2021 | Opinion

Opinion: 988 line for suicide calls can help shift from policing to mental health service

Government funding needed to support 2022 rollout

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“I kinda wanna try to stay alive since you were nice enough to hear me out. It kinda gives me another reason to think people are still good,” a teenage caller said to one of EveryMind’s specialists on the National Suicide Prevention Lifeline after nearly two hours of emergency counseling. 

The caller is a suicide attempt survivor. She had a plan to kill herself at the beginning of the call.

But for the existence of Lifeline, she could have easily taken the pills she had scavenged that night, or her family could have discovered her plan. It is not hard to imagine that somebody would have eventually called 911. 

We do not know how many people at risk like this caller land at the police department’s doorstep or end up taking their own lives every day because they do not know of Lifeline. 

While society continues to debate police reform, everyone seems to agree on one thing: Law enforcement personnel are not well suited for handling mental or behavioral health crises. Diverting this type of emergency to professionals trained in crisis intervention can lead to more peaceful and therapeutic outcomes.

One of the best pieces of news that got buried in the tumult of 2020 is that Congress passed the historic National Suicide Hotline Designation Act.

By July 2022, the extension 988 will come online as an alternative to 911 for individuals who are in mental distress or suicidal. Highly trained and accredited counselors in Lifeline centers nationwide like EveryMind will answer calls through this new 988 extension. 

 “The Lifeline is based on the concept that we’re trying to de-escalate callers, we’re trying to keep them out of hospital rooms, we’re trying to keep law enforcement from having to go out, from 911 from having to be called. … It saves money,” said Shari Sinwelski from Vibrant Emotional Health, the administrative arm of Lifeline.

Currently, only 5 percent of the Lifeline calls we receive are passed on to 911. Given that an average of 10 percent of law enforcement agencies’ total budgets was spent responding to and transporting people with mental illness in 2017, from a financial standpoint, using 988 is a bargain compared to dispatching emergency personnel in response to every suicidal caller.

At the same time, underserved communities will have the peace of mind that, by calling 988, they are talking directly with mental health professionals immersed in best practices focused on connection and support.

They no longer have to agonize over calling 911 for the help they desperately need and fearing unforeseen outcomes, which sometimes arise when law enforcement officers interact with residents in acute crises. 

“How do we do the least invasive thing, at any given point, reinforce people’s dignity and create the best possible structure, to avoid things going wrong, that are going to stop that person from calling the next time,” noted Eduardo Vega, CEO of Humanovations, another one of the nation’s 180 Lifeline centers. 

Here comes the catch: Unlike 911, federal, state and local governments have yet to put in place the necessary funding to ensure Lifeline centers will be able to meet the increased demand at the time of the 988 rollout. Government needs to make this investment if we really want to change the paradigm in handling mental health calls from law enforcement to social services.    

Currently, Lifeline centers like EveryMind rely primarily on local funding, private donations, and dedicated support from volunteers to remain operational 24/7.

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that when 988 comes online, Lifeline call volume, which was about 2.2 million as of 2018, could increase greatly. It has the potential of overwhelming the existing system.

Richard McKeon, the branch chief for suicide prevention for SAMHSA, said, “Our effort rests on the shoulders of these local crisis centers, who are working in their communities in the middle of the night, trying to be a beacon of hope to people in despair.”

It is now up to individual states to locate resources and funding, so that these beacons of hope do not get inundated and that they continue to meet the growing needs of our communities. 

We can ill afford to create the mechanism for easy access to mental health support but not the capacity for it. No cries for help should go unanswered. 

Long a leader in the human services arena, Maryland has an opportunity to distinguish itself and set the standard by ensuring that its well developed network of Lifeline centers has the capacity it needs to field a multifold increase in potentially lifesaving calls.

We urge Gov. Larry Hogan, Maryland state legislators and the key state and local health and human service departments to prepare for the onset of 988, and begin putting together the funding now. Lives literally depend on it. 

Dipika Cheung and Rachel Larkin are the manager and director of crisis prevention and intervention services at EveryMind in Rockville. EveryMind is Montgomery County’s only accredited Lifeline center. It answers calls, texts and chats through the National Suicide Prevention Lifeline (800-273-8255) and the Montgomery County Hotline (301-273-2255 for call/text; every-mind.org/chat).

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