Earlier this week, there was a really important but subtle change. People who are in mental health and suicidal crisis can now call a 3 digit number — 9-8-8 for help
988 serves as a universal entry point so that no matter where you live in the U.S., you can easily access 24/7 emotional support. You don’t have to be suicidal to reach out-our trained counselors can help you through any #mentalhealth challenges you’re experiencing. #988Lifeline
— 988 Suicide & Crisis Lifeline (@988Lifeline) July 16, 2022
There has long been a suicide hotline but it is a long number that is not easy to memorize.
A 3 digit hotline number makes getting help easier. And if help is easier to get, however marginal the improvement in access, more people will actually be able to use the resource.
Always remember, help is available no matter what.
raven
Will they route vets to a specific service
eta
The website includes a link to the Veterans Crisis line
The process will not change with the transition to 988. Veterans, Service Members, and their families will be able to call 988 and press option 1 the same as they are able to do by calling 1-800-273-8255. To learn more, please visit https://www.veteranscrisisline.net/about/what-is-988.
trollhattan
Heard that since the rollout calls to helplines ticked up noticeably, and an operator interviewed said a lot were seeking further information so that the caller could refer somebody else. Which seems like a good thing.
It’s also geographically aware and will direct callers to helplines in their region.
SamIAm
This is really a huge step forward. Anyone have the details on how this came about?
Benw
Interesting! My insurance provider left a VM just today about new mental health call services; I wonder if that’s related as well?
Andrya
This is a huge step forward, but there needs to be a second step forward on a community by community basis.
As long as the problem can be handled with just a phone call, everything will be fine. However some calls (a minority of calls, but still) will require that someone go out to the troubled person’s location. It is very important that the responders be mental health and de-escalation trained, preferably mental health professionals rather than policemen. There have been all too many reports of police shooting mentally ill people who could have been talked down with a less aggressive approach.
I have some personal experience of this. Some years ago, an elderly relative with dementia called the police in the city where I live and told them that I was mentally ill and suicidal. (I wasn’t- the relative was not in touch with reality, though unfortunately she managed to sound coherent on the phone.) The police organized a massive raid in the small hours of the morning, multiple police cars, flashing lights, dogs- the works. I was treated as a criminal suspect rather than a sick person. If I had been suicidal, this would quite likely have pushed me over the edge.
SiubhanDuinne
@Andrya:
What a terrible experience. I hope the effect on you was as minimal as possible. I also hope your elderly relative was able to get the kind of care she needed.
Matt McIrvin
@SamIAm: Bipartisan federal legislation, signed by Trump (believe it or not). I think it was inspired by local efforts in some states.
trollhattan
@Andrya: Jesus, that’s…mental. How awful.
And no, cops aren’t sociologists or psychologists and treat every problem like a nail, which naturally calls for the hammer.
Andrya
@SiubhanDuinne: She was getting loads of care. In fact, the problem resulted from a family decision not to put her in a facility, not to restrict her phone privileges, and let her lead a totally normal life despite her mental condition.
I survived OK- I think I am emotionally robust enough to handle a trauma of that magnitude. But it definitely added to my distrust of the police.
WereBear
@Andrya:
I wish more people would realize it’s irresponsible. It not only protects other people, it protects the person from their own lack of understanding.
I was part of the group who agreed to take the distributor cap out of Grandma’s car, for instance.
olster
“Always remember, help is available no matter what.”
Unless you are using a Microsoft product.
olster
@WereBear:
“I was part of the group who agreed to take the distributor cap out of Grandma’s car, for instance.”
So the responsibility was distributed, too.
Ah, distributor caps! I was trying to explain one to a 25-year old the other day. “Yes, completely analogue — the engine turned a spindle which had a contact on the end of it, and as the contact rotated around the clock-face, it completed a circuit to each spark-plug in turn. Then there was something we called “top dead center,” and you had to adjust the timing in relation to that….” It all sounded hilarious to this son of the digital world.
Matt McIrvin
@Andrya: I think one of the purposes of this is that it’s NOT 911 so the immediate response won’t be to send cops. But there’s still that question of what to do when things escalate from a phone call to sending someone.
StringOnAStick
I hope there’s something and someone to send too after they call. Last year I was suspicious that my younger sister was suicidal, but as I tried to find a suicide hotline in NV I found it had closed a few years before.
Mel
@Andrya: Something similar happened when my grandmother was suffering from dementia. She believed that the (absolutely wonderful) lady who came in twice a week to provide a break and to assist with light housekeeping was “sick in the head” and “stalking the family”.
