As of July 16, anybody can contact a certified counselor at a National Suicide Prevention Lifeline crisis center by calling, texting, or chatting with 988. The National Suicide Hotline Designation Act of 2020 gave rise to a three-digit dialing code that is intended to be simpler to remember than the existing number, 1-800-273-TALK (8255), and to provide a direct channel for those going through any kind of emotional distress, not only a suicide crisis.
Suicide is the second-leading cause of death among adolescents between the ages of 10 and 14 and 25 and 34, according to the U.S. Centers for Disease Control and Prevention. Since its debut in 2005, The Lifeline has answered more than 20 million calls. However, according to the network’s quarterly statistics, one in six calls to the crisis line are dropped before a counselor can answer them.
Hannah Collins, director of marketing and communications for Vibrant Emotional Health, which manages the Lifeline, notes that 80% of callers who hang up after waiting two minutes or less after the greeting. According to Collins, 28 percent of calls that were categorized as abandoned by the caller in 2021 were contacted again within 24 hours and linked to a counselor.
Long wait times and poor response rates, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), which funds the National Suicide Prevention Lifeline, are mostly due to previous underfunding and underresourcing in terms of the availability of qualified counselors. In order to implement 988, the Biden-Harris administration set aside $282 million in 2021 and another $150 million in 2022, with $177 million of the 2021 monies going to Vibrant. Locally, the law that led to the creation of the new number permits states to enact telecommunications fees to assist in funding 988 operations as well as access grants and other mental health programs.
According to Collins, “these funds are currently being used to pay crisis centers in the Lifeline network, which includes the national backup network, chat and text network, and Spanish subnetwork, as well as to keep developing the services and infrastructure required to support 988.” Despite an increase in volume, more Lifeline calls, chats, and messages are now being answered and done so more quickly because to these timely investments.
The National Suicide Prevention Lifeline is a network of more than 200 crisis centers across the nation and provides free, round-the-clock crisis counseling. To assist with the anticipated surge of callers, it is stepping up hiring for both paid personnel and volunteers. The number of calls, chats, and messages placed to the Lifeline increased by 13%, 148%, and 77% respectively between June 2021 and June 2022. The network is also in the process of expanding the number of national backup centers it uses from nine in March to 17 by the end of August when local centers are at capacity.
However, Rachel Bhagwat, director of policy at NAMI Chicago, questions if it will be sufficient.
“Roughly 30% of calls in Illinois are being dropped before being answered, and the reason is a lengthy wait. Because of this, we must provide adequate financing and construct appropriate infrastructure. Because of this, NAMI chapters all over the nation—from our national affiliate all the way down to the local level—are advocating for the big idea of an all-inclusive crisis system, according to Bhagwat. “We’re examining what sustainable funding would entail. What would it look like to bridge the gaps in the crisis continuum while still being coordinated and creative? It involves more than just being prepared to pick up the phone. What occurs next is the subject.
A qualified crisis worker at the Lifeline crisis center nearest to them will answer any calls or texts to 988 or messages left on the Lifeline website. The crisis worker will then listen to the caller’s story and offer any necessary support and resources. Callers to Lifeline do not need to be suicidal. Anyone who needs emotional support, is worried about a loved one, or is experiencing a substance use crisis can access the network.
According to Bhagwat, “in the last few years, we’ve seen an increase in both people who are willing to reach out for help with their mental health and those who are facing mental health emergencies.” The problem is that our system is incredibly complicated, making it difficult to know who to contact in a mental health emergency.
In accordance with the National Suicide Hotline Designation Act of 2020, the Departments of Health and Human Services and Veterans Affairs must also collaborate to “develop a strategy to provide access to competent, specialized services for high-risk populations such as lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth; minorities; and rural individuals.”
Because there is a dearth of preventive and community treatment, Bhagwat says, “we know that people from Black and Brown communities and those from lower-income communities are more likely to get mental health care through the police, jails, and the crisis system.” We also know that folks who have previously been excluded or who are dealing with other difficulties are less inclined to trust systems and are more afraid of what it would be like to deal with them.
SAMHSA has revealed its grander vision for 988, which includes “a day when everyone across our country has someone to contact, someone to respond, and a secure place to go for crisis care,” in an effort to help dispel such obstacles and anxieties.
Not much will change immediately after the launch on July 16, according to Bhagwat. This launch is a tremendous first step toward truly redesigning our mental health crisis system, but the actual effort needs to continue for many years beyond that.