This Saturday marks the official launch for the three-digit 988 Suicide & Crisis Lifeline, which officials hope will make the service more accessible and effective than the current 10-digit National Suicide Prevention Lifeline. While not all states are prepared for the launch, HHS officials on a press call sounded excited about and confident in the initiative’s success.
“Our goal here is a sustainable long-term change,” said an official (under condition of anonymity) during a background call with reporters on Thursday. It took over 5 decades for 911 and emergency medical services to grow to scale across the country, the official noted. While this transition is expected to be faster, “[w]e’re on a journey, not a sprint.”
The new lifeline will offer 24/7 access to trained counselors who can support individuals experiencing suicidal, substance use and other mental health care crises, she said.
“Our vision is that it will be a universal entry point, so that no matter where you live, you can reach a trained crisis counselor to help.”
The current 10-digit number (800-273-TALK) will remain active indefinitely, the lifeline’s sponsors have promised.
Funding for the National Suicide Prevention Lifeline historically stood at $24 million. The Biden-Harris administration has raised it 18-fold, for a total of $432 million, noted the official.
This includes $177 million to strengthen and grow the lifeline infrastructure, such as national backup centers, text and chat centers, and a Spanish-language network. It also includes nearly $105 million in grant funding to enhance local capacity for response, and $150 million in funding from the recently passed Bipartisan Safer Communities Act.
It’s these recent investments that have led to “a substantial increase” in the number of phone calls, texts, and chats, said officials. From June 2021 to June 2022, the lifeline answered 17,000 more phone calls (a 13% increase), 37,000 more chats (148%), and 3,000 more texts (77%).
However, the program’s success hinges on “the willingness of state, territorial, and local leaders to make additional investments in shoring up the system,” the official warned.
And many states appear far from ready for the transition. A June 2 report from the RAND Corporation revealed that fewer than half of the public health officials responsible for rolling out the hotline in their states felt confident that their jurisdiction was prepared for the new hotline.
Most states still lack short-term crisis stabilization programs and few have urgent care units for mental health, according to the report.
To that end, HHS leaders have held phone calls with mental health and substance use commissioners in several states to discuss progress and challenges in implementing the system. They acknowledged that developing the workforce is a core challenge, as is financing the lifeline and broader crisis care system. While HHS does not employ counselors, the agency is working with crisis centers to help recruit them and has developed a web page to help link potential volunteers or employees to more than 200 crisis centers.
In addition, the HHS secretary and the assistant secretary for preparedness response have sent letters to governors and territory leaders offering federal support and sharing their state’s “answer rates” in comparison to other states, to help them gauge their preparedness. There have also been several meetings with government partners including CMS, HHS, the Health Resources and Services Administration, and the Department of Veterans Affairs to help states leverage all available financial supports.
The Substance Abuse and Mental Health Services Administration has also created a 988 partner toolkit with posters, frequently asked questions, “social shareables,” and fact sheets in English and Spanish.
Asked about the ability for the hotline to track and locate callers whose area codes do not match the state in which they are located, HHS officials acknowledged that “geolocation” is not in place yet. “That is an issue that HHS, the Federal Communications Commission, and other agencies are continuing to study, but in the meantime, officials said they are also looking into other interim ways to improve routing calls.”
Centers will ask callers if they are comfortable sharing their location, which can help to facilitate access to local services.
As for how officials would measure 988’s success, one HHS official cited the “massively improved answering rates,” and the development of text and chat response systems that didn’t exist a year ago.
“I think if we were able to see all states come up with us on this journey, I think that would be an incredible success for us,” the official said.
HHS Secretary Xavier Becerra is expected to hold a press conference in Philadelphia on Friday morning to promote 988’s launch.
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