988 mental health crisis hotline to offer text and chat services in Spanish
Thanks to a trio of digits -- 988 -- the past year has been "transformative" in the United States' ongoing efforts to tackle the nation's mental health crisis, according to health officials. But as it heads into its second year of existence, the three-digit number for the country's mental health crisis lifeline still has some hurdles to overcome when it comes to awareness, staffing and routing.
The 988 Suicide and Crisis Lifeline, formerly known as the National Suicide Prevention Lifeline, transitioned last year from 1-800-273-TALK to a simpler dial code, 988. Those three numbers are intended to be easier to remember, like 911 for emergency medical services.
Sunday marks the first anniversary of 988's launch, and there have been nearly 5 million calls, texts and online chat messages answered through 988 in the year since its launch, according to data released Thursday by the US Department of Health and Human Services.
"That is well over a million, close to 2 million, more than what we saw in previous similar time frames," HHS Secretary Xavier Becerra told CNN. "We now have to make sure that we continue to build the end of the pipeline, which means once they've called in, we've got to make sure they're getting services as well."
Almost 1 million of the nearly 5 million contacts were linked to the Veterans Crisis Line, which military members, veterans and their families can reach by dialing 988 and pressing option 1.
The Biden-Harris administration has invested nearly $1 billion in the initiative. Much of that investment has gone directly to states, territories, and tribes to hire crisis counselors and improve local response, according to HHS officials.
"This is a three-digit number, easy to remember - 988 - you can call it, text it or chat when you feel like you need support, whether that's for depression, sadness, anxiety, whatever it may be," said Monica Johnson, director of the 988 & Behavioral Health Crisis Coordinating office at the US Substance Abuse and Mental Health Services Administration (SAMHSA). The 988 lifeline is supported by HHS through SAMHSA.
Yet many people still don't know that the lifeline exists or that 988 call centers face ongoing staffing challenges - and are actively seeking counselors.
"When the FCC started our work on 988 several years ago, I encouraged our agency to explore incorporating texting into the Lifeline. It shouldn't make a difference how you reach out in an emergency, but that you can connect to mental health resources, no matter how you communicate," FCC Chairwoman Jessica Rosenworcel said in a news release Thursday.
"In the past year, both text and chat have become an integral part of the 988 Lifeline. And now, that reach is further expanded to Spanish speakers, who can communicate in Spanish by text and chat for the first time," Rosenworcel said. "I'm extremely proud of the work that our agencies have done to make this life-saving service more accessible to those who need it most."
As for what else the future holds for 988, the lifeline is rolling out text and chat features in Spanish this week and there will be future efforts to route calls, texts and chats to call centers in the same geographic area as the user, called geo-routing, Johnson said.
Currently, calls are routed to centers in the same geographic location as the user's area code. For instance, someone based in Los Angeles who has a cell phone number with a New York area code would reach a center in New York. That call center would then need to route the call to a center in Los Angeles so someone can direct the caller to the most relevant information on local services such as mental health, housing or food security resources.
"We know that the best outcomes happen when a call is answered locally, because it's those local call centers that know what local resources exist," Wesolowski said. "It's those local call centers who are able to make that connection and make sure we're not just dealing with the immediate crisis, but we're helping people connect to the resources that are going to support them long-term."
Getting people connected to local resources can reduce the number of people seeking mental health care in a hospital emergency department, said Dr. Mariam Betz, an emergency medicine physician and professor at the Colorado School of Public Health in Denver, who is not involved in 988.
"What we really want to do is match people to the services they need, and so if this also frees up ambulances and it frees up police, then that's a great ultimate outcome," Betz said.
988 routing differs from 911, which connects callers to the call center closest to their geographic location.
"What we'd like to do as we continue to evolve is get you closer beyond just the area code," Johnson said. "So we are exploring ways in which we can look at routing opportunities that don't just depend on your area code."
But as far as other advancements, such as using chatbots or artificial intelligence to help respond to calls, Johnson said that was unlikely any time soon.
"We don't see AI playing a role with 988 as it relates to the call. We want people to be connected to another person - so rather that's via the call, text or chat," she said. "Right now, we're not interested in seeing how AI can work with people that are reaching out to be connected. We want people to have a human contact in these moments that are very distressful for people who are often reaching out."
If you are struggling with thoughts of suicide or worried about a friend or loved one, call the Suicide & Crisis Lifeline at 988 for free, confidential emotional support 24 hours a day, seven days a week.
