RESEARCH WEEKLY: State and Local Preparedness for 988 Rollout Found Lacking
By Kelli South
Editor’s note: Starting July 16, anyone living in the United States will be able to dial 988 to access the National Suicide Prevention Lifeline, a national mental health emergency hotline available for anyone in crisis. Each Research Weekly published in July will focus on some aspect of the 988 implementation.
(July 6, 2022) In the same way that people can dial 911 to contact emergency services, next week, U.S. citizens will be able to dial 988 to reach the National Suicide Prevention Lifeline, a national mental health emergency hotline available for anyone in crisis. Individuals can call, text or chat this number and be connected to trained counselors available to discuss mental health concerns and connect the individual to crisis and treatment services in their area.
In anticipation of the 988 rollout this month, the nonprofit RAND Corporation published a working paper analyzing the country’s preparedness for the 988 implementation, finding room for improvement in state and local preparedness.
Study details and findings
The authors conducted a survey of individuals who work in mental health agencies at the state, regional and county levels, receiving 180 responses total from 23 states. After the initial survey, the authors followed up with in-depth qualitative interviews for 15 of the original respondents.
Only 41% of respondents reported that their agency was involved in preparation for the hotline, though 83% said that it was very important for their agency to be prepared for the transition. The most commonly cited challenges to 988 preparation were insufficient mental health workforce and lack of funding. While many experts expect that the creation of 988 will lead to an increase in call volume to the hotline, this lack of designated resources and staff indicates that the current mental health continuum of care will struggle to accommodate this increased need.
Lack of focus on severe mental illness
Importantly, the researchers asked if the locality currently has sufficient psychiatric bed capacity and 81% said that there is insufficient capacity. This is particularly crucial because these beds serve not only as the frontline for mental health crisis management but are one of the most important tools for treating an individual with a severe mental illness.
The report fails to mention severe mental illness in its findings at all, which is a particularly concerning indicator that perhaps those implementing 988 have not considered the needs of this specific population. Individuals with severe mental illness constitute a large portion of people who use crisis care services, despite the fact that they make up just over 3% of the U.S. population. Due to the nature of their disease and symptoms, those with severe mental illness have a unique set of treatment needs and it is imperative that infrastructure is in place to assist them with their specific needs, building more trust in crisis hotlines among this population.
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