In July 2022, a new mental health emergency number was launched to address rising rates of mental illness in the United States. The Center for Disease Control (CDC) reports that 1 in 5 Americans will experience a mental illness in a given year, and during the COVID-19 pandemic, psychiatric emergency department visits increased by 25.66%.[1]

This helpline has been promoted as the mental health and substance abuse equivalent of 911, and many have welcomed this addition to emergency response because the United States is dealing with rising rates of suicide, overdose, and addiction year after year. It is now six months since this helpline was launched, and it is time to review the strengths and identify areas that need improvement in this essential service.

What is the 988 Emergency Helpline?

The 988 Mental Health Emergency Hotline was set up to widen existing access to mental health crisis responses and substance abuse prevention. The aim of the service was to provide adequate funding to local authorities and ensure that responses to mental health crises prioritize compassionate and caring intervention, particularly for BIPOC individuals who experience higher rates of substance abuse, police violence, and incarceration. 

This 24/7, free, and confidential helpline, which replaced the former 1-800-273-8255 emergency number, provides support to thousands of people each day who are in suicidal crisis or emotional distress. 

Having received just under $1 billion in federal funds, the 988 mental health emergency helpline has rapidly expanded its capacity in the six months since it launched and has received a staggering 2 million calls, texts, and chat messages. 

Service Use Data 

Overall, the call volume has surpassed what most individuals working within the service anticipated. As a much more accessible helpline than its predecessor, the 988 service was expected to reach more people than before, but nobody predicted the usage over the past six months. 

Calls answered in December 2022 increased by 48%, chats answered increased by 263%, and texts answered increased by 1445% compared to December 2021.[2]

The immediacy of responses also increased despite the increased demand for services. The average speed to answer across all contacts decreased from 172 seconds to just 44 seconds,[2] which contributed to a lower number of abandoned calls and more immediate assistance for those who need it.

Strengths of the Service 

There has been a number of additional services launched since July 2022 to improve access to the service for minority groups. In November, Washington became the first state to build on the existing 988 services to add a specific service dedicated to American Indian and Alaska Native people. This can be reached by pressing “4” after calling 988. Service users will then be put through to 1 of the 13 Indigenous counselors who staff the phones.

This addition is an essential service for Native/Indigenous people who report experiencing serious psychological distress 2.5 times more than the general population and statistically abuse drugs at a younger age than white Americans.[3] Responses can also be tailored to the specific needs of the community, and individuals who understand the culture can decode certain terms that others cannot. This means that fewer vulnerable people are slipping through the net. Moreover, Native/Indigenous communities often communicate their distrust of the government or government-supported agencies, so having a service that is managed and staffed by indigenous people may make it easier for them to seek support and trust a stranger with their struggles.

An additional line for veterans has also been added: the Veterans Crisis Line, for which callers can press “1” after texting or calling 988. There is hope that more specialist services like this will be added over time as a clearer picture of national and community-specific needs becomes clear.

Improvements 

The quality and scope of the service vary significantly across the country. In Maryland, the 988 response rate in November was 89%. However, in Texas, it was just 63%, so although the service is functioning well in some areas, there are significant improvements to be made in others. This could be due to issues with staffing, which have been one of the largest obstacles with the rollout of the service so far.

Referrals are another downside with the number. 988 recognizes the caller’s area code rather than using geolocation to connect the call to the crisis center closest to the caller. For those calling from outside of their state or residence, such as college students, this may pose challenges. Calls that cannot be answered locally are also passed to an out-of-state overflow facility. Staff at this facility may be unfamiliar with local resources, which presents challenges for connecting callers with resources or additional assistance.

Even when the caller is connected to the local crisis center, shortages in mental health and addiction services make providing tailored interventions and long-term mental health care a challenge. There is a shortage of mental health professionals and social workers, which means that there are often gaps in the services that people are being referred to. Over 115 million people in America live in areas where there is less than 1 mental health professional per 30,000 people,[4] and more than half of U.S. counties lack a single psychiatrist.[5]

There is also uncertainty about the future of funding for the service. While the federal government has provided millions of dollars for the service so far, states are expected to take responsibility for the operation and funding of the 988 line like they do with 911 emergency call services. There is a greater concern for the future of the mental health emergency service in some states than in others because certain states have not yet confirmed a permanent funding plan for it. 

So far, the majority of states have not yet passed legislation to permanently fund the 988 mental health helpline, which leaves the future of the service unknown at a time when mental health support is more crucial than ever.

If you or a loved one is struggling with anything you have read in this blog, please get in touch with Heather R. Hayes & Associates – call 800-335-0316 or email info@heatherhayes.com today.

References 

[1] Centers for Disease Control and Prevention. (2021, June 28). About mental health. Centers for Disease Control and Prevention. Retrieved January 19, 2023, from https://www.cdc.gov/mentalhealth/learn/index.htm#:~:text=1%20in%205%20Americans%20will,illness%20in%20a%20given%20year.&text=1%20in%205%20children%2C%20either,a%20seriously%20debilitating%20mental%20illness.&text=1%20in%2025%20Americans%20lives,bipolar%20disorder%2C%20or%20major%20depression. 

[2] 988 suicide & crisis lifeline. SAMHSA. Retrieved January 19, 2023, from https://www.samhsa.gov/find-help/988 

[3]Centers for Disease Control and Prevention. (n.d.). Retrieved January 19, 2023, from https://www.cdc.gov/nchs/data/hus/hus17.pdf 

[4]Mental Health Care Health Professional Shortage Areas (HPSAS). KFF. (2022, October 21). Retrieved January 19, 2023, from https://www.kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0&sortModel=%7B%22colId%22%3A%22Location%22%2C%22sort%22%3A%22asc%22%7D 

[5] Behavioral Health Workforce. (n.d.). Retrieved January 19, 2023, from https://behavioralhealthworkforce.org/wp-content/uploads/2019/02/Y3-FA2-P2-Psych-Sub_Full-Report-FINAL2.19.2019.pdf