New suicide hotline can help as mental health crisis worsens

This column contains discussion of suicide. If you or someone you know might be struggling with suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-8255.

Before COVID-19, nearly 40 million people in the United States were identified in 2019 as having mental illness. Worse, fewer than half (45%) received treatment. The stress of the pandemic has exacerbated this crisis, with isolation, stress and worsening access to treatment. 

Across the country, mental illness and suicide rates are high and rising. Approximately 20% of adults reported in 2020 that they suffered from mental illness, and the share of adults reporting anxiety or depression disorders spiked to over 41% last year.

Deaths attributed to suicide

About 47,500 deaths were attributed to suicide in 2019, compared with more than 38,000 in 2010, according to the Centers for Disease Control and Prevention.

Mental illness and suicide are particularly pronounced among young people and those in rural areas. In rural America, higher suicide rates are further compounded by even greater challenges in accessing care.

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July’s launch of 988, a new mental health crisis response number, marks a historic opportunity to ensure that the growing number of people in crisis can get appropriate and more equitable access to mental health services – and that our broader emergency response infrastructure (which includes 911, emergency medical services and law enforcement) can guide people to the right places, at the right times.

By July 16, all telecommunications carriers must provide access to 988, which will direct calls to the National Suicide Prevention Lifeline, a switchboard that provides free crisis counseling and emotional support to more than 2 million callers a year and connects them to one of more than 180 crisis centers nationwide.

The new, easy-to-remember 988 will provide an alternate access point into care and help keep people in crisis from needlessly cycling through hospital emergency rooms and the criminal justice system. It will also provide minority communities that are often fearful of calling 911 for a loved one in mental health crisis, an option less biased toward a response based solely in law enforcement.

This new option will save lives and steer thousands of people into more appropriate treatment.

We have plenty more work to do

The National Suicide Hotline Designation Act of 2020, which mandated the creation of 988, was a seminal bipartisan achievement. It did not, however, require states to build out crisis call centers or mobile crisis response networks, which are critical components of the nation’s crisis response continuum.

Despite the rising need for behavioral health-trained clinicians, few states and localities have an adequate infrastructure to treat people with mental illness. As a result, even with 988, those in crisis might find it hard to get effective help, especially in rural communities.

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In April, President Joe Biden and Congress invested historic sums in behavioral health care, including a $77 million increase for the National Suicide Prevention Lifeline and $10 million for a new Mental Health Crisis Response Partnership program to expand access to model crisis response programs.

This funding will prove important, but as a recent Bipartisan Policy Center report highlights, policymakers must do more to ensure that 988 is equitably and effectively implemented, and to strengthen the broader crisis response system.

Federal agencies need to work together more closely to develop a 988 communications strategy, so the public knows and trusts the services it will provide. We also need to support and expand the crisis response workforce and expand crisis intervention team programs that train police. And policymakers should establish sustainable funding for the crisis response continuum, with guidance for states on how best to tap federal funding.

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With the right coordination, training and financial support, 988 can work effectively with the existing emergency infrastructure to ensure that more Americans receive timely and effective services when they need them. It can also provide less stigmatized access to care, thus encouraging more in need to call. 

The new 988 hotline can be a new beginning in our fight to promote mental health and wellness, and better treat mental illness and mental health crises – but a beginning always requires a next step. I’m calling on state and congressional leaders to take this next step, for the sake of the mental health of our nation.    

Dr. Jerome Adams, a former U.S. surgeon general, is a distinguished professor and executive director of health equity initiatives at Purdue University. Follow him on Twitter: @JeromeAdamsMD

If you or someone you know may be struggling with suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-8255.