The new mental health hotline at 988, which will act as a 911 for suicidal people, is expected to open to muted applause on Saturday.
The National Suicide Prevention Lifeline will change its number from 1-800-273-TALK to just 988 on Saturday as part of a larger endeavor to help people with mental health needs, including local services and facility care.
“988 isn’t just a number, it’s a message,” Health and Human Services Xavier Becerra told reporters earlier this month. “It’s the signal to America that we want to consolidate that service, we want to strengthen that service, and we want to make it consistent. We won’t have the luxury of decades like 911 had to get on the ground and running.”
But while the Biden administration has presented the FCC’s approval of 988 as a significant step toward an expansion of mental healthcare, not all states have prepared enough funding or human resources to accommodate the expected surge in calls.
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The change in phone numbers is part of a more significant effort to provide more thorough resources. “988 call centers represent one component of a larger crisis continuum in states, which include call centers, mobile crisis teams that can be dispatched if necessary (though this is not the primary goal of 988), and facility-based care,” Jodi Manz, the policy director at the National Academy for State Health Policy, told the Washington Examiner.
While Congress passed a law to fund the 988 program in late 2020, the budget did not become substantial enough to cause a change until 2022. It was also insufficient to cover the anticipated costs of the service of states alone. Only 22 states have established a fund for local calls or amended their telecom laws so that 988 calls are charged like 911 calls. Some states also have workgroups or current studies designed to analyze costs and make policy recommendations moving forward, according to Manz. That has left the majority of states without funding for the updated lifeline.
Iowa is a noteworthy example of the struggles that states could see in the near future. Iowa analysts estimated that 988 would cost the state $4.4 million, but state officials only allocated $3 million to local call centers, according to Iowa Public Radio. This left a significant gap in funding and an even larger staffing gap. At least one Iowa call center has struggled to get at least half of the staff to accommodate the expected uptick in mental health-related calls, according to Foundation 2 Crisis Services CEO Emily Blomme.
If a state does not have the necessary funding or staffing, the calls are typically forwarded to one of 15 backup centers funded by the National Suicide Prevention Lifeline network. This lack of workforce could mean that several callers would not receive assistance.
At least 1 in 3 of the calls to the lifeline made in May 2022 were sent to an out-of-state call center, according to HHS data. While these call centers are helpful and can provide services, they often lack critical insights into state-based resources that may be more useful.
HHS has attempted to convince states with lower response rates to prepare for the launch while providing additional funding to improve their infrastructure. However, state leaders said they were hesitant to dedicate funding to the cause due to uncertainty about the actual costs of the service or determining if additional taxes would need to be implemented.
Other call center executives have expressed concerns that other demands may overload the phone services. The single call center in West Virginia answers calls from more than 15 additional numbers, which places it under significant stress. “We have a very real fear that without funding our program in a substantial way,” West Virginia-based First Choice Services executive Lata Menon told the New York Times. “Our West Virginia callers will suddenly be facing what has been a problem nationally.”
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The lifeline has already reported a significant increase in calls as of June 2022. The phone network answered 27,000 more calls than expected in 2022, according to Miriam Delphin-Rittmon, the HHS assistant secretary for mental health and substance use. It also saw 27,000 more chats and 3,000 more texts than the previous year, implying a rise in mental health concerns.
