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"988" to become national mental health crisis helpline number

As the switchover date approaches for telephone number 988, mental health organizations are calling for a reimagining of the crisis response system.
Credit: WPMT

HARRISBURG, Pa. — In July 2022, “988” will become the number to reach the National Suicide Prevention Lifeline. Advocates say the number is easier to remember, especially in times of stress such as a mental health crisis.

The National Suicide Prevention Lifeline was established in 2005. The lifeline received 2.1 million calls and 234,671 chats in 2020, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

Congress passed a law on Oct. 17 designating 988 as the universal number for the lifeline.

As the switchover date approaches, mental health organizations are calling for a reimagining of the crisis response system.

“The question the mental health community has: what help will be available on the other end of the phone?” said Hannah Wesolowski, director of government, policy and advocacy at the National Alliance on Mental Illness (NAMI).

Wesolowski believes mental health crises should be handled by mental health professionals—and not police—if possible. Currently about 20 percent of 911 calls are for mental health issues, according to the American Psychological Association.

“And the only response that’s available is a law enforcement response,” Wesolowski said. “We’re trying to change that paradigm.”

The new crisis response system proposed by NAMI and other mental health organizations includes three pillars:

  • 24/7 crisis call centers: “Someone to talk to”
    • All calls to 988 should be answered locally by staff who are well-trained and experienced in responding to a wide range of mental health, substance use and suicidal crises. Crisis call centers should be able to connect people to local services, including dispatching mobile crisis teams and scheduling follow-up appointments with local providers.
  • Mobile crisis teams: “Someone to respond”
    • Mobile crisis teams should be available for people in crisis who need more support than can be offered over the phone. Staffed by mental health professionals, including peers, these teams can de-escalate crisis situations and connect a person to crisis stabilization programs or other services. Mobile crisis teams should collaborate closely with law enforcement, but only include police as co-responders in high-risk situations.
  • Crisis stabilization programs: “Somewhere to go”
    • Some individuals in crisis will need more assistance from crisis stabilization programs that provide short-term observation and stabilization. These trauma-informed programs may also identify additional treatment needs and provide a “warm hand-off” to follow-up care, from peer supports and outpatient services to more intensive services, such as hospitalization.

Funding these changes remains a hurdle to achieving them.

The law that designated 988 as the official crisis lifeline number allows states to raise funds through fees on phone lines. One option is charging user fees similar to how states charge from 25 cents to $5 to use 911 services. Another is charging all phone lines a monthly fee.

So far 16 states have passed or are considering legislation with funding solutions.

Colorado, Nevada and Washington passed legislation with user fees. Virginia passed legislation with limited user fees. California, Kentucky, New Jersey and Massachusetts have legislation pending with user fees. Alabama, Illinois, Indiana, Nebraska, New York, Oregon, Texas and Utah passed legislation with no user fees.

Pennsylvania does not have any 988 funding legislation pending, though the Department of Human Services (DHS) allocated $340,000 in January to 13 crisis centers across the state for the transition:

  • Center for Community Resources, Butler, PA;
  • Keystone Health Crisis Intervention Program, Chambersburg, PA;
  • Safe Harbor Behavioral Health, Erie, PA;
  • Valley Creek Crisis Center, Exton, PA;
  • TrueNorth Wellness Services, Hanover, PA;
  • Lancaster County Crisis Intervention, Lancaster, PA;
  • Family Service Association of Bucks County, Langhorne, PA;
  • Montgomery County Emergency Service, Inc., Norristown, PA;
  • The City of Philadelphia, Philadelphia, PA;
  • Resolve Crisis Services, Pittsburgh, PA;
  • Centre Helps, State College, PA;
  • Resources for Human Development, New Perspectives Crisis Services, Stroudsburg, PA; and,
  • Chestnut Ridge Counseling Services, Uniontown, PA

“Just because legislation hasn’t passed yet doesn’t mean the state isn’t working on it,” Wesolowski said.

DHS has a deadline of December to finalize their planning report.

NAMI will host an free virtual event Nov. 15 to 19, REIMAGINE: A Week of Action to Reimagine Our National Response to People in Crisis.

988 is not yet active and people in crisis now should call 1-800-273-8255 to be connected to the National Suicide Prevention Lifeline or reach out to the Crisis Text Line by texting HOME to 741741.

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