Suicide is a public health crisis and a leading cause of death in the United States.
Since 2005, people with suicidal thoughts can call the National Suicide Prevention Lifeline at 1-800-287-TALK. The federal government recently launched the 988 helpline to make the resource more accessible and easier to remember. However, without adequate funding and personnel, this vital resource could be wasted.
Reviews say many states and communities may be ill-prepared to implement 988 or handle the expected influx of calls. Some have gone so far warn others on social media to avoid dialing the number. Despite Lifeline’s extensive suicide prevention work, local call centers have generally received little funding, dependent more on state and local funds as well as private and individual donations. With initiative 988, States are called upon to invest now more than ever. According to the U.S. Department of Health and Human Services (HHS), “the success of 988 now rests in large part on the willingness of state, territory, and local leaders to make additional investments to strengthen the continuum of care.” of crisis”.
Currently, just under half of adults with mental illness receive treatment and the rate is even lower among communities of color. Without treatment, symptoms can worsen and lead to seizures. The 988 The initiative seeks ambitious change in the way we approach mental health and mental health crises as a society. 988’s vision is to be a vital resource available in mental health emergencies, connecting people to a continuum of mental health services. Although law enforcement may still be needed in high-risk situations, 988 is designed to reduce mental health crises currently handled by law enforcement and local emergency services that may not be equipped or able to handle these situations in the most appropriate way. If done right, 988 will forever change the way our society handles and responds to mental health crises.
To support implementation, in line with the U.S. bailout, HHS awarded over $100 million to states and territories to strengthen crisis call centers, build workforce capacity, and improve call center policies and practices. For this grant, there was a wide variation in funding awarded to states and territories, with amounts ranging from $250,000 to over $14 million. The current volume of calls to the Lifeline was a key yardstick used to determine the amount awarded to states, but suicide rates do not appear to have been taken into account. States and territories with fewer than 4,300 calls to Lifeline were only able to apply for $250,000. Some of those states include South Dakota, North Dakota, Delaware and Wyoming, all of which had higher suicide rates than Minnesota. Here in Minnesota, the Department of Health received $1.8 million for the implementation of 988, with the goal of answering 90% of 988 calls, chats and texts. This is an ambitious goal if the it is considered that only 10% of calls coming from Minnesota at the Lifeline in 2020 were answered by someone in the state.
A major hurdle that states face for the success of 988 is future funding. Since January 2021, the Biden administration has earmarked $432 million for the Crisis Center initiative and moving forward, the project 2023 fiscal year budget is asking for an additional $697 million for 988 and the behavioral health services program. While these initial federal investments in 988 are incredible, it is unclear to what extent the federal government will support local crisis call centers in the future and to what extent this support will be evenly distributed among states, territories and tribal communities. Building and maintaining a well-trained workforce to meet expected 988 call demands will be a daunting challenge for many states. To date, only four states passed legislation to fund the 988 crisis phone service in their state.
Now that 988 is launched, there is still a lot of work to do. As behavioral health leaders work alongside important community partners to improve the mental health systems and resources that support 988, community members can play a role in making 988 successful. Here’s what you can TO DO :
- Follow and support 988 legislation. Currently in Minnesota, bills are being discussed to implement a $0.12/month phone service charge to fund 988 (HF 4398, SF 4014) and creating a behavioral health department as well as expanding mobile crisis services for adults (HF 4706, SF 4410). Contact your local Minnesota legislators and express your support for these bills.
- Get involved in promoting mental health in your community by joining or starting a mental health task force, volunteering with a mental health organization, or becoming qualified to volunteer or work for your local crisis call center.
- Consider ways to promote and normalize mental health help-seeking and self-care, and 988 services through your daily conversations and interactions with others. A good place to get inspiration is reimaginecrisis.org.
Although 988 faces implementation challenges, we can all play a part in supporting its success and offering mental health hope and support to others.
If you or someone you know needs help, you can call or text the National Suicide Prevention Lifeline at 988 or 800-273-TALK (8255). You can also text a crisis counselor by messaging the crisis text line on 741741.
Amy Hedman-Robertson is a professor of health and exercise science at the University of St. Thomas Morrison Family College of Health.