Direct Hotline 988 is in place, but few know of its existence
TRI-COUNTY — Few Americans are aware of a relatively new service that is intended to be like 911 for emergency services but is designated as 988, a direct hotline named the “Lifeline” for mental health, suicide and crisis intervention. The 988 Lifeline system came online in 2021 and was available nationwide by July 2022, but it has not been widely promoted in the Big Bend, partially because the tri-county area has long had a hotline administered by PermiaCare that provides mental healthcare services locally.
“In concept, 988 is awesome because it provides a universal number that [people] don’t even have to think about,” said Todd Luzadder, director of mental health services and chief operating officer for PermiaCare. Those facing a crisis have the choice of speaking on the phone, texting or chatting online at 988Lifeline.org.
PermiaCare’s Crisis Intervention/Suicide Prevention Hotline is 1-844-420-3964. It’s not as easy to remember as 988, but Luzadder said that there are some advantages to using local numbers instead of 988, which usually covers large regions. “The problem is if those regional 988 sites are not adequately staffed the call could get routed to a site that’s not familiar with local services,” he said.
Luzadder said the good news for the Big Bend is that the system responding to 988 calls here goes to the Emergence Health Network in El Paso, a crisis center familiar with tri-county services.
In addition to providing immediate help, PermiaCare’s crisis center also works to direct callers to follow-up resources, he said. The PermiaCare hotline center is accredited by the American Association of Suicidology (AAS). All 988 centers have to meet standards for accreditation from select organizations like AAS.
Noreen Jaramillo, Emergence Health Network’s communications director, said the organization’s transition to accepting 988 calls has been smooth, since staff are already trained in the necessary counseling. Emergence will get “overflow” calls from areas like Dallas occasionally as well, she said.
Jaramillo said different regions and states have approached the marketing of 988 differently. New Mexico, for example, had a big rollout with its own website, commercials and a news conference, she said. Emergence has simply started listing its existing hotline number next to 988, although Jaramillo said the local TV stations often opt to promote 988.
Luzadder said that when 988 debuted, crisis centers were taking it slow in participating in the network or promoting it to ensure it had time to ramp up and serve a large number of calls. By spring of 2023, a Pew Research poll showed that only 13% of Americans had heard of the Lifeline. But by the summer of 2023, after more marketing nationally, that number rose closer to half of all Americans.
The Lifeline has come under criticism for long hold times for callers, which translated into a large number of people abandoning a call — something that could be devastating for those facing suicidal thoughts. The science-oriented investigative podcast “Radiolab” recently explained how the 988 system underwent an extensive effort of surveys and research in an attempt to find the perfect hold music that would keep callers from hanging up. (Callers had complained about a jazzy, upbeat music clip first used. The result was a piano-based piece that did improve the hang-up rate, although minimally.)
Media stories in 2022 reported callers complaining of being on hold for 15 minutes or longer. However, as the 988 system grew with additional crisis centers and tried to perfect its process, stats for answered calls have grown and abandoned calls have dropped, according to statistics kept by the federal Substance Abuse and Mental Health Services administration. In July 2022, the Lifeline answered 84% of calls with an average wait time of one minute and 33 seconds and 16% of calls abandoned. By March 2024, 91% of calls were answered with an average wait time of 40 seconds and 9% of calls abandoned.
Lifeline has received 9.6 million calls, texts and chats since it started in 2022, with 482,528 in March of this year alone. The system is paid for by a combination of federal funds and state grants allocated to Texas crisis centers. Callers can choose if they want to be routed to a veterans crisis line or a Spanish language counselor, and the hearing impaired can use their TTY relay service or dial 711 and then 988.
Luzadder said some people facing a crisis may prefer a number they’ve contacted before or have seen promoted when they get mental healthcare services, even if they have to look it up. But he said the more options the better. “It’s always better to have more resources available,” he said.
It remains to be seen whether the Big Bend will do more to promote the number. “Everyone across the nation is doing 988 in their own way,” Luzadder said. He added that the beauty of 988 is that you could be visiting somewhere far from home, and if you face a crisis, you can always dial 988.
This story is part of a series on mental health in the Big Bend funded by the Presidio Community Fund.