MENTAL HEALTH

Can the New 988 Suicide Lifeline Fix America’s Mental Health Epidemic? | Healthiest Communities Health News

With calls increasing and wait times improving, early signs seemed to suggest the new 988 Suicide & Crisis Lifeline could help answer the nation’s unmet mental health need. But questions remain.

After the switch, data indicates the simplified number may be delivering on its promise. The volume of lifeline encounters – which includes phone calls, texts and messages through the network’s chat line – totaled 350,629 in September 2022, a nearly 33% increase over the 264,639 contacts in September 2021, according to figures from the Substance Abuse and Mental Health Services Administrationwhich funds the 988 system, and Vibrant Emotional Healthwhich administers it.

The rate at which contacts were answered improved from 63% to 88%, while the average speed of answers through the nation’s network of call centers quickened from 2 minutes and 51 seconds in September 2021 to 42 seconds in September 2022.

Despite those gains, the data also indicates overall contacts are slowing slightly, raising questions about whether 988 can one day overtake 911 as the first number people think to dial in a mental health crisis. The figures from this past September indicate the number of encounters fell by 3% compared with August – the first full month after the launch of the three-digit line – and declined by 1% from the number of lifeline encounters reported in July. Phone calls specifically fell by 7% from August to September, though chats ticked up 3% and texts rose by 12%.

Stakeholders say a major challenge is the lack of overall public awareness about 988. Results of a recent survey of more than 2,000 adults conducted between July 28 and Aug. 9 for CNN and the Kaiser Family Foundation found that while 90% acknowledged there was a mental health crisis in the US, 56% said they had heard “nothing at all” about 988.

Any possible slowdown in lifeline encounters comes at a time when demand for mental health care is high. A recent KFF analysis of federal data found 33% of adults reported having symptoms of either anxiety or depression compared with just 11% in 2019.

Experts believe raising awareness about 988 is the crucial next step needed for the number to become ingrained in people’s minds as the primary resource to turn to during a mental health emergency.

“We know that this country is in a mental health crisis and more and more people need help and are struggling, and I don’t anticipate that that’s going to level off,” says Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness.

In Floridathe Crisis Center of Tampa Bay fields 988 contacts for the surrounding area, staffing a team of approximately seven specialists on call 24/7 to aid individuals who reach out through lifeline.

Eric Bledsoe, the center’s director of gateway services, says his team has seen a fourfold increase in the average number of weekly calls following the launch of 988, jumping from approximately 100 a week before July to as many as 400 a week.

While Bledose feels the center is equipped to meet the demand, he notes that delays in initial program funding made it difficult to plan for the anticipated increase in volume.

“It was really hard to prepare and staff because the funding wasn’t approved until around the beginning of August,” Bledsoe says.

Ken Gibson, senior director of marketing and public relations for the Crisis Center of Tampa Bay, feels this period has served as more of a “soft launch” for the system to ensure call centers across the country built up adequate capacity to handle more contacts. That may help explain why he says federal and state policymakers have yet to truly prioritize marketing campaigns to raise awareness of 988.

“Wisely, I think they wanted to make sure the infrastructure was built before the big push,” Gibson says.

Wesolowski agrees the lack of a full-bore awareness campaign has been partly by design to give call centers time to identify and address potential gaps in their systems that could hinder their ability to handle an influx of 988 users.

But Wesolowski says she expects policymakers over the next year to ramp up public promotion of 988, as confidence about the system’s readiness continues to grow.

“To me, it shows that a lot of the investments made on the federal and state level are bearing fruit at just the right time when people are becoming aware of this and reaching out for help,” Wesolowski says. “I anticipate when there are resources available for widespread public awareness efforts that volume is going to continue to increase.”

Kyle Kinney, program manager for Boys Town, a not-for-profit organization that fields 988 calls in Nebraska and has its own national hotlinedescribes his team’s transition to 988 as relatively smooth, thanks in large part to having the infrastructure in place around the state to support calls well before July.

Since 988 debuted, Boys Town has so far seen an increase of 30 to 50 daily lifeline calls, which are answered by a full-time staff of approximately 20 trained professionals. Kinney expects call volumes to keep rising as more marketing is committed to raising awareness of 988.

“I think we’ve only seen the tip of the iceberg as far as it relates to growth,” Kinney says.

Danielle Bennett, a spokesperson for SAMHSA’s parent agency, the US Department of Health and Human Services, tells US News in an email that HHS is “…working with Congress to ensure federal resources for a national campaign to advertise or promote awareness of 988 to the audience.”

Bennett mentioned SAMHSA has provided resources to its 988 partners in the form of a tool kitwhich includes national guidelinespromotional documents, public service announcement scripts for radio, PowerPoint slides for presentations and content graphics for sharing on social media.

At the local level, Bledsoe says awareness efforts have included printing information about 988 on the back of student identification cards for those attending public high schools in Hillsborough, Florida – the county surrounding his crisis center. He expects the real test for the system will come once more robust national efforts get off the ground.

“We truly believe there are even more people out there who are still not reaching out for different reasons,” Bledsoe says. “Marketing is really going to eventually get those people to realize that there’s something out there for them.”

Chuck Ingoglia, president and CEO of the National Council for Mental Wellbeing, says the 988 system is the first of three pillars needed for the nation to build a system of care that can effectively respond to people in mental health crises.

In addition to 988, he says states need appropriate and effective in-person mobile crisis intervention teams to be first responders for those experiencing a mental health emergency, as well as places of respite other than hospital emergency rooms or jail where those in crisis can get stabilized before receiving treatment.

“You think of 911, and though it’s not perfect, they have figured out who’s responsible for doing what and they’ve built an infrastructure so that in most parts of the country, you can get a fairly timely response,” Ingoglia says.

Dr. Christine Yu Moutier, chief medical officer for the American Foundation for Suicide Prevention, says 988 is part of an ultimate goal to reduce the country’s reliance on police as the first responders to people experiencing a mental health crisis. Of the approximately 1,000 people fatally shot by police in 2015, close to 25% displayed signs of a mental illness, according to a study published in the International Journal of Law and Psychiatry.

Ultimately, Moutier says any effort to establish a more robust response to mental health crises will involve normalizing discussion around behavioral health and eliminating any stigma associated with calling a crisis line for help.

“That is a longer-game strategy that is essentially leaning on each state to implement their multiple layers of what we consider a crisis response system that needs to be reimagined and revised,” Moutier says.

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