace an old 10-digit number. Since launch, hotline responders have answered most, but not all, of the 5 million calls, chats, and texts they’ve received.

A 988 call is for a different type of emergency and carries a different focus of help than 988. The 988 call center provides 24/7 call, text, and chat access to trained crisis counselors who can help people who are suicidal, resources use and/or mental health crisis or any other type of emotional distress, according to federal officials.

The 911 system focuses on dispatching emergency medical services, firefighters, and police. Only a small percentage of 988 Lifeline calls require activation of the 911 system.

Suicide, depression and anxiety grew at record levels during the pandemic, several studies show, and the government wanted to create an easy way for Americans to seek help amid the growing need.

The Biden administration initially invested in the hotline with $1 billion in spending to ramp up services and has continued to fund it. The Department of Health and Human Services announced an additional $200 million for the crisis line in May, in part to help states speed up response times, “ensure access to culturally competent 988 crisis center support” and improve follow-up services.

“Our country’s transition to 988 moves us closer to better serving the crisis health care needs of people across America,” said Xavier Becerra, then secretary of the U.S. Department of Health and Human Services. “988 will not be a busy signal and 988 will not put you on hold. You will receive assistance.”

Battle, the vice president of community access and engagement at The Harris Center for Mental Health and Intellectual and Developmental Disabilities, said she is ecstatic about the progress, but there is room for improvement.

Harris Center staff have been unable to answer some calls coming through the hotline due to a lack of resources, and people calling in are directed to the service closest to their phone number’s area code instead of their phone number. exact location for example.

Mental health experts, state and local providers, and Americans who have used the suicide and crisis hotline have shared both the hotline’s ups and downs.

Service providers told US TODAY that the crisis line has a long way to go before it becomes as efficient as the 911 emergency number and that more staff and money is needed to get there, but that it is a good starting point. They said the hotline has provided an efficient way for people to talk to a trained professional if they are in crisis, and provides a route for those in need, such as youth and veterans, to ask for help.

Other Americans who have used the social media hotline or have been hesitant to use it have said mistrust in the service remains, especially those fearful of police involvement. Some have said it saved them in a time of need.

What works with the 988 Suicide & Crisis Lifeline?

The 988 Suicide & Crisis Lifeline has received more than 5 million calls and texts since its launch in the summer of 2022, according to data from the Substance Abuse and Mental Health Services Administration.

For example, of the 402,494 calls, texts, and chats the hotline received in May 2023, responders answered 89% of calls, 98% of chats, and 93% of texts. Those percentages have changed as of July 2022, when responders received 354,625 requests for help and answered 83% of phone calls, 82% of chats, and 94% of text messages.

“Data continues to show an increase in calls, texts and chats over the previous year, while at the same time response rates are improving significantly, meaning more people are getting help and they are getting help faster, which is critical for someone in crisis,” said Miriam E. Delphin-Rittmon, assistant secretary for mental health and substance use in the Department of Health and Human Services and the chief of the Substance Abuse and Mental Health Services Administration.

Of all calls made to the hotline in the past year, the department estimates that “nearly 1 million,” or one-fifth of those, were answered by Veterans Crisis Line, which is linked to the 988 Lifeline.

“There is nothing more important to VA than preventing veterans from committing suicide — and that means veterans need to get the support they need, right when they need it,” said Denis McDonough, the secretary of the Department of Veterans Affairs.

The Department of Health and Human Services announced Thursday that it has added Spanish text and chat services to its existing hotline. Earlier this month, that division expanded “specialized services” for LGBTQI+ youth and young adults, which were recently added to the list of services offered through the hotline.

Ashley Peña, an executive director of Mission Connection, an intensive outpatient telehealth program, said the hotline “has been a game changer” especially for young people because of the texting option it offers.

“We have people that we serve who sometimes use it on a weekly basis,” she said. “It’s been really powerful for that age group.”

Phone companies must allow people to both text and call a new

Phone companies should allow people to text and call a new “988” number for the suicide prevention hotline, regulators say.

What’s not working with the helpline?

Mistrust of the hotline, particularly in communities where mental health is stigmatized, still exists, Peña said, and breaking it is critical to the hotline’s future success.

Some people worry about emergency workers calling local police because they express suicidal thoughts, or even being forced to go to a psychiatric hospital, she said.

On Thursday, the National Alliance for Mental Health released the results of a new study showing that “58% of Americans are somewhat confident, and 22% are very confident, that 988 would provide them with the help they need — even if they are not personally familiar with it or know of anyone who has contacted the Lifeline.”

Some suggestions that providers and people who have used the hotline have said it could improve include:

  • Improving the location where the hotline directs Americans to better align with where they are. The hotline directs someone calling the nearest connected provider to the area code from which someone is calling. If someone has an area code that is different from the area they live in, emergency responders should connect that person with more local information. It’s a barrier, Battle said, because it adds an extra step that some callers may not want to wait for.

  • Investing in more staff and improving the workforce so that qualified responders can answer all calls quickly and efficiently.

  • Providing permanent funding to providers for the program, in part to account for callers who may not have insurance to cover mental health care, including therapy, Peña said.

  • Raising awareness about the resource, Peña said. The National Alliance on Mental Health research shows that “fewer than 1 in 5 people are somewhat or very familiar” with the crisis line.

How are Americans’ mental health doing??

Suicide, depression and anxiety rates increased during the pandemic and are continuing. Young people are especially at risk. A new report from the National Institute of Mental Health shows that youth suicide rates have risen during the pandemic, making it the “leading cause of youth death in the United States.”

The Centers for Disease Control and Prevention found that teen girls experienced more grief, violence and suicide risk in 2021 than years before. And another 2021 study from the group shows that “suicide was the second leading cause of death for people ages 10–14 and 25–34.”

Recent data from a national survey conducted by the Substance Abuse and Mental Health Services Administration shows that approximately 12.3 million people age 18 or older, or 4.8%, “had serious suicidal thoughts. About 3.3 million youth aged 12 up to age 17, or 12.7%, had similar thoughts.

Bigger differences: Suicide rates rise after 2 years of decline

CDC survey finds: Teenage girls report record levels of violence, grief and suicide risk

Please contact Kayla Jimenez at Follow her on Twitter at @kaylajjimenez.

This article originally appeared on USA TODAY: One Year Later: 988 Hotline Has Received 5 Million Calls, Texts

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