Mental Health Crisis Line: Transformative Lifeline in the United States

Mental Health Crisis Line

 Mental Health Crisis Line : Thanks to a trio of digits — 988 — the past year has been “transformative” in the United States’ ongoing efforts to tackle the nation’s mental health crisis, according to health officials. But as it heads into its second year of existence, the three-digit number for the country’s mental health crisis lifeline still has some hurdles to overcome when it comes to awareness, staffing, and routing.

A Year of Impact and Growth

The 988 Suicide and Crisis Lifeline, formerly known as the National Suicide Prevention Lifeline, transitioned last year from 1-800-273-TALK to a simpler dial code, 988. Those three numbers are intended to be easier to remember, like 911 for emergency medical services.

Sunday marks the first anniversary of 988’s launch, and there have been nearly 5 million calls, texts, and online chat messages answered through 988 in the year since its launch, according to data released Thursday by the US Department of Health and Human Services.

“That is well over a million, close to 2 million, more than what we saw in previous similar time frames,” HHS Secretary Xavier Becerra told CNN. “We now have to make sure that we continue to build the end of the pipeline, which means once they’ve called in, we’ve got to make sure they’re getting services as well.”

Almost 1 million of the nearly 5 million contacts were linked to the Veterans Crisis Line, which military members, veterans, and their families can reach by dialing 988 and pressing option 1.

Compared with the 12 months before the launch last July, text messages through the lifeline increased by 1,135%, chats answered increased by 141%, and calls answered increased by 46%, according to the HHS data. The average speed to answer for contacts decreased from 2 minutes and 39 seconds to 41 seconds.

Addressing Awareness and Staffing Challenges

Yet many people still don’t know that the lifeline exists or that 988 call centers face ongoing staffing challenges – and are actively seeking counselors.

Most people across states and territories don’t know that they can call, text, or send a chat online to 988 to reach licensed counselors trained to de-escalate a crisis, provide emotional support, or connect them with additional mental health resources.

A new poll from the National Alliance on Mental Illness (NAMI) released Thursday found that 82% of adults were either unfamiliar with or had never heard of the 988 Suicide and Crisis Lifeline. Only 17% were “very” or “somewhat” familiar with the service.

Conducted in collaboration with the marketing research firm Ipsos, the poll surveyed about 2,000 adults nationwide in early June. While most respondents didn’t fully understand what 988 offered, more than 3 in 5 were aware of its existence — a 19% increase from the last NAMI/Ipsos poll in September 2022.

Young adults ages 18 to 29 were more likely to be familiar with 988 than older Americans, the survey found. Similarly, LGBTQ+ adults were more than twice as likely to report familiarity with 988 than their non-LGBTQ+ counterparts.

SAMHSA and Vibrant Emotional Health, the nonprofit administrator and operator of the 988 lifeline, plan to launch an awareness campaign this fall to help spread the word about the three-digit number, said Tia Dole, chief 988 Suicide & Crisis Lifeline officer for Vibrant Emotional Health.

“We engaged with a few different firms to help us with a national campaign. And my guess is that the campaign will start generally, and then from there, we’ll market specific populations,” Dole said.

 Mental Health Crisis Line

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Strengthening the Lifeline and Call Center Resources

Many 988 call centers have announced that they need more licensed counselors to answer the influx of calls, texts, and chat messages.

The increasing demand for 988 is projected to reach 6 million calls, texts, and chats this year and 9 million next year. Efforts are being made to recruit and retain crisis counselors while prioritizing their mental health and well-being to prevent burnout.

The 988 network includes more than 200 centers responding to people in crisis, and those centers are seeking volunteers as well as paid employees. The 988 website lists job postings and volunteer opportunities across 50 states and territories.

This call for more crisis counselors is emerging amid a broader shortage of health-care workers across the United States.

“Workforce challenges are a real thing,” Johnson said. “This remains an ongoing challenge.”

Sometimes, Vibrant Emotional Health will provide advice to call centers on how to help recruit staff and will share strategies that have helped other centers build and retain counselors, Dole said.

“The nonprofits that offer remote work are the ones who have the easiest time staffing,” she added. “I think that there’s more work to be done, from my perspective, around the wellness of the individual counselor.”

 Mental Health Crisis Line

 Progress and Future Developments of Mental Health Crisis Line

At the one-year mark, states have established separate plans for how to either integrate 988 into existing crisis call systems or maintain new separate systems for 988.

As of early June, more than half of states — at least 26 so far — have enacted some form of legislation to fund and implement the 988 Suicide and Crisis Lifeline, according to NASHP’s data.

“All states have set up 988, and it’s running, and it’s in operation. Even if there’s a state that’s not listed as having legislation this session, they could be doing some of this work outside of enacting legislation,” Tewarson said.

Looking ahead, plans are in place to introduce text and chat services in Spanish and improve routing by connecting users to call centers in their geographic area. The goal is to ensure that callers are connected to local resources, reducing the need for emergency services and enabling long-term support.

The introduction of 988 as a dedicated lifeline for mental health and crisis support marks a significant milestone in the United States’ efforts to address the nation’s mental health crisis. Despite the challenges that remain, the impact and potential of this initiative cannot be understated. With ongoing efforts to raise awareness, enhance staffing, and refine routing systems, the 988 Suicide and Crisis Lifeline is poised to continue providing vital support to those in need.

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