Help for a mental health crisis is down to triple digits: 9-8-8.
Early data shows people are increasingly turning to a national mental health hotline launched July 16 as an easy-to-remember alternative to 911. But how does it work? And is it “friendly”?
Instead of being directed to the police, callers (or texters) are connected with compassionate listeners trained to talk about crises ranging from suicidal thoughts to substance abuse. They can even counsel people who aren’t in crisis but are hoping to help a struggling friend. It’s free and staffed 24 hours a day.
“We want to make sure that we give people effective, evidence-based care in a crisis, rather than giving them care that forces them to go through incarceration, hospitalization, emergency room visits, over and over. again, which has always been how we’ve approached the crisis in this country,” said Hannah Wesolowski, advocacy manager for the National Alliance on Mental Illness.
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Before 988 went live, those seeking help had to dial a 10-digit 800 number to reach the National Suicide Prevention Lifeline. Calls to this number — (800) 273-TALK — will always be answered.
An increase in use
In August, the hotline’s first fully operational month, its overall volume – including calls, texts and chats – jumped 45% across the country, compared to the same month last year for the Lifeline, according to the US Department of Health and Human Services.
Meanwhile, the average time it took for a response has decreased year on year, from 2½ minutes to 42 seconds. The Substance Abuse and Mental Health Services Administration, which is part of Health and Human Services, oversees the helpline.
Didi Hirsch Mental Health Services, who leads crisis call response for most of Southern California, said her call volume doubled the day 988 went live.
The number has since declined, but the West Los Angeles agency said that as of September 12, its overall volume since the July launch had increased by 27%. Text messages increased by 176% and chats decreased by 20%. Calls increased by 27%.
“It’s a good thing. It means people are calling. They understand that 988 is there to help them,” said Lyn Morris, Managing Director of Didi Hirsch.
It sounds warm and fuzzy, but what about the fine print?
How do I access 988 services?
Anyone in the US can call or text 988. There is also an online chat option, 988lifeline.org/chat.
Didi Hirsch offers English and Spanish speaking crisis counselors 24/7. Korean speakers are available during peak evening hours and there is support for the deaf and hard of hearing. See the website, didihirsch.org, for more details.
Who will pick up or answer?
A crisis counselor trained in suicide prevention and the management of other mental health and addiction issues.
Where are the advisers?
988 calls are routed to the nearest crisis center that matches the caller’s area code.
For example, if you are calling from Los Angeles but still have a hometown number in Pittsburgh, your call will likely be answered first by someone in Pennsylvania.
If a local center cannot answer, the call is automatically routed to a national emergency center.
In the United States, there are 200 call centers. There are 13 such centers in California.
Will they know my location?
Unlike 911, calls to 988 do not use geolocation. That is, they do not track the address or location of the caller.
In a 2021 report, the Federal Communications Commission examined the cost and feasibility of adding geolocation to 988 calls. Federal officials hosted a forum in May to discuss adding the feature. The information collected during the forum is under review.
Will the police show up if I call 988?
It depends. The majority of 988 calls are resolved over the phone. However, 911 services can be wiretapped if the caller’s life is in imminent danger, such as a suicide attempt in progress.
Morris said about 5% of the calls, texts and chats that Didi Hirsch receives require an emergency response. That equates to 6,850 of the roughly 137,000 contacts the agency received last year.
The proportion drops to 2% nationally, according to federal officials. This represents approximately 72,000 of the 3.6 million contacts received by Lifeline last year.
The Los Angeles Police Department may redirect calls to Didi Hirsch when the caller is experiencing a mental health crisis and is not a danger to themselves or others. Of 5,000 calls made to Didi Hirsch last year, Morris said, 82% were defused over the phone. The remaining 18% were referred to the police.
Who pays for this?
The Biden administration has earmarked $432 million to bolster call centers and related services. The administration requested more money for Lifeline in its annual budget. Congress provided funding for the workforce, and a mental health legislative package that advanced out of the House would allocate $988 more federal dollars.
California executives paid $20 million to the hotline.
States are allowed to levy telecommunications fees to provide ongoing funding for 988, which is similar to how 911 is supported. A California bill that would add a monthly charge to every phone line starting Jan. 1, 2023, sits on Governor Gavin Newsom’s desk. The rate would remain at 8 cents per line until 2025, after which it could not exceed 30 cents per line.
“The transition to 988 is just the beginning,” Health and Human Services Secretary Xavier Becerra said in a statement.
The long-term vision of 988 is to rethink the national crisis response system. The Lifeline represents the first step, providing someone to call.
The architects of 988 envision a system that will also include someone to respond in person, such as mobile crisis teams, and a place to go, including crisis stabilization programs.
“It’s a work in progress,” Wesolowski said. “It’s going to take many years.”
In the meantime, she said 988 saves lives.
“For people who might be having suicidal thoughts or thoughts of harm, who might be in other types of crisis, having someone to talk to can make all the difference,” she said. “Knowing a 10-digit number is difficult at the best of times. Especially when you’re in crisis, it’s incredibly difficult.