Advocates hope 988 mental health lifeline will help those in crisis

The nation’s new Suicide & Crisis Lifeline, 988, is up and running, offering what advocates think will be an easy-to-remember option for people experiencing mental health episodes, shifting the response away from the ill-fitting 911 emergency line.

Still, some wonder if the already overburdened system of crisis centers can support what is expected to be an increase in calls.

“Right now, if you call 988, you will be directed to one of the existing national suicide prevention hotlines,” said Mary Frances Walsh, executive director of NAMI Sonoma County, the local outpost of the National Alliance on Mental Illness.

“There is some concern we’ll maybe see a high volume of calls that existing centers can’t handle. We don’t know yet. It’s a good thing this is happening, but there is a lot of investment of services that needs to take place.”

Most agree 988 is an improvement over the previous phone system.

A national suicide hotline has existed since 2005, and has fielded more than 23 million calls since then. But the old 10-digit number of 800-273-8255, many have claimed, is too hard to remember during the stress of a true crisis. As a result, many people wind up calling 911.

That option is increasingly recognized as inappropriate.

“That usually means fire departments or EMTs or police that respond,” said state Assembly member Jim Wood, whose district includes much of Sonoma County. “Those are really not the best trained people to handle these emergencies.”

In fact, those encounters can be deadly. Nearly a quarter of fatal police shootings in recent years have involved people with mental illness, psychologist Benjamin Miller told National Public Radio. Miller is president of Well Being Trust, an Oakland-based foundation focused on mental, social and spiritual health.

Local law enforcement officers can sign up for crisis intervention training, Walsh said, and many of them are sensitive to mental health needs. They will still be involved if someone in crisis is acting violently.

“But the fact is, that’s a very small percentage of calls,” Walsh said.

The city of Santa Rosa has responded by launching the inRESPONSE program, which dispatches trained behavioral health professionals to calls involving medical emergencies, suicide, homelessness, substance use, minor crimes and mental health. There are similar, if smaller, programs elsewhere in Sonoma County.

“But they are not available to everyone,” Walsh said. “If you live in an isolated area, or even in Healdsburg, Cloverdale or Bodega Bay, you will rely on law enforcement.”

Many advocates have referred to what they see as a cresting wave of mental health issues over the past few years, all of it exacerbated by the isolation and stress of the COVID-19 pandemic. Suicide was the 12th leading cause of death for Americans of all ages in 2020, according to the Centers for Disease Control and Prevention, and the second leading cause among those ages 10 to 14 and 25 to 34.

Calls to the 10-digit suicide prevention line bear out the need. They have risen almost annually since 2016, from about 1.6 million that year to more than 2.5 million in 2021.

The system hasn’t always performed well. A 2021 report by the Substance Abuse and Mental Health Services Administration, the branch of the U.S. Department of Health and Human Services that oversees the crisis line, found the system was able to respond to only 85% of calls, 56% of texts and 30% of chats.

A recent data analysis by The New York Times was even more damning. It revealed that about 18% of roughly 1 million calls placed to the Lifeline in the first half of 2022 were abandoned.

Those are disturbing numbers, considering federal health officials project that the number of calls, chats and texts will at least double in the next year, with the advent of 988.

But there are hopeful signs, too. In anticipation of the 988 line, the federal government earmarked $400 million to beef up the system of call centers and to provide related services, including a subnetwork for Spanish speakers.

It appears to be having an effect. The average wait time on the Lifeline decreased from 16 minutes in January to about three minutes in June, according to data supplied by the Substance Abuse and Mental Health Services Administration.

The government’s stated goal is to eventually answer 95% of all calls within 20 seconds.

There will have to be contributions at the state level, too. Four states have already passed bills allocating money from cellphone service fees to assist the creation of call centers and mobile response teams.

California hasn’t yet, though Assembly Bill 988 has cleared the state Assembly and has been approved by the state Senate’s Health and Appropriations committees.

Wood said money has already been approved in the most recent California budget, which makes him confident the bill will pass. It will earmark a small surcharge, escalating from 8 cents to 30 cents on each monthly cellphone bill.

Currently, there are 200 crisis centers in the U.S., and 13 in California. None of them are in Sonoma County. The closest is Buckelew Programs Suicide Prevention center in Novato. The Marin County organization is also a key partner in Santa Rosa’s inResponse program.

“Beginning July 2022, California’s call centers will automatically receive phone calls from callers with California area codes, regardless of the caller’s location,” Jan Cobaleda-Kegler, director of the Sonoma County Behavioral Health division, explained in an email. “In addition, when a caller’s home call center is at capacity, callers from all over the nation will be rerouted to other states.”

The trained counselors on the lifeline will connect callers to local crisis support services, Cobaleda-Kegler added.

Any phone connection with a mental health worker can be crucial in a time of crisis. And it’s no secret that the North Bay has been hit particularly hard in the past five years, with a series of cataclysmic wildfires preceding the pandemic.

“It’s been a long haul for many people,” Walsh said. “And there is a definite shortage of people working in the mental health care field right now. Just like employers in many industries have had trouble hiring staff, that is absolutely the case in the mental health world. There aren’t enough trained therapists, nurses or psychiatrists.”

Moving from a 10-digit crisis number to a three-digit number won’t solve these systemic problems. But it feels like a step in the right direction.

“Certainly, it’s a good start,” Wood said.

“There is a strong commitment in California to make this program work. My hope is that we look at this launch as a beginning. As we get better and better, we can provide more services to the people who need them, and keep them out of the 911 system as much as possible.”

You can reach Phil Barber at 707-521-5263 or phil.barber@pressdemocrat.com. On Twitter @Skinny_Post.