NEW 988 CALL HOTLINE FOR PSYCHIATRIC EMERGENCIES MAKES ITS DEBUT TODAY
County calls to number will be answered by local Access and Crisis Line
Since 2005, people in crisis and feeling suicidal have been able to call (800) 273-8255, the National Suicide Prevention Lifeline.
Starting today, that Lifeline is a three-digit number — 988 — and its focus is to become the 911 for psychiatric emergencies, offering people in any kind of mental distress the ability to call or text to connect with trained clinicians who will offer support.
In San Diego County, when someone with a local area code calls 988, they will automatically be transferred to the local Access and Crisis Line, which has been part of the Lifeline network and is run by the county-contracted agency Optum.
The 988 effort kicked off with federal legislation in October 2020 as a step toward transforming the nation’s behavioral health crisis system “in much the same way that, over time, 911 spurred the growth of emergency medical services in the United States,” according to a Substance Abuse and Mental Health Services Administration report. The long-term goals, it said, are to reduce the reliance on law enforcement by linking 988 callers to mobile crisis teams when necessary, relieve emergency rooms and encourage people to seek help early.
States and their counties are tasked with bringing that vision to
fruition. The federal government budgeted $282 million for states to expand the existing infrastructure used by more than 200 call centers of the Lifeline network and to increase staffing, as call volumes are likely to rise.
A June survey the RAND Corporation released found that fewer than half of 180 behavioral health program directors interviewed felt confident their jurisdictions were prepared for the 988 launch with financing, workforce and infrastructure. “Our findings have confirmed what many advocates and experts feared,”
said Ryan McBain, a RAND policy researcher. Concerns center on the anticipated increase in calls, and insufficient staffing and long-term funding.
The San Diego Access and Crisis Line is anticipating “really significant increases in the total volume of calls,” but the county “is in good shape” as 988 makes its debut because of “robust investments” to the call center and new services like the mobile crisis response teams, said Luke Bergmann, director of the county’s Behavioral Health Services.
For one, California is investing $28 million in the 13 public and private call centers that take Lifeline calls, including the San Diego Access
and Crisis Line. But in a state as large as California, Bergmann said that’s not enough funding. The county allocated $1.5 million in its fiscal 2022-23 budget to update telephone infrastructure and double its on-call workforce with a plan to hire 20 counselors.
The Access and Crisis Line, which handles about 7,000 monthly calls, is anticipating a 125 percent increase in calls during the first year of the 988 launch, according to the county.
Between the first three months of this year, California’s 13 call centers answered 85 percent of calls to Lifeline, of which 58,000 were answered in-state and nearly 250 were redirected to
other states. The Access and Crisis Line had a rate of unanswered calls between 0.7 and 1.1 percent from January through May, said Bergmann.
It’s too early to tell how much the call volume will rise and how many calls may go unanswered, which is why more long-term funding is needed, said Cathyrn Nacario, CEO of mental health service provider NAMI San Diego.
“Federal, state and local governments must emphasize and acknowledge that we are in a behavioral health workforce crisis and as we ask people to use more mental health or early intervention services, such as 988, we hope that they put more dollars
into place,” she said.
The county’s mobile crisis response teams service providers Telecare Corp. and Exodus Recovery, Inc. are also gearing up for what they expect will be an increase in 988 calls that will require their help.
“We are making strides with staffing and we continue to hire every week as our calls continue to go up,” said Telecare Director Mary Woods. To date, the agency has answered more than 1,700 calls and receives an average of up to 25 calls daily, she added.
Financial support for mobile crisis response teams and to increase staffing at call centers could come via a proposed state
bill that would create a monthly telephone surcharge of up to 30 cents per line, which could bring in more than $190 million annually. The measure, introduced in February 2021, remains stalled in committee hearings.
In the immediate term, the county will “prioritize this service as much as possible within our budgetary latitudes and push for additional funds from our local spend,” said Bergmann, adding that Saturday’s launch is more a “first wave of an opportunity to culturally transition how we think about behavioral health care.”