PHILADELPHIA – By July, the United States will switch to an extended suicide helpline where people can call a three-digit number – 988 – for help.
Easier to remember than the 800-273-TALK number currently in use, the 988 is supposed to mimic 911 with simplicity and seriousness.
It is also hoped that 988, and not 911, will eventually become the number called when someone experiences a behavioral health crisis, saving the police from showing up to an emergency for which they cannot. -be not trained.
Behavioral health professionals believe a Type 988 system could have prevented the death of Walter Wallace Jr., 27, a mentally distressed West Philadelphia man who was killed by police last year .
It is estimated that 30% of all 911 calls would be more appropriate for 988, according to Kristen Houser, assistant secretary of the Pennsylvania Office of Mental Health and Addiction Services, who will oversee the 988 implementation in the state. The office is part of the Department of Social Services.
The 988 line was established by Congress in October 2020 as part of the bipartisan law to designate the national suicide helpline. The legislation sets July 16, 2022 as the official start date and states that individual states must propose legislation to show how the service will be funded and implemented. So far, nine states have done so. New Jersey has a bill under consideration. Such legislation does not yet exist in Harrisburg, although Gov. Tom Wolf’s office has proposed a bill without information on funding.
Although suicide rates in the United States appear to have declined during the pandemic, there were still around 2 million calls to the 10-figure national suicide prevention lifeline last year. The simplified, easier-to-remember 988 line will receive 24 million calls, texts and online chat requests by 2027, according to Pew Charitable Trusts.
Once fully functional, the 988 will be seen as much more than a suicide hotline. What separates it from the current option is a “continuum of care” that behavioral health experts hope will apply to better support a person with anxiety. A person first speaks on the phone with a qualified responder in a call center; then, a mobile crisis team shows up at the person’s door; if necessary, the person is taken to a crisis stabilization site in a non-hospital setting; and the person continues to receive follow-up care.
“The continuum can keep people out of courts, prisons and emergency rooms,” said Ann Torregrossa, executive director of the Pennsylvania Health Funders Collaborative, a group of 40 foundations headquartered in Swarthmore. “With our existing hotline, we really don’t have a call system that can solve all of this.
“It’s long overdue and could be extraordinary.”
However, the way forward may not be easy.
For starters, 988 should be expensive, although no one can say how much. Congress has stipulated that states can offset the costs through additional charges on telephone lines.
It is the primary source of income for 911. In Pennsylvania, according to figures from the Pennsylvania Emergency Management Agency (PEMA), customers over the phone must pay a fee of $ 1.65 per month to help purchase the line. emergency to call the police, fire and ambulance services. .
In 2020, that surcharge generated $ 318.3 million, according to PEMA figures. Together, the state’s 911 lines cost $ 415.5 million, a difference of about $ 97.2 million. In Pennsylvania, each county is responsible for providing 911 service within its jurisdiction, so the 2020 deficit was paid for out of general county funds or other county revenue sources, a spokesperson for the county said. PEMA.
Further funding for 988 could come from Medicaid reimbursements for mental health care, as well as block federal grants, according to an October Pew report.
Americans seem to support the idea. About 70% of those polled said they would be willing to pay a fee to underwrite 988, according to Hannah Wesolowski, director of the National Alliance on Mental Illness, an advocacy group in Arlington, Virginia.
In press releases, the telecommunications industry also says it supports 988. CTIA, the lobbying arm of the wireless telecommunications industry, issued a statement in 2020 supporting the implementation of 988 “to ensure that Americans are more aware of the supports and services needed to prevent suicide ”. The CTIA even said it has already turned on the 988 in many places, although it only connects to the existing national suicide hotline system, with none of the 988 features on offer in place.
The organization listed Verizon, T-Mobile, and AT&T as being enthusiastically on board with 988.
But during testimony in Colorado in April to discuss Bill 988, a CTIA official said all telecom charges should pay only call centers and “shouldn’t fund the response” – teams mobile crisis and stabilization and monitoring services.
It has drawn the wrath of Congress, including Senate Finance Committee Chairman Ron Wyden, D-Ore. of that vital lifeline for Americans in crisis. “Senators added that mobile crisis teams and crisis stabilization services” are all fundamental to breaking the cycle of suicide. “
CTIA officials did not respond to a request for an interview.
Pennsylvania State Representative Michael Schlossberg, D-Allentown, Co-Chair of the Legislative Assembly Mental Health Caucus, agreed that carriers “aren’t too keen on raising their fees to pay 988” . But, he added, the 988 “is a significant elevation of the mental health issue.” Personal experience informs his current efforts in the Legislature to pass a 988 Underwriting Bill, he said, adding: “I have been suicidal at times in my life and that is why I’m more in that role. “
The lack of legislation in Pennsylvania that would limit the operation of the 988 is worrying for some.
“We’re not where we need to be to be ready by July,” said Joe Pyle, president of the Thomas Scattergood Behavioral Health Foundation, a downtown grantmaker. “There is no real champion for mental health in Harrisburg.”
Still, Houser of DHS said that “no one is adamant against the legislation,” which behavioral health advocates say is a sign the project will be brought to fruition. Yet, experts say, it could take up to two years for the ambitious continuum of care model to be completed.
Houser said there are plans to market 988 closer to the July launch. Even few local health professionals know about the project. One exception is Thomas Jefferson University, where researchers are helping set up the new line, according to people familiar with the work. A research official at the university declined to be interviewed.
Ultimately, 988 – if performed as planned – may “turn people away from suicide and reduce [drug] overdoses as well as psychiatric visits to inpatients, ”said Joni Schwager, executive director of the Staunton Farm Foundation, a Pittsburgh nonprofit that distributes grants to benefit behavioral health.
She reiterated the importance of the line limiting the number of police officers called for a mental health crisis.
“The fewer guns there are,” she said, “the less chance that someone will be killed.”
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