WASHINGTON (NEXSTAR) – The launch of a national mental health hotline is just days away, but there are concerns about whether the country is prepared.
Starting July 16, 988 will be the number to call to get help during a mental health crisis. Calls and texts to 988 will be connected to the already-existing National Suicide Prevention Lifeline, which is then routed to about 200 local crisis centers throughout the country.
The hope is that the new number will become more widely known and easier to use.
The transition to 988 is happening because of legislation passed by Congress in 2020. That effort was bipartisan and led in the House by Democratic Rep. Seth Moulton and Republican Rep. Chris Stewart. Both lawmakers are veterans and spoke of the mental health challenges faced by military members as motivation to create this hotline. Now they’re excited to see it go live.
“Too many Americans die by suicide today because they just don’t know how to get help. And this is going to change that,” Moulton, D-Mass., said. “It’s going to save lives. It’s going to change lives. It’s going to make America a healthier, stronger nation.”
“Anywhere in the country – you call 988 and you’re going to immediately be talking to someone who is trained and professional and is going to be able to help you,” Stewart, R-Utah, said. “This will literally save people’s lives. It’s going to give help to the most vulnerable among us.”
While legislation mandated the creation of 988, it largely left coordination and funding for the hotline up to states. A June 2022 study by RAND Corporation with local mental health agencies found that fewer than half of them felt prepared for the 988 rollout.
Dr. Stephanie Brooks Holliday, a RAND behavioral scientist, was part of conducting that study. She noted that the concerns stem from the expectation that the launch will mean a larger number of calls for the crisis centers.
“Some estimates have even suggested that in the first year that 988 is live, there could be a 50% increase in call volume, and that’s huge,” Dr. Brooks Holliday said.
Many of the centers have already had trouble making sure they have enough staff to handle the current call volume, which has led to issues like dropped calls.
“The concern is that if more people are calling because 988 is easier to reach than the current phone number, that there could potentially be even more abandoned calls,” Dr. Brooks Holliday said.
Congressman Stewart says that is a problem he’s concerned about.
“If your house is on fire, you don’t call 911 and they say ‘hey we’ll be there on Thursday.’ You expect immediate help,” Stewart said. “And if you call 988, you expect someone to answer the phone and you expect them to be trained and to be able to help you. And some of the states are honestly behind on this. So in the interim, some of those calls will be forwarded.”
However, transferring calls to other centers brings a different set of worries.
“Will that person who answers the phone be aware of the local resources for the person who is calling?” Dr. Brooks Holliday said.
To fix that, she says local officials indicated they need more funding. The federal government has provided some money for the hotline, but states are expected to contribute as well.
Dr. Miriam Delphin-Rittman, the assistant secretary for Mental Health and Substance Use, is one of the leaders coordinating the launch at the national level. She says so far, the Dept. of Health and Human Services has allocated $432 million for the 988 transition, including direct stipends and grants for jurisdictions.
While that is helpful for the initial costs, it may not be enough for the hotline in the future.
“In our interviews, we learned that people have figured out how they’re going to fund 988 and the continuum of emergency mental health care at least for the near term, but in the long term they don’t have a stable source of funding that they will be able to draw on,” Dr. Brooks Holliday said.
That’s because many states simply haven’t allocated the resources needed. The 2020 legislation gives states the option to add a surcharge on monthly phone bills to fund the hotline. However, only a small handful of them have done that.
Angela Kimball, a mental health advocate with Inseparable, believes it will take public pressure to come up with solutions.
“That’s going to take people stepping up and demanding that elected officials invest. It’s not going to happen for free,” Kimball said.
Congressman Moulton is supportive of passing further legislation to provide more federal money, but says it currently lacks the votes it would need to happen. He’s hopeful that could change after the launch.
“Once this is up and running and we hear about the deficiencies in certain states, there probably will be more bipartisan support for this legislation,” Moulton said.
But Congressman Stewart says state officials should take the lead on further funding efforts.
“I think we’ve done everything the federal government can do with this. We implemented the program, we worked with the FCC to clear the number 988. We’ve broken down every barricade that would allow this program to be implemented and successful. Now it’s up to the states to fund it,” Stewart said.
Another thing local jurisdictions are looking for, according to the RAND study, is more direction from state and federal leaders. Dr. Delphin-Rittmon says DHHS is working to connect with local centers to troubleshoot problems and offer additional sources of funding.
“We know that [June] 16 really is the start of the transition and not an end. There’s still a lot of work to be done, we know to strengthen and transform the crisis care continuum,” Delphin-Rittmon said.
Even with the concerns, mental health advocates are optimistic that 988 will be a critical step in increasing access to mental health services and helping people heal.
“Crisis response in too many places is a 911 call that often results in trauma or tragedy and it shouldn’t be that way,” Kimball said. “No one’s worst day should ruin their chance to live their best life. With 988 we started a mission to transform crisis response and give people that chance.”
Congressman Moulton believes launching 988 now is the right move and insists it will be transformative.
“We know that there will be kinks in the system that we have to work out, but because it’s going live we’ll actually know what those are and be able to fix the problems,” Moulton said. “It’s not going to be perfect on day 1, we all know that. But the simple fact that it’s going to be up and running means a lot of lives will be saved.”