The 988 mental health helpline expands rapidly in the United States

HYATTSVILLE, Md. — With bipartisan support from Congress and just under $1 billion in federal funds, the 988 mental health helpline rapidly expanded its reach in the six months following its launch, with more than 2 million calls, messages and chat messages pouring in .

The number of centers answering calls in Spanish grew from three to seven last year. A pilot line dedicated to LGBTQ youth began taking calls in September.

Plans are underway to keep up the momentum, with the federal government adding Spanish-language chat and text options later this year and aiming to expand those services to a 24/7 operation for the LGBTQ line.

When Jamieson Brill answers an emergency call from a Spanish speaker on the newly launched 988 National Mental Health Helpline, he rarely mentions the word suicide or “suicide”.

Brill, whose family hails from Puerto Rico, knows that just discussing the term in some Spanish-speaking cultures is so frowned upon that many callers are too scared to admit they’re calling for themselves.

“As strong as the stigma around mental health problems is in English-speaking cultures, it’s triple in Spanish-speaking cultures,” said Brill, who helps people through mental health crises from a tiny brick building tucked away in Hyattsville, Md.

Brill works in one of more than 200 call centers spread across the country tasked with responding to an increase in calls day and night from people contemplating suicide or experiencing a mental health emergency.

DEPRESSION ON THE RISE

When the 24-hour service launched last summer, it built on the existing network that operated the old national lifeline, 1-800-273-8255. The new number 988 is designed to be as easy to remember as 911.

It couldn’t have come at a more needed time: US adult depression rates, overdose deaths, and suicide rates are on the rise.

“The volume of calls is, in some cases, well beyond what was anticipated,” said Miriam Delphin-Rittmon, assistant secretary for mental health and substance use in the Department of Health and Human Services. “It lets us know that people are struggling, people are having a tough time. Where I feel heartened is that people are connecting to services and supports, instead of struggling alone.”

The 988 helpline recorded 154,585 more calls, text messages and chats in November 2022 than the old national helpline in November 2021, according to the latest available data.

Text messaging has been particularly popular, with the Substance Abuse and Mental Health Services Administration noting a 1,227 percent increase in online messaging during the same period.

The Veterans Crisis Line — callers can press “1” after texting or dialing 988 to reach her — answered 450,000 calls, text messages and chat messages, according to the Department of Veterans Affairs. By the end of the year, the line had seen an increase of almost 10% compared to 2021.

Calls show no signs of slowing down this year, with advisors answering 3,869 calls on New Years and the first day of 2023, up 30% from previous holidays. The Spanish-language line saw an increase of 3,800 year-over-year calls from November 2021 to November 2022.

SPECIALIZED LINES TAKE A LOOK

Meanwhile, some states are considering unveiling their own hotlines to certain communities.

In November, Washington became the first state to launch a mental health crisis line dedicated to American Indians and Alaska Natives. Callers to Washington can reach the line by dialing 988, then pressing “4” to be greeted by one of 13 counselors — all indigenous — who operate the phones.

Having fellow American Indians answer those calls is key, because those familiar with the culture can instantly decode some terms that others can’t, said Rochelle Williams, head of tribal operations for Volunteers of America Western Washington, which oversees the call center.

For example, she said, when a caller says a relative is “bothering” me, that immediately sets off a red flag: The person is likely reporting that they’re the victim of a sexual assault.

“Who has a better understanding of natives than natives?” Williams said. “We don’t trust a lot of government programs. Knowing you’re talking to another indigenous person is really important.”

Next Williams wants to add chat and text options. He hopes Washington’s 988 line for Native Americans will become a model for others. He has already given presentations in New Mexico, Oklahoma, Montana and Canada, which this year will launch its 988 nationally.

States are expected to receive more money to fund the line from the $1.7 trillion year-end spending package, which set aside another half-billion dollars for the project.

However, long-term funding for the 988 helpline is at risk in some states, which have yet to work out a permanent funding plan for it. While the federal government has poured millions of dollars into the project, states would have to take over the operation and funding of the 988 line, just as they do 911 emergency calling services.

So far, fewer than 20 states have passed legislation to permanently fund their 988 line, according to the National Alliance on Mental Health Illness.

In Ohio, for example, advocates are pushing for the state legislature to sign a 50-cent fee that would be added to cell phone bills, bumping up from about $50 million to $55 million each year to run the line, said Tony Coder of the ‘Ohio Foundation for Suicide Prevention.

“Frankly, lives depend on it,” Coder said. “The need for 988 services is more critical than ever, simply because of the consequences and mental health issues caused by covid.”