The launch of a three-digit mental health emergency number this month is being seen by many as an important step forward in expanding access to mental health support at a time when Interest is still high about long-term psychological and emotional effects of the COVID-19 pandemic.
Starting Saturday, National Suicide Prevention Hotline – funded through the Substance Abuse and Mental Health Services Administration and managed by the nonprofit Vibrant Emotional Health Foundation – is planned to expand and receive Calls or texts are sent to the new three-digit emergency number, 988, along with previous calls and messages to the hotline at 1-800-273-8255.
Goal: Provide people with easier access to appropriate crisis counseling and referrals to resources and support, as well as mobile intervention team visits to available areas those services. Some experts say that the new 988 prefix marks the first major step forward in many years in efforts to create ongoing care for people with mental health crises.
Shawn Coughlin, president and CEO of the National Association for Behavioral Health Care, acknowledges the initial process to improve the nation’s mental health crisis response system will be one Take the right steps and get started. It is hoped that the move to 988 will accelerate the delivery of mental health services over time by helping state and local governments identify gaps in their systems, he said.
“The idea is that this will really help us identify areas where the system is lacking and where we need to improve,” Coughlin said.
But while 988 is supposed to be a common emergency number – and has been mandated by the federal government – the challenges of building the infrastructure to help callers fall on each state. The initial concern was simply awareness: Results of an online survey of more than 2,000 people conducted in May for National Alliance on Mental Illness showed that 77% of respondents said they had never heard of the number 988 – a number that is virtually unchanged from the results in October.
“We can’t take years – these things need to be figured out pretty quickly,” said Robert Gebbia, executive director of the American Foundation for Suicide Prevention.
Gebbia said raising awareness of the 988 will be crucial in determining how quickly it becomes the default for mental health crisis response rather than the 911 emergency system. But he feels Since many calls to 988 will be handled by a counselor over the phone and do not require a direct response like 911, implementing the new system is a bit easier.
“When individuals start talking to a counselor, it should be their gateway into the mental health system. Those services can start to be offered right then and there,” Gebbia said.
Colleen Carr, director of the National Coalition for Action on Suicide Prevention, said in a recent press call that her organization recently worked with several partners to create a framework for a messaging campaign that aims to help stakeholders raise awareness of 988 while ensuring outreach is consistent with the availability of local resources.
“We know crisis services look different depending on where you live,” says Carr. “So it’s really important that our message is built on the right framework when we speak to the public about 988.”
Under the existing system, calls to the National Suicide Prevention Lifeline are answered by a mix of volunteers and paid mental health professionals working at one of more than 180 centers. crisis centers around the country. According to one December report from the Substance Abuse and Mental Health Services Administration, Lifeline received approximately 3.3 million contacts in 2020 from a combination of phone calls, text messages and chats. online.
The estimates in the report show the volume of meetings with 988 – including those that were directed to a Veterans Crisis Series – can reach between 6 million and 12 million after the first year of implementation, increasing from 13 million to 41 million in the fifth year. Notably, as the COVID-19 pandemic continued, the proportion of adults with recently reported symptoms of anxiety or depressive disorder increased from 36.4% to 41.5% over the time period. from August 2020 to February 2021, according to an analysis of Centers for Disease Control and Prevention.
Miriam Delphin-Rittmon, assistant secretary for mental health and substance abuse at the Department of Health and Human Services and leader of SAMHSA, said in a recent press call that the Biden administration invested a total of $432 million in the transition to 988, including $177 million dedicated to enhancing and expanding existing Lifeline network infrastructure and operations, $105 million to help local crisis call centers and add $150 million as part of Bipartisan Safer Communities Actpassed by Parliament in June.
However, countries are responsible for much of the capacity and stability of the system, and there are various advances in efforts to build the necessary infrastructure to meet pending demand.
“At the end of the day, states are responsible for most of the funding and implementation,” says Coughlin. “And there is growing evidence that not all states are at the same level or interact as deeply as others.”
Megghun Redmon, sales manager of US Suicide Prevention Service – the company that runs a crisis call center in the Chicago area – said the transition to 988 means trying to attract more paid staff to make up for the shortage of volunteers . However, she said delays in getting funding from the state made it difficult to recruit and hire the amount of staff needed to run the call center 24 hours a day.
“They were very slow to spread the money, so the financial resources were not available to hire workers,” Redmon said. “So it’s this kind of domino effect.”
Gebbia Says He Was Encouraged By President Joe Biden’s proposed fiscal year 2023 budgetcalls for $697 million for “the 988 program and Behavioral Health Services.”
But other, more sustainable sources of funding will need to be found at the state level to ensure call centers have the resources they need. Among the more popular proposals is for states to levy a new telecommunications fee to help pay for the 988 system, similar to how the 911 system receives funding in many states.
Gebbia said: “The nations will have to do their part. “We think telecom fees are the way to go.”
Data to help detail demand: From From April to June this yearOnly six states and the District of Columbia had at least 90% of calls on the National Suicide Prevention Lifeline answered within their borders, compared with 10 states where 66% fewer calls were received. respond from within the state. According to LifelineCallers not answered by the call center in their state will be redirected to a national backup center, and those rerouted outside of their state may have a longer wait and are more likely to drop the call before they get help.
Recently Wall Street Journal report also found that between 2016 and 2021, 1 in 6 calls to the National Suicide Prevention Lifeline ended before a caller spoke to a counselor. Hannah Collins, director of marketing and communications for 988 Lifeline and Vibrant Emotional Health, said the call abandonment rate is about 17% by 2021, but explained that that number includes people who have chosen to disconnect themselves. connect before connecting with others. She said 80% of callers drop a call after waiting two minutes or less after saying hello, and of those calls, 28% in 2021 called back within 24 hours and were connected to a staff member. advise.
Gebbia says having access to some form of support during a mental health crisis can play an important role in reducing suicide risk. He estimates that half of all deaths are by suicide Do not receive any form of mental health care at the time of their death.
“It’s a very dangerous void,” Gebbia said. “When someone has the courage to reach out and ask for help, we have to make sure they get it.”
Advocates say one of the long-term goals around the new 988 system is to provide responses that avoid the involvement of law enforcement. 2015 report from non-profit organization Treatment Advocacy Center says that an estimated 1 in 4 fatal police encounters involve someone with a serious mental illness.
Hannah Wesolowski, advocacy director for the National Alliance on Mental Illness, said it was estimated that anywhere from 80% to 98% of calls to 988 could be resolved by phone, thus reducing The need for a direct response to a mental health crisis is usually handled by the police. But she says alternatives to avoid potentially criminalizing someone in the midst of a mental health crisis are still needed to support the remaining 2% to 20% of calls with direct intervention.
“When direct response is required, having mobile crisis teams composed of behavioral health professionals dispatched to the scene is far more effective than relying on law enforcement for a job they are not registered for. for and not equipped to handle,” she said.
Mobile Crisis Team available in some states, like Georgia, to respond to mental health emergencies. Wesolowski said states should also invest in creating crisis stabilization facilities that can provide short-term assistance and connect people to long-term assistance.
“Two million times Every year, people with mental illness are placed in our nation’s prisons, Wesolowski said. “It’s notoriously difficult to get mental health treatment in a criminal justice setting.”
Lisa Dailey, executive director of the Treatment Advocacy Center, says law enforcement involvement in mental health emergencies is a symptom of longstanding gaps in public mental health system.
The birth of the 988 is an opportunity for health care and social services to flourish, she said.
“Over time, it became clear that this was a better system,” Dailey said.
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