Billed as the 911 of mental health, the three-digit national Suicide & Crisis Lifeline hotline rolled out this month to a lot of applause, but there are some local concerns.
Formerly known as the National Suicide Prevention Lifeline (a 10-digit number), people can now call or text 988 and be connected to a trained mental health counselor. The 988 Lifeline is a network of more than 200 state and local call centers supported by U.S. Health and Human Services through the Substance Abuse and Mental Health Services Administration. It provides 24/7, confidential support to people in suicidal crisis or mental health-related distress.
People in San Luis Obispo and northern Santa Barbara counties continue to have access to Central Coast Hotline at 1-800-783-0607. It too is a 24/7 mental health guidance, crisis and suicide prevention telephone line that provides local mental health resource information. That program is offered through the county’s Transitions Mental Health Association (TMHA) and receives about 10,000 calls annually.
“I think 988 is a wonderful evolution for supporting people in the middle of crisis,” said Meghan Boaz Alvarez, clinical director for TMHA. “It’s great to have three digits instead of 10. When somebody’s in crisis, it’s hard to remember ‘who am I supposed to call, what was that number.’ The idea of a three-digit number helping people quickly connect to a skilled response is a wonderful, it is essential.”
However, TMHA is concerned that California, the third largest state by area and 11th by population, only has 13 call centers.
“Our  calls will be answered in either Sacramento County or Los Angeles County,” said Boaz Alvarez, “and those are going to be great knowledgeable folks. They’re going to be warm and supportive and helpful to somebody who’s in crisis. And then, they’re going to Google what resources are available in San Luis Obispo County and do their best working online to find out how to navigate the resources here. I think that’s less than ideal. The advantage with our Central Coast Hotline is that our staff and volunteers know the local agencies; they know the local crisis resources. Those networks are in place, and we’re very skilled at getting people connected to the right resource quickly.”
Central Coast Hotline did apply to become a 988 Lifeline call center, but was not accepted. They are accredited by the American Association of Suicidology, a suicide prevention advocacy organization, and, thanks to a grant by MUST! Charities, are in alignment with a web based call system, and texting capabilities will roll out in August.
“I think, timing wise, in the midst of a national rollout of all of these crisis centers with 988, they just didn’t have capacity to onboard another center,” Boaz Alvarez said. “I think funding was also an issue — there’s a limited amount of funding for California and it was kind of already spoken for with the existing centers.”
Central Coast Hotline will reapply to become a part of the national network, perhaps in the fall.
“We’re aware that there are kinks that have to be worked out,” said Boaz Alvarez. “I think we’ll want to wait until things settle down a bit before applying because we want to make sure our application can be considered thoughtfully.”
Until then, like 988 Lifeline, the local hotline will continue to offer support to people in need as well as family and friends who are concerned about the mental health of loved ones.
“We’re a great resource for questions about mental health issues, referrals for mental health services, not just specific to crisis,” Boaz Alvarez said. “The staff and volunteers do a great job of supporting a person who’s struggling, whether it’s their own mental health issues, or they’ve got a friend or family member who’s struggling with anxiety or depression, and they’re not sure how to help.”
Readers interested in volunteering with Central Coast Hotline can start the application process at https://bit.ly/3b27zER. There is a 50-hour training period that is expected to begin in September.
Although only in the early stages of the rollout, 988 Lifeline has its opposition on social media.
On Instagram, lizwins_peersupport posted that, “988 is not friendly. Don’t call it, Don’t post it, Don’t share it, without knowing the risks.” According to a NBC news affiliate in Las Vegas, that post amassed nearly 240,000 likes.
Liz Winston, a New York based organizer of the support group Rehumanize, which is opposed to “involuntary treatment” or “psychiatric incarceration,” runs the account.
That post goes on to read, “988 reduces the likelihood that a cadre of police with guns drawn will respond to a mental health crisis, but 988 will arrange for some police or a mobile crisis team to transport the person to an emergency room or psychiatric facility.”
Boaz Alvarez said that law enforcement hauling off someone who calls a hotline to a psychiatric facility or medical emergency room is a step that is almost never taken.
“We would like to help the person, and they have reached out to us for help, so we’re kind of on the same page at the outset,” she said. “I would say 99% of the time, maybe even more than 99% of the time, we’re able to work with that person collaboratively to talk with them about what has led to them being in this place, to talk about what resources they can use to support themselves and to talk about our local crisis line as a resource.”
Should a person call who has already injured themselves and there is a suicide attempt in progress, then a call center would mobilize an emergency response.
“Again, that person has reached out to us for help,” said Boaz Alvarez. “So, I would say, we’re still doing that in collaboration with the person. What you are seeing described on social media is not how these hotlines operate.”
In 2020 alone, the U.S. had one death by suicide about every 11 minutes—and for people aged 10-34 years, suicide is a leading cause of death, according to the US Federal Communications Commission.
The National Suicide Prevention Lifeline launched in 2005 with the number 1-800-273-8255 and received 46 thousand calls in the first year. All phone companies and text messaging providers are required to route all calls and text messages to “988” to the 988 Suicide and Crisis Lifeline.
If you are in crisis, call 988 or the Central Coast Hotline at 1-800-783-0607.
For more information and specific resources, go to 988lifeline.org or t-mha.org.