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When we are in our worst and most vulnerable moments, consumed by feelings of anxiety and stress, the common solution proposed is to simply reach out to your loved ones to discuss and reflect on our feelings rather than resort to harmful alternatives. However, this solution isn’t always feasible, as many might feel uncomfortable revealing their concerns and insecurities even to those they’ve known their whole life, or they simply can’t afford the costs of frequent therapy.
This unfortunate reality is why crisis hotlines are often portrayed as "the answer," since they are incredibly inexpensive and provide the caller with anonymity to discreetly disclose their needs. One such major crisis hotline is The National Suicide Prevention Lifeline. Until recently, the hotline had utilized the lengthy number of 800-273-8255, but will now be upgraded to a three-digit number of 988, which is intended to be memorable and reliable during emergencies (akin to the 911 of personal crises). Beyond the convenience of adopting a 3-digit number, the improved Lifeline will also be staffed by operators who will be trained to counsel callers, as well as how to dispatch crisis response teams, which will reduce the need to dispatch authorities and depend on the usage of emergency rooms.
Despite the immense achievement that a 3-digit number is, there are several concerns that 988 is too ill-prepared to receive the surge of expected calls. A national hotline requires reforms to infrastructure nationwide, which is why the hotline was conceived from The National Suicide Hotline Designation Act, signed by Donald Trump in 2020. The Act would provide funding for 988 through state legislation increasing phone bill fees, yet The National Alliance on Mental Health (NAMI) reported that only the states of Virginia, Nevada, Washington, and Colorado have passed such legislation, which is a relatively small percentage of participating states given that it is meant to be a national initiative.
The consequences of this inability to provide proper funding is exemplified by call centers’ struggle to respond to the massive flood of calls they did not respond to. The Lifeline reported that 17% of calls were abandoned before a caller received help, while it was 41% for texts and 73% of online chats. While it seems that calls were neglected less than online chats by operators, all of these numbers are incredibly alarming, and imply that while there are several people who were experiencing a crisis and thought to contact a hotline, but these hotlines were still rather difficult to access.
Additionally, NAMI claimed that only Virginia, Utah, Oregon, Washington, Nevada, and Colorado currently have statewide crisis response teams or are in the process of developing them. This means that although several states supposedly have crisis response teams to some degree, it is not widely distributed on a statewide level, so even if callers are able to reach a center, that doesn’t necessarily mean that a response team is within their area or would arrive in time to de-escalate the situation. The next step following the hypothetical receiving of crisis response help should be to redirect the individual, if needed, to a crisis stabilization program, which would allow individuals to rehabilitate and receive proper care so that they can stabilize, but this would be difficult to accomplish if there are no crisis response teams within the vicinity.
Overall, the implementation of a 3-digit number for The National Suicide Prevention Lifeline is an accomplishment which, in theory, should be commended for the significant progress it means for mental health and crisis resources. However, the implementation of the 988 is something which clearly still has room for improvement, as the inconsistent access to an operator and crisis response teams discourages any future use of it, while instilling community distrust within services meant to be a reliable resource and “the answer” to crisis.
