988 National Suicide Hotline: Key Insights One Year Post-launch

Contestants participating in “Celebrity Jeopardy!” were left puzzled last fall when asked about the newly established three-digit national hotline phone number for suicide prevention in the United States, which was introduced in July. Comedian Iliza Shlesinger wrongly guessed, “What is 311?” It turns out, she was not alone. Despite being one year since the National Suicide Prevention Lifeline transformed its 10-digit number to 988, many individuals are unaware of this change and the services offered by the hotline.

The purpose of the new number is to make it easier for those in need to connect with assistance when experiencing suicidal thoughts, emotional distress, or substance use-related crises. However, only 17 percent of Americans claim to be familiar with the number, according to a survey released by the National Alliance on Mental Illness. Furthermore, the survey revealed that people are still uncertain about what to expect when they call the hotline.

A common misconception is that calling 988 will lead to someone being dispatched, similar to the emergency number 911. However, this is not the case for the vast majority of callers. Hannah Wesolowski, NAMI’s chief advocacy officer, explains that this misunderstanding prevails among callers. To clarify, only a small portion of Lifeline calls require emergency services. Additionally, the 988 hotline does not currently utilize geolocation, ensuring caller anonymity unless they choose to provide identifying information. The creation of 988 aimed to reduce reliance on law enforcement and emergency departments for handling mental health crises and instead build an expanded array of services.

It is important to note that individuals do not have to be in crisis or feeling suicidal to call 988 and speak with a counselor. This service is available 24/7, free of charge, and offers support to anyone in need. Tia Dole, chief officer of the 988 Suicide and Crisis Lifeline at Vibrant Emotional Health, emphasizes the importance of seeking help before reaching a mental health crisis.

Despite the significance of the Lifeline and its services, a large portion of the population remains uninformed. In the past year, no federal funding was allocated to a public relations campaign for 988. Concerns about overwhelming demand led to the delay in raising widespread awareness. However, Vibrant plans to initiate a campaign in the fall to increase awareness and address disparities in understanding and acceptance of the hotline. The NAMI survey highlights that certain groups, such as Black individuals and adults aged 50 and older, were least likely to be familiar with 988.

In addition to raising awareness, long-term funding poses a significant challenge for the expanded network. With over 200 call centers, mostly operated by nonprofits with limited budgets and reliance on volunteers and private contributions, the availability of financial resources is crucial. Although the Biden administration’s 2024 budget proposal includes an increase in funding for 988, experts argue that more funding is necessary at the local and state levels.

The anticipated surge in demand for the Lifeline in the coming years, coupled with the shortage of behavioral health professionals, further complicates the expansion of the network. Backup centers are utilized when local centers are unable to answer calls, potentially resulting in longer wait times or callers hanging up. Additionally, routing callers by area code may pose a challenge for individuals whose phone numbers do not reflect their current location. Crisis counselors assisting individuals from different states may find it difficult to provide local referrals.

Despite the obstacles, the Lifeline has made significant improvements. Despite the increased demand, the average wait time for a counselor response has decreased, allowing more people to receive help promptly. Previously, reaching a counselor took minutes, but now the average response time is 41 seconds. The Lifeline has also improved its ability to handle text messages and chats. While the previous system could only handle a limited proportion of incoming messages, recent data suggests a higher capacity to respond effectively.

Looking ahead, demand for the Lifeline is expected to rise as mental illness remains a prevalent public health concern. Anxiety and depression rates, particularly among young adults, have increased significantly. The suicide rate has also risen over the past two decades. In addition to serving the general population, the 988 Lifeline aims to provide specialized assistance to specific groups. Initiatives such as the L.G.B.T.Q. subnetwork for individuals under 25 and the introduction of Spanish text and chat options have been introduced. Furthermore, plans are underway to introduce a video phone service for the deaf and hard of hearing later this year.

For individuals experiencing thoughts of suicide, calling or texting 988 will connect them to the 988 Suicide and Crisis Lifeline, while SpeakingOfSuicide.com/resources provides a list of additional resources. Resources for individuals outside the United States can be found here.

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