A new report from RAND Corp. suggests many communities may not be prepared to fully implement the vision of the 988 hotline. RAND recently released the results of its survey of 180 behavioral health professionals. The survey, conducted from Feb. 8 to March 17, was intended to assess how well communities have prepared for the 988 implementation.
Only 16% of survey participants reported that their agency had established a budget for the transition and long-term support of the 988 hotline. More than half —51% — of survey participants said they had not been involved in the development of a strategic plan related to the launch.
“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, co-lead of the research project and a policy researcher at RAND, a nonprofit research organization, in a statement.
Journalists can find interesting stories by investigating how well their states and local agencies have prepared for the official July 16 launch date for the new three-digit mental health emergency hotline (988).
Hotline expectations and challenges
There have been great expectations and challenges surrounding the development of the 988 hotline.
Congress in 2020 mandated the creation of the new 988 dialing code to be operated via the existing National Suicide Prevention Lifeline. The 988 hotline is intended to be available nationally for call, text, or chat beginning in July 2022, according to the Substance Use And Mental Health Services Administration (SAMHSA).
The new hotline “holds incredible promise toward decriminalizing the response to mental health emergencies,” wrote Polina Krass, M.D., an attending physician at Children’s Hospital of Philadelphia and co-authors in a February article in Health Affairs. It could allow for a shift away from a system in which many people in desperate need of help end up “in a police vehicle, many times in handcuffs, a scenario that contradicts central tenets of trauma-informed mental health care,” Krass and co-authors wrote.
The groundwork for 988 began during the height of the COVID-19 pandemic. Government agencies have been largely preoccupied with their response to that crisis, raising concerns about the risk of 988 calls going unanswered or hotline staff being unable to connect callers to needed local resources, the authors said.
he Sozosei Foundation, established in 2019 as a philanthropic arm of Otsuka America Pharmaceutical, sponsored the RAND report on the 988 implementation efforts.
To assess how communities have prepared for the 988 launch, RAND researchers enlisted the help of the National Association of State Mental Health Program Directors (NASMHPD). The researchers developed a pool of about 690 potential survey participants among people in mental health programs at the state and county level throughout the United States. Participants were offered a $10 Amazon card for their time. Outreach efforts including NASMHPD circulating an email with a link to the survey and a listserv comprising mental health program directors, the RAND researchers wrote.
The 2000 law establishing 988 gave states the option of raising money for call centers the same way they do for 911: with a monthly fee on phone bills, reported Steve Eder in the New York Times in March. These fees collect an estimated $3 billion annually for 911.
“For 988, such fees could also help pay for mobile response teams that can be dispatched to people in crisis, as well as for specialized triage centers — both significant and costly elements of what advocates see as a watershed opportunity to recast the delivery of mental health care,” Elder wrote.
But there has been resistance in some states to creating these fees, Elder noted. Journalists may consider reporting on how different states are handling this issue of funding the 988 hotline and attendant services.
The National Academy for State Health Policy has a webpage that tracks state actions toward providing funds for 988. The National Alliance on Mental Illness is also keeping tabs on this through its 988 Crisis Response State Legislation Map.
- NASMHPD’s 988 – Transforming Crisis Systems Resources webpage
- SAMHSA’s congressional justification for its fiscal 2023 budget request. Jump to “the 988 and Behavioral Health Crisis Services” section of this document. It provides many details about the current demand for calls for help from people feeling suicidal or experiencing other mental health crises.
- AHCJ’s January 2022 tip sheet, which highlights details on the work of the Federal Communications Commission (FCC) and congressional appropriators in overseeing the startup of the 988 hotline.
- AHCJ’s mental health webpage
Email me if you write about this issue and have an article that might make a good “How I Did It” piece. Also, feel free to send suggestions and tips for covering the implementation of the 988 hotline to email@example.com.