She made a short call to a local mental health hotline. A counselor there notified police, who arrived for a safety check at my grandparents’ house, but also showed up at the care assistant’s house, full of threats and bluster, and humiliating her thoroughly in front of her children and her neighbors. They also called her employer and nearly caused her to lose her job. It was a terrible experience all around.
I think that increased access to mental health care is absolutely essential, but its effectiveness hinges upon how well organized and networked the system is, how well-trained the front and mid line staff are, and what the intention of the line is. Is it to intervene in high-risk situations, dealing with suicidal callers and those who might be a risk to others? If so, how do they plan to avoid situations like what Andrya encountered?
If the line will also be dealing with callers with non-life threatening mental health concerns, how will it arrange for proper referrals and support? Equally importantly, how will the info that callers provide be dealt with to ensure the callers’ privacy and safety? (I have worked with abused teenagers and with adult victims of domestic violence, and have seen some cases where the actions of the systems in place put them at even greater risk instead if protecting them.)
Hopefully, these are all kinks that have already been ironed out prior to the launch of the hotline.
Ken
@olster: “So before computers, did they have some analog way to seal you into your burning car?”
dmsilev
@Ken: I think imprinted wax was traditional.
Andrya
@Matt McIrvin: PRECISELY! Although I totally appreciate the sympathy different jackals have expressed, the point of my post was DO NOT SEND POLICE (AND ESPECIALLY NOT POLICE WHO DON’T HAVE MENTAL ILLNESS TRAINING) to answer a mental illness call.
Police are trained to demand immediate compliance to their orders- and a person in a mental illness crisis might not even hear what the police are saying. Police are trained to bring a hammer to situations where finesse could save human lives.
Important point: many Americans believe mental illness is a voluntary moral failing- hence the vehement Republican objections to Obamacare requiring that health insurance cover mental illness. This is not true- mental illness is as much an involuntary biological illness as cancer.
ArchTeryx
Be very, VERY careful with suicide hotlines. I’ve been reading, and collecting stories, for years about how they routinely violate HIPAA, get the cops involved without the person’s consent, and they end up killing the very person they are trying to save. Cops are the *LAST* person you should even send to someone having a mental health breakdown unless they are a clear threat to others, but the assumption nowadays is that ALL sucides are a potential threat to others, so your agency is taken away almost immediately by police.
I’ve had multiple suicidal crises but I avoid hotlines like the plague they are. The one time I had a breakdown like that at work, the FIRST THING these hotline-trained counselors did was call the cops. Were I not a white male, I might not have survived what came next.
I know this is a serious amount of piss on people’s parades here but AFAI have seen, hotlines exist for two reasons: To raise money and cover their own asses. The people who volunteer for them are hardly that cynical but the administrators absolutely are.
olster
@Ken:
Sometimes the threads inside of the locking knob — the one that looked like a golfer’s tee? — would strip out, and it could be hard to pull up on the skinny threaded rod.
Other than that, no — old cars would kill you in a million ways, but at least they didn’t require you to become a fanboy of a megalomaniacal South African charlatan.
Doc H
Key phrase: nonconsensual active rescue.
“Thoughts from a suicidologist on the new 988 crisis hotline:
1. Having a simple number is good.
2. Having more trained crisis teams is good.
2. It’s still linked to nonconsensual active rescue which means they can & will trace your call & send police if they deem it necessary.”
https://twitter.com/SaltySicky/status/1548841406617329664
“This is hugely problematic & a barrier for folks who want help. They won’t call if they know it’s not truly confidential. This is for a good reason, as people can & do get fired from jobs, lose housing, lose access to their kids, etc. after being deemed a danger to themselves.”
https://twitter.com/SaltySicky/status/1548841428436062215
More in the thread inc cop’s propensity to shoot people in crisis.
Old Man Shadow
@Andrya:
Yeah, that was my first fear too. I hope the 988 number and the 911 services are, for the most part, separate and the 988 folks have options other than sending armed potential killers out to ‘help’ folks.
I’ve tangentially known more than one family who called 911 to come help a relative and the police arrived and ultimately ended up killing the person.
dnfree
I heard an article about this on NPR. Sounds like it depends on links to local agencies and networks, some of which have ramped up and prepared and others haven’t. Large swaths of the country don’t even have responding agencies. I’m afraid this isn’t ready for prime time but I hope I’m wrong.
Zzyzx
It’s nice to see this reaction instead of the one my Twitter feed has, mainly, “988 is evil and will take away your privacy and probably will involve cops!”
Mel
@WereBear: Agreed.
