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988 Hotline Struggling with Growing Pains?

According to a recent survey, it sure seems that way:

People with severe psychological distress were more likely than others to have heard of 988 and to have used the lifeline, according to research published Tuesday in JAMA Network Open. But overall, only a quarter of people said they would be very likely turn to 988 in the future if they or a loved one were experiencing a mental health crisis or suicidality – and less than a third of people with severe psychological distress who had already tried the lifeline were very likely to use it again.

This isn’t great, and the article goes on to explain some of the reasons this is happening. Some, in retrospect, seem obvious. The 988 line is larger and serves a broader audience than the Suicide Prevention Hotline it replaced. There are likely some callers that operators haven’t had enough training to successfully help. People with serious mental health issues are unlikely to reach out once, let alone a second time, to anyone, not just the 988 line.

There’s also one reason that we can see between the lines that will be a bit harder to overcome.

Success for the 988 lifeline would involve active management of acute crisis and help connecting people to broader mental health resources, he said.

“It’s active supportive listening, assessment and it’s a door to care. It’s a way into a system,” he said. “In an ideal world, success looks like getting all that on the call, but also getting follow-up care in a good supportive system once off the phone or done texting.”

What if the operators on the line do get the necessary training and we make all the improvements we can make as we learn how to do this better, and there is just no system to hand the caller off to? Because I feel like that might be the case for some callers. The call is a door to care, but is the follow-up care available?

If we believe what we see and read from various sources the answer to that question is no. 988 can be the door, but if the door only leads you right out the back of the system and back on your own, I wouldn’t call again either.

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