The National Suicide Hotline Designation Act was signed into law on October 17, 2020 and as of July 16, 2022, will go into effect. This means that starting on that date anyone in the U.S. experiencing a behavioral health crisis can call or send a text message to 988 instead of the previous National Suicide Prevention Lifeline number 1-800-273-8255.
The services received will be the same as before, when you call or text 988 you will still be routed or connected to the nearest Access Crisis Intervention center for your region of the state. For example, if you live in Osage or Cole counties in Missouri you will be connected to a crisis counselor at Compass Health Network’s call center. All of these centers in Missouri and in the other states operate 24/7, all calls and texts are free and conversations are confidential.
The main purpose behind the law was to ensure that an easy to remember number was established and that effective behavioral health crisis response services were developed nationwide. The implementation of this new three-digit number should reduce the amount of calls being made to 911 dispatch that do not correlate with medical emergencies, reducing the occurrences where law enforcement and fire rescue personnel are dispatched to non-medical emergency situations.
Anyone experiencing suicidal thoughts or behavior, struggling with the symptoms of a mental health condition or substance use disorder, or anyone in emotional duress can contact 988 by calling or texting. If necessary, the Access Crisis Intervention centers are also supposed to be equipped with specialized teams of responders who can physically go to the callers/texters location to provide behavioral health aid.
However, this service does not replace law enforcement, fire rescue, or EMT first responders, and so any situation involving imminent risk of harm or death, such as a suicide attempt or overdose having already occurred where someone ingested/injected something or physically harmed themselves or others, should contact 911 as that is a medical emergency and not solely a mental health crisis.
There are urgent realities driving the need for crisis service transformation across our country. Per the CDC, in 2020 alone, the U.S. had one death by suicide about every 11 minutes. For people aged 10 – 34 years, suicide is a leading cause of death. From April 2020 to 2021, over 100,000 individuals died from substance use overdoses.
According to Mental Health America, we have not seen suicide rates this high since the 1940’s. They report that at least 2.5 million American youth have some form of severe depression. Suicide rates are highest among Indigenous peoples of America and white/Caucasian populations. Per population, suicide occurs more frequently in rural and suburban areas than urban populations, and suicide rates are also disproportionately high for those who identify as LGBTQ+.
According to the Substance Abuse and Mental Health Services Administration and the National Institutes of Health, 1 in 5 Americans is currently struggling with a mental health condition or substance use disorder, 45% of Americans will develop a mental health condition or substance use disorder at some point in their lifetime, and more than half of those developed symptoms by the age of 14 and have not sought (and are statistically unlikely to seek) professional treatment for their condition or disorder.
With 31 million Americans struggling with a mental health condition, 19 million Americans struggling with a substance use disorder, 11 million Americans experiencing suicidal thoughts, and all at this very moment, the need for crisis intervention and support services is high.
The unfortunate reality is that the whole behavioral health industry is understaffed, not effectively equipped, and are underfunded. The amount of turnover, burnout, and compassion fatigue experienced by those in this industry is high. According to the Missouri Department of Mental Health, about half of all Missouri college graduates in the field of behavioral health leave their industry jobs by the end of their first year of employment.
For those struggling and those who are assisting or supporting those who are struggling, the need for expanded services and funding is right now. There are state and federal funding initiatives supporting the 988 lifeline, but more needs to be done to ensure this crisis intervention service continues to be effective in the longterm for all of our communities. Several states in the U.S. have added a small fee to telecommunications services to help fund the 988 lifeline, Missouri needs to be one of those states.
For information from the Missouri Department of Mental Health: https://dmh.mo.gov/behavioral-health/988-suicide-and-crisis-lifeline
For information from the Substance Abuse and Mental Health Services Administration: https://www.samhsa.gov/find-help/988/faqs#about-988