This incident was the catalyst that finally got my parents to listen to physicians and to my sibling and me, and to understand that my grandmother had passed the point where it was safe or even ethical to care for her at home. Quite simply, as difficult and heartbreaking as it was for them to face, she had crossed that tipping point where the problems were manageable with environmental adjustments, support, and supervision, and was in a stage of cognitive loss where she was a danger to herself and to others.
Acknowledging that was doubly difficult for them, because that meant accepting that their hidden hopes that a cure might suddenly be found, or that somehow the disease process would stabilize and not progress further if they just took the best care of her, had to be put aside, and the awful reality of her prognosis had to be faced head-on.
Dementia is a terrible, terrible disease.
oldster
That’s so weird — some how my nym got trimmed in the comment box.
I’m “oldster”, i.e. very old person, — not “olster”, i.e. what the Kray Twins carried their pistols in.
trollhattan
@olster: Or your Amazon order has gone AWOL.
trollhattan
@oldster: Cockney cowboys?
SamIAm
@Andrya:
@Andrya:
That’s awful, yes there does need to be a follow up with local community teams trained for going out to check on people who are NOT the police.
SamIAm
@Matt McIrvin:
Color me gobsmacked…
SamIAm
@olster:
Then you get Clippie!
trollhattan
@olster: Did you get into mechanical and vacuum timing advance? “But, I thought it needed to be set here.” “Right, but as RPMs rise then the spark has to happen sooner. Or later, I forget which.”
“Now explain ‘dwell’.”
“Class dismissed.”
My current car has separate systems to change both valve timing and valve amplitude. My head explodes well before I finish explanations of those.
Ken
@trollhattan: Naw, if they were Cockney they’d “lie-and-stammer their Mrs. Markey’s dogs in their onions-and-butter”, which (after a five-minute explanation of rhyming slang) would work out to “keep their pistols in their holsters”.
SamIAm
Not to minimize the destructiveness that has happened when suicide hotlines have called the cops on a caller. But I have had several friends who are alive because the police came by when they suddenly hung up on the councilor.
None are black, one is East Asian, one white gay male, and the other Hispanic. In all three cases only two offices showed up and were helpful and sympathetic.
I can’t imagine WTF the police were thinking in calling out a SWAT team in poor Andrya’s case.
Obviously they were not thinking in any human sense of the word
ArchTeryx
@Zzyzx: In this case Twitter might actually have a point.
oldster
@trollhattan:
‘appy trails to you, ‘Opalong!
Eunicecycle
My daughter used to work in a nursing home and it wasn’t unusual for some of the people to get very confused and call 911 because someone kidnapped them, or there were strange people in their house. And 911 was required to respond, although they didn’t go in with guns blazing or anything.
sab
@WereBear: When Dad’s nurse’s aide and I decided it was time to put my dad in assisted living two of my three siblings squawked about it. I was having to stay overnight at his house, and it had gotten to the point that when he fell down in the middle of the night I wasn’t strong enough to pick him up. So I would have to call my husband asleep at our house, and he would get up and get dressed and drive a mile in the middle of the night to help me put Dad back into bed.
And two of my three siblings thought this arrangement was okay, Sibling three was married to a guy who put himself through college working as an orderly in a VA nursing home.
oldster
@trollhattan:
Our last move involved a major down-sizing and a thorough purge of the workshop. I gave away my old timing-light to a local re-use/recycle place. Otherwise, I would have shown him the whole rigamarole.
I remember the vacuum advance, and “dwell” sounds familiar but I could not currently explain it to anyone.
Those were the days! No computer error codes, and you could adjust everything in the carburetor with a screw-driver and a pair of slip-joint pliers.
…And the cars were horrible polluters and got terrible gas mileage and killed you if you crashed. I honestly prefer the new machines. But I do sometimes lament their inscrutability and resistance to repair. It’s all a black box, now.
frosty
@trollhattan: We’ll, no. Good cops are good at de-escalating. That’s how they get out of a family dispute with no injuries all around.
rikyrah
I hope that more people get the help that they need
Ruckus
@Andrya:
I just deleted a post saying the same concept. I’ve told here before that I was a volunteer mental health counselor decades ago and that the police were often called because who else is there and they are often the last people able to properly handle the situation. And if anything, it’s gotten worse in the last 40-50 yrs. Cops often are there to end a situation rather than deal with it. They often respond with the only tool they seem to know – force. Or overwhelming force.
Mel
@ArchTeryx: I am so sorry that you have had to go through that, esp. on top of /in conjunction with fighting chronic health issues. I’m walking that road, too, and it is a trial by fire.
