US Has New Crisis Hotline: 988. Is It Prepared For A Surprise Call?

Americans in distress have a new number to call for help – 988, a revamped National Suicide Prevention Lifeline that is being billed as the 911 of mental health.

The numbers, will go live on Saturday and is supported by more than $400 million in federal funding, in response to the rising tide of mental illness in the United States. But concerns persist that short-term call centers nationwide may not be ready to face this increase.

Many people who have called the Hotline in recent months have disconnected before they can get help. According to an analysis of data by The New York Times, about 18% of the nearly 1 million calls to Lifeline in the first half of this year were dropped. One previous time analysis in March discovered similar issues, and the switch to a well-publicized three-digit phone number is expected to strain capacity further.

Xavier Becerra, secretary of health and human services, welcomed the efforts to prepare for 988 while acknowledging that extensive work still lies ahead. “Once you get that, someone has to answer the phone,” he said in an interview. “It’s not good enough to receive a busy or paused signal.”

Hundreds of millions of federal dollars have made a huge splash for Lifeline over the past half year. The money has helped a longtime underfunded crisis line – long answered by a patchwork of call centers, often nonprofits that arrange several hotlines and rely on both paid consultants and volunteers – enlisted more phone banks across the country, bringing the total from 180 to over 200.

The funding has also strengthened a Spanish-speaking network; national backup centers where counselors can receive unanswered calls locally; and digital messaging services, seen as an important tool for reaching younger people who need help.

Lifeline’s messaging and chat lines received about 500,000 contacts in the first half of 2022, but only about 42% of them were answered. However, data provided by the organization that administers Lifeline shows a steady improvement – response rates increased to 74% in June and average wait times dropped from 16 minutes in January to around 3 minutes. last month.

There was no significant increase in response rates for phone calls, although one 988 goal was to eventually answer 95% of them within 20 seconds. Lifeline says 80% of callers who disconnected last year did so within two minutes of the automated greeting, and about a quarter of those hung up tried again within 24 hours and passed.

John Draper oversees Lifeline and is the executive director of the nonprofit Vibrant Emotional Health, which manages services for the Substance Abuse and Mental Health Services Administration. Mr Draper pointed to a “significant increase” in responses to digital messages. He predicts that the new investments will lead to improvements in phone call answering in the coming months, noting that call centers have been able to catch up with a steady increase in numbers. .

“We want to make sure that we are responding to everyone who is in crisis,” he said.

But less than half of the public health officials responsible for implementing 988 feel confident that their communities are prepared, according to a recent survey by RAND Corporation.

Lifeline’s overhaul isn’t just limited to calls, texts, and chats. While data shows that hotlines can resolve about 80% of crises without further intervention, 988’s vision is that counselors will eventually be able to connect callers with groups Mobile crisis management can reach where they are, as well as short-term mental health triage centers.

The changes are supposed to reduce law enforcement intervention and reliance on emergency rooms, ultimately keeping more people, advocates say.

The new Lifeline comes at a time when mental illness is on the rise, including what the US surgeon general called a “devastating” crisis among young people. Suicide is the 12th leading cause of death for Americans of all ages in 2020, According to the Centers for Disease Control and Preventionand is the second leading cause of death between the ages of 10 and 14 and 25 to 34. One in every person dies by suicide 11 minutes in 2020. Many believe the pandemic has exacerbated mental health problems, and the hotline has been revamped to extend beyond suicide to help anyone in crisis.

Despite the expected increase in volume, questions remain about long-term sustainable funding for the 988. That’s partly because of the law establishing it, signed into law by President Donald J. Trump last month. October 2020 with bipartisan support, leaving call center funding largely to the states. .

While it does give states the option to raise money for the 988 the same way they do for 911, with a monthly fee on the phone bill, only four states authorized to charge the phone bill. Many other states have used grants or mutual funds or have enact other laws to prepare for the new Lifeline.

“I think 988 represents the best and worst of the way America approaches mental health,” said Benjamin F. Miller, psychologist and president of the Well Being Trust, a mental health organization. God. “At best, it’s ingenuity, creativity, positioning. At its worst, it’s lack of resources, lack of leadership and follow-up. “

Dr. Miller is concerned about whether funding will be ongoing, he said, because mental health in the country has always been an “afterthought”.

“It’s the fringe aspect of our healthcare that we continue to avoid investing heavily in,” he said.

Jennifer Piver, executive director of Greenville County’s Mental Health America, the only 988 call center in South Carolina, says federal funding has allowed her to fill eight new positions. But she fears that won’t be enough in the long term and said her team is seeking grants and raising money through the GoFundMe page.

“I’m sure we’ll be fine on Saturday,” Ms Piver said. “But you know, dealing with that growth isn’t something we’re financially prepared for in terms of staff.” The center answers more than 80% of calls in the state, but if funding stays the same, she says, “we can see that number drop pretty quickly to 50, 40, even 30% when you take into account that some systems will change. “

The national labor shortage has also affected the ability to hire and retain employees. The Substance Abuse and Mental Health Services Administration has a long page on its website list job opportunities nationwide.

Hannah Wesolowski, lead advocacy director for the National Alliance on Mental Illness, said the workforce was a problem for the mental health sector “long before the pandemic.”

While a lot of work has been done since 988 was signed into law, Ms Wesolowski said, “we are trying to build a comprehensive system and that will take more than two years”.

Representative Tony Cárdenas, Democrat of California and key proponent of the 988 congress, noted that 911, founded more than 50 years ago, “didn’t start without a hitch”.

Despite the uncertainties, backers still hope that the 988 will live up to its promise.

“Everybody’s life is on the line, so we have to get there,” said Preston Mitchum, advocacy director at The Trevor Project, a crisis intervention organization for LGBTQ youth.

“We’ll get there.”

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