What Works and What Doesn’t with the 988 Suicide & Crisis Lifeline

The Mental Health Center in Houston, Texas is a good example of how the 988 Suicide & Crisis Lifeline is doing across the country.

Staff members such as Jennifer Battle and others have fielded more than 52,000 crisis phone calls from local Texans – in the last twelve months alone. That’s an 80% pickup rate, down from 45% under the old system before it was overhauled by the federal government in 2022.

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

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

A call to 988 is for a different emergency and provides different help than 911. The 988 call center offers 24/7 access to calls, texts and chat with trained crisis counselors that can help people who are suicidal, addicted and/or have a mental health crisis or any other type of emotional distress, according to federal officials.

The 911 system focuses on the dispatch of emergency medical, fire and police services. Only a small percentage of Lifeline 988 calls require the 911 system to be activated.

Suicide, depression and anxiety have risen in record numbers during the pandemic, according to multiple research, and the administration wanted to create an easy way for Americans to seek help in the face of growing need.

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

“Our country’s transition to 988 brings us closer to better meeting the crisis care needs of people across America,” said Xavier Becerra, secretary of the U.S. Department of Health and Human Services, at the time. . “988 will not be busy and 988 will not put you on hold. You will get help.”

Battle, vice president of community access and engagement at the Harris Center for Mental Health and Intellectual and Developmental Disabilities, said she was pleased with the progress, but there was room for improvement.

Staff at the Harris Center have been unable to respond to some of the incoming calls through the helpline due to lack of resources, and callers are being directed to the service closest to the area code. their phone number instead of their exact location, for example.

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

Service providers told USA TODAY that the crisis line has a long way to go before it becomes as effective as the “911” emergency phone number and will need more staff and funding to get there, but that it is at a good start. They said the hotline has provided an effective way for people to speak to a trained professional when in crisis, giving people in need like young people and veterans a way to seek help.

Other Americans who have used or hesitated to use the hotline on social media said mistrust of the service persists, especially those who fear police involvement. Some have said it saved them in time of need.

What works with the 988 Suicide & Crisis Lifeline?

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

Out of 402,494 calls, text messages and chats received by the hotline in May 2023, for example, responders responded to 89% of calls, 98% of chats and 93% of texts. These percentages have changed since July 2022, when responders received 354,625 requests for help and responded to 83% of phone calls, 82% of chats and 94% of text messages.

“The data continues to show an increase in the overall number of calls, texts and chats compared to the previous year, and at the same time response rates are improving significantly, which means that more people get help and they get help faster, which is crucial for someone in crisis,” said Miriam E. Delphin-Rittmon, assistant secretary for mental health and addictions at the ministry. of Health and Human Services and head of the Substance Abuse and Mental Health Services Administration.

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

“There is nothing more important to VA than preventing veteran suicide – and that means giving veterans the support they need, exactly when they need it,” said Denis McDonough, Secretary of the Department of Health. Veterans.

The Department of Health and Human Services announced on Thursday that it had added Spanish text and chat services to the existing hotline. Earlier this month, this department expanded “Specialty Services” for LGBTQI+ youth and young adults, which was recently added to the list of services offered through the hotline.

Ashley Peña, 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 we serve who sometimes use it every week,” she said. “It’s really powerful for this age group.”

Phone companies must allow people to text as well as call a new

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

What doesn’t work with the hotline?

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

Some people fear responders will call local police for expressing suicidal thoughts, or even that they have been forced into a psychiatric hospital, she said.

On Thursday, the National Alliance for Mental Health released the results of a new study which shows that “58% of Americans have some confidence, and 22% have a great deal of confidence, that 988 would get them the help they need. need – even if they don’t know him personally or know anyone who has contacted the Lifeline.”

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

  • Improve the location the hotline directs Americans calling to to better align where they are. The hotline directs a caller to the nearest affiliate provider to the area code a caller is calling from. If someone has a different area code than the area they live in, responders will need to connect that person with more local information. That’s a hindrance, Battle said, because it adds an extra step that some callers may not want to wait.

  • Invest in more staff and improve the workforce so that qualified responders can answer all telephone calls quickly and efficiently.

  • Giving providers ongoing funding for the program in part to accommodate callers who may not have insurance to cover mental health supports, including therapy, Peña said.

  • Increase awareness of the resource, Peña said. Research from the National Alliance for Mental Health shows that “less than 1 in 5 people are somewhat or very familiar” with the crisis line.

How is the mental health of Americans?

Rates of suicide, depression and anxiety have increased during the pandemic and have persisted. Young people are particularly at risk. A new report from the National Institute of Mental Health shows that youth suicide rates have increased during the pandemic, and it’s the “leading cause of death among young people in the United States.”

The Centers for Disease Control and Prevention found that teenage girls experienced more sadness, violence and risk of suicide in 2021 than in previous years. And another study from the 2021 group shows that “suicide was the second leading cause of death among people aged 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 aged 18 or older, or 4.8 percent, “had serious suicidal thoughts.” About 3.3 million young people aged 12 to 17, or 12.7%, had similar thoughts.

The disparities are widening: Suicide rates rise after 2 years of decline

The CDC investigation reveals: Teenage girls report record levels of violence, sadness and suicide risk

Contact Kayla Jimenez at kjimenez@usatoday.com. Follow her on Twitter at @kaylajjimenez.

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

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