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988 Suicide Hotline Kicks in Saturday, Raising Concerns

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By Jorge Casuso

July 14, 2022 -- Starting Saturday, call centers in the Los Angeles area and nationwide will start taking 988 calls for the National Suicide Prevention Lifeline (NSPL), raising preparedness and privacy concerns.

The new three-number hotline -- run by Vibrant Emotional Health, the New York-based nonprofit that operates NSPL -- provides support for "anyone experiencing mental health related distress," according to the Substance Abuse and Mental Health Services Administration (SAMHSA), which oversees the program.

Callers -- who can be experiencing "thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress" -- will be connected with a "trained crisis counselor," the website states.

Some 39 million people in the U.S. were identified as having a mental illness in 2019, according to SAMHSA, while the number of those calling the hotline rose from 50,000 calls in 2005 to more than 2.4 million in 2020.

Though the new number provides access to the same services as the 800-273-TALK crisis hotline number, which will remain in service, the call volume is expected to skyrocket with the easier-to-remember number, potentially overwhelming the system.

According to a June 2 report by the Santa Monica-based RAND Corporation, more than half of the 180 public health officials responsible for helping to roll out the new service "reported that they had not been involved in the development of a strategic plan related to the launch."

Only 16 percent of respondents -- who included state, regional and county behavioral health program directors covering 120 million Americans -- "reported that they had helped develop a budget to support 988 operations," the think tank found.

"Our findings have confirmed what many advocates and experts feared: communities throughout the U.S. have not had the time or resources to adequately prepare for the debut of the 988 hotline number," said Ryan McBain, a policy researcher at RAND who co-led the project.

While a large majority of hotlines supported phone-based communication, fewer than half supported text/SMS, and fewer yet supported online chat, a problem given the "high rates of suicide observed among adolescents and young adults," RAND found.

In addition to its share of some $284 million in federal funding to upgrade infrastructure for call centers nationwide, California has been preparing for the rollout.

Last September, State officials vowed to add $20 million to help upgrade California's 13 call centers, including $8 million in the proposed 2023 state budget.

In addition, a bill authored by Assemblymember Rebecca Bauer-Kahan (D-Orinda) would impose a tax capped at 30 cents on phone lines "to pay for maintaining staffing at the call centers as well as paying for teams of medical professionals to respond to calls in person," according to a report by CBS News.

In addition to Federal funding in the current budget, two SAMHSA grants totaling $48 million "will fund the effort to better harness technology to help Americans in mental health crisis and save more lives," according to an agency press release last year.

The major influx of funding and technology upgrades have raised privacy concerns, particularly since about a fifth of mobile devices use area codes that don't correspond to where the owner lives, according to a January 29 report in "Mad in America," a webzine dedicated to critical perspectives on modern psychiatry.

According to the report, "Vibrant/NSPL leaders argued to the FCC that they should be able to automatically route all online and phone contacts to the nearest NSPL call center based on that person’s current geolocation" helping call-responders "give callers relevant local referrals to resources and services."

In addition, they argued that "rather than having to contact a 911 dispatch center to initiate a trace, all NSPL call centers should themselves be able to directly access every caller’s personal information and precise current geolocation. This would, they suggested, enable speedier emergency responses."

The FCC noted that revealing all 988 callers’ names and locations “could undermine the benefits of the Lifeline by dissuading at-risk and vulnerable populations from using the service in a time of need, out of fear of embarrassment, aversion to intervention by authorities, or other similar reasons,” Mad in America reported.

The FCC recommended that Congress form a national “multi-stakeholder advisory committee” to examine the “important legal issues for consideration, including those surrounding the privacy of caller information,” according to the article, which noted that such an agency had not been announced.

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