A three-digit phone number debuting next month seeks to change conversation around suicide, a leading cause of death, and reduce the stigma around seeking help for mental illness.
In Philadelphia and nationally, assistance will be available with a call to 988, a mental health crisis health hotline going live on July 16. It seeks to replicate for suicide prevention the easy-to-remember 911 emergency call drill.
No one expects people to know the ten-digit number of their local police station in case of an emergency, explains Matthew Wintersteen, a clinical psychologist at Thomas Jefferson University. “When somebody is in a crisis, they need to be able to easily access, who do I call? Where can I go? And the idea is that 988 will become that number,” he said.
Bringing so much attention to addressing suicide is a milestone in mental health, experts say. Much of the logistics are already in place: The new number will route to the crisis centers that currently respond to calls to the National Suicide Prevention Lifeline, which now operates at 1-800-273-8255 (1-800-273-TALK).
“It’s a really big sea change in the approach to people who have mental health crises,” Jill Bowen, Philadelphia’s commissioner of Behavioral Health and Intellectual Disability Services said.
The number of people dying by suicide has been rising over the past two decades in Pennsylvania and nationally, ranking the second leading cause of death for people between the ages of 10 and 34, according to the latest statistics from the National Institute of Mental Health.
In 2020, nearly 1,700 people died by suicide in Pennsylvania. This represents a decline of 10 percent from the year prior, despite concerns that the pandemic would lead to an increase in suicide deaths, 22% higher than the average throughout the 1990s.
A call to a suicide prevention lifeline can save a life, experts say.
“When you get on the line with someone who is trained as a professional counselor, they are able to help instill hope,” Dale Adair, chief psychiatric officer at the Pennsylvania Department of Human Services. “The person taking the call is able to help the person develop a safety plan.”
Experts say the vast majority of issues can be resolved over the phone without any additional intervention at that time. In the rest of the calls, the person responding can deploy a crisis response team, make a referral, or connect with 911 if needed.
In Philadelphia, 988 is part of a larger effort that DBHIDS is calling Crisis 2.0 that has included expanding the capacity of the Philadelphia crisis call center — that now averages about 188 calls per day, according to DBHIDS — and the capacity of the community mobile crisis response teams.
The origin of 988 is in the National Suicide Hotline Designation Act of 2020, which set the launch date of 988 on which states to be ready to respond to calls.
The law also instructs states to introduce legislation to ensure funding for the call service — such as imposing a telecommunication fee or creating a trust fund. According to the National Alliance on Mental Illness, the majority of states did not introduce 988 legislation and only a handful actually enacted it.
“988 is one of the biggest things that has happened in the mental health system in a long, long time,” said Christine Michaels, chief executive of the organization’s Pennsylvania affiliate.
Pennsylvania has not yet acted on the new law, but has a system of 13 crisis call centers funded by a mix of federal, state, and local sources.
Pennsylvania call centers currently respond to about 85% of in-state calls to the National Suicide Prevention Lifeline. The rest are answered out of state. That is close to the 90% in-state response rate that the federal government is hoping to see with 988.
» READ MORE: A new suicide hotline, 988, will launch in July 2022 and offer expanded services
The new number will not be widely promoted nationwide for a year, so any operating kinks can be addressed.
At the Valley Creek Crisis Center in Exton, one of Pennsylvania’s 13 crisis call centers that will receive 988 calls, little change is expected immediately. The center already receives calls from all throughout Chester County — through the National Suicide Prevention Lifeline but mainly through a county crisis line (610-280-3270).
“I don’t think that on July 17 we’re all of a sudden going to be getting 300 to 400 more calls,” said Sonja Keeney, the director of crisis services, who expects the service will grow in time.
Some hope that 988 will be a national catalyst for expanding services to help.
Just within Pennsylvania, what services are available for the calls that aren’t resolved over the phone — or availability of services to refer people to at times when demand exceeds supply — varies by where people live. “Some communities do have pretty robust mobile response teams — and they tend to be in areas like Philadelphia or Pittsburgh — but it may be that the demand for them is also higher,” Pennsylvania Department of Human Services deputy secretary Kristen Houser said.
There are also disparities among call centers. Philadelphia and Exton are well staffed, but other centers across the state are struggling to hire — meaning that they both can’t answer in-state to all current calls and might fall even further behind as 988 is promoted and call volume increases. For example, True North Wellness Services, the call center in the more rural area of Hanover, in York County, is operating with about half of the staff it needs, according to WESA.
Pennsylvania received a $3.2 in April from the federal government to assist with building up call center capacity.
“988 can be a gateway, it can be an entry point, into the mental health system — a system that a lot of people have struggled accessing it,” said Rep. Mike Schlossberg, a Leigh County Democrat who has been open about his own past struggles with depression. “There really is an incredible moment here.”