Less than a year before ‘988’ suicide help number is activated, some states may not be ready

WASHINGTON – A new three-digit phone number for the National Suicide Prevention Lifeline, set to launch next July, is expected to increase the use of mental health crisis services as access becomes easier.

But advocacy organizations worry some states may not have the funding or capacity to support increased use of the “988” hotline and its related programs.

“We’re envisioning the number… to be a way to really transform the way national crisis response is handled in the United States,” Laurel Stine, senior vice president of public policy for the American Foundation for Suicide Prevention, told Capital News Service. “It’s a pivotal moment for the mental health and behavioral health community.”

The “988” line is intended to be a faster, easy-to-remember way to get help in a mental health emergency. Calls to the new number will be routed to the already-in-existence National Suicide Prevention Lifeline.

The Maryland Department of Health is expecting an increase in the volume of calls and messages once 988 goes live, spokesman David McCallister said in an email to CNS.

“We expect contact volume to increase due to ease of remembering a three-digit number,” McCallister said.

An increase in calls means additional costs for local crisis centers in the hotline network that field calls and provide care.

McCallister said the federal government has provided funding to states, including Maryland, through the American Rescue Plan Act of 2021 to support these services. Maryland is using those funds to support crisis call centers, he said.

The state has also submitted a draft plan addressing issues like funding and capacity to Vibrant Emotional Health, the administrator of the hotline. McCallister said the department is awaiting feedback on the draft plan. The finalized plan is due in January.

According to a state legislation map provided by the mental health advocacy group National Alliance on Mental Illness, only 20 states have so far had even proposed 988-related bills for funding and implementation.

Federal funding for the hotline flows through the Substances Abuse and Mental Health Services Administration. According to a press release from that agency, the Biden administration’s proposed budget for Fiscal Year 2022 allots $102 million for the transition to 988, in addition to separate funding for other suicide prevention programs.

The proposed federal funding is “significant,” according to Stine. “However, we believe that additional resources are needed.”

Cost estimates for one year of nationwide implementation for the three-digit number go as high as $240 million, she explained.

When Congress cleared the way for the establishment of the three-digit number with the passage of the National Suicide Hotline Designation Act of 2020 last fall, it included provisions to allow individual states to levy taxes on phone bills to help fund and implement the hotline and crisis intervention services that would follow calls for assistance. That bill was signed into law by then-President Donald Trump.

Four states so far have passed bills including phone bill fees for this purpose. One signed into law in Virginia establishes a 12-cent fee for most wireless phone plans, and an 8-cent fee for prepaid wireless plans, which will fund crisis call centers in the state.

But because individual states need to develop their own funding and implementation plans, there is some concern among mental health advocates that they won’t all be ready for the “988” launch less than nine months from now.

“This kind of crisis infrastructure is going to take a lot of communities some time to develop, but they need to get started now,” said Angela Kimball, national director of government relations, policy, and advocacy for the National Alliance on Mental Illness.

“The real fear though, is that if people call 988 and expect a mental health response, we want them to get a mental health response,” Kimball said. “We don’t want what we’ve always had, which is typically a law enforcement response.”

Kimball explained that police calls to mental health emergencies have sometimes led to arrests, inappropriate uses of emergency departments and hospitals, as well as deaths.

“That kind of trauma and tragedy is the last thing that we need,” Kimball said.

On average, 130 people die by suicide every day in the United States, according to the American Foundation for Suicide Prevention. As a result, crisis intervention and care are major public policy priorities for mental health advocacy organizations.

Those groups say the work doesn’t stop at providing the hotline — there needs to be a system that addresses the need for care after someone calls.

“There is a subset of people, about three in 10, for whom the phone call isn’t going to be enough,” Kimball explained.

In 2020, the National Suicide Prevention Lifeline received 2.4 million calls.

Of those calls, 42,934 came from Maryland. About two-thirds of those Marylanders were connected with one of the eight crisis centers covering all regions in the state.

These crisis centers are facilities for people experiencing a mental health crisis where they can receive an evaluation, care, and referrals for more long-term treatment. Advocates say they are more effective and humane alternatives to placing someone in a hospital emergency department during a mental health crisis.

“A lot of our work is focused on the states in order to ensure that states take up legislation to fund the work,” Stine said. “And so we’re devoting a lot of our time to this.”

The 988 three-digit hotline is not yet operational. If you are struggling with thoughts of suicide, call the National Suicide Prevention Lifeline at 1(800)273-8255 or visit its website at https://suicidepreventionlifeline.org/

By KELLY LIVINGSTON
Capital News Service