I was so glad to see your nym pop up in the comments. Hoping that things are okay with you, and happy to hear your voice.
Andrya
@SamIAm: No, in my case the police were thinking quite rationally- they were hoping for a drug bust. They offered me a deal- we won’t take you in on a 72 hour psychiatric hold if you give “voluntary” consent to search your house for drugs. Obviously, they were aware that many mentally ill/profoundly depressed people self-medicate with illegal drugs. And I was lucky- when they didn’t find any drugs they went away rather than “planting” drugs on me.
However, my experience is not the point. The point is that it is vitally important that when it’s necessary to send someone to a mental health crisis, THAT PERSON SHOULD BE TRAINED IN MENTAL HEALTH ISSUES AND PREFERABLY NOT BE A POLICE OFFICER.
frosty
This is absolutely needed. My policeman son was on a call like this and called in for a crisis team:
Team: We’re on a call and we’ve got another one after that. We can be there in four hours.
Son: But I need somebody here now!
I don’t recall how it ended, probably someone taken downtown. No shooting though.
There are a lot of calls that need social workers or psychologists. There aren’t enough of them and most aren’t trained for the situations the cops are called in on.
Matt McIrvin
@Zzyzx:
Well, is it true? We’ve now had some warnings along these lines in this thread.
raven
@trollhattan: I’m so glad I finally put electronic ignition in my 350!
Gravenstone
Of course they thought it was “okay”. They weren’t the ones being forced to confront the issues live and in person. Had they been so “inconvenienced” they probably would have elected for an iceberg rather than assisted living facility. The quicker to rid themselves of the nuisance, as they likely saw it. Yeah, we likely all know some people like that.
J R in WV
@olster:
I love this, as a deliberate non-user of MS products in every case!
gene108
@SamIAm:
I doubt most places have the resources to send not-police to make house calls for someone suspected to be in crisis, as well as the fact those calls can become very dangerous if the person in crisis is prone to violence.
I’m not sure how many counselors would be willing to go to an unknown person’s residence, without police protection.
It’s dangerous enough for counselors to go to client’s who are receiving care and have a known diagnosis. I just can’t picture many wanting to sign up to go rush into an emergency.
Also, depending on what the state laws are on involuntary committal, there may not be a lot for a counselor to do during a home visit, if the person has calmed down a bit between the call and the counselor’s arrival.
I’m not sure there’s any clear cut idea of how to respond to an emergency call with someone in crisis.
Matt McIrvin
@Andrya:
A sufficiently fucked up system makes a lot of things rational, I suppose.
ArchTeryx
@Mel: Things have been going okay for me. I got a much much better job and that greatly improves my outlook on things, despite the horrible politics of the day. Still fighting Crohn’s and depression but at least I have a tailwind now instead of a screaming headwind.
J R in WV
@ArchTeryx:
So glad to hear that you have a tailwind now!! And a tolerable job!!
Take care, stick around!
Ruckus
@Mel:
My sister did not want to put our dad, with Alzheimer’s, into a care facility. And yet I knew from my work as a mental health counselor that with a disease like Alzheimer’s, the family is most often the last people that can work effectively to help the person who needs it. She lasted 6 weeks caring for dad. It almost broke her. The key word is one that often the family does not understand in the least – detachment. There is a need for distance that being related most often/always takes away. The relationship, the need to help family gets in the way to providing the care necessary. I’ll say two words – adult diapers. Not the actual issue, it is a psychological issue to have to care for a parent as they did for you as an infant, for most people.
lowtechcyclist
Something more than just not being clueful about mental health situations is going on here. This sounds exactly like the police response to a SWATting call.
For some reason, a lot of police have no skeptical filter: if someone calls 911, they take it as gospel truth, rather than going in with the attitude that the caller may be describing the situation accurately, but to the extent that time allows, they should see what it looks like to them when they get there.
Again, it doesn’t have to be mental health: if someone calls 911 and says heavily-armed people have taken them hostage in your house, they’ll be busting down your door before you even know there’s a problem. Or if someone calls to report a kid with a gun in a deserted park, RIP Tamir Rice.
karen marie
@Doc H: Thank you for posting this. I read E Krebs’ tweets this morning and was about to pop in to say the same thing.
No one in crisis needs cops showing up and making things worse.
karen marie
@Zzyzx: Do you often stick your fingers in your ears and scream “lalalala,” or is it limited to this topic?
Matt McIrvin
@lowtechcyclist: When I saw that recent link about police fainting from panic attacks that they call “ODs” when they touch (or even stand near) what they think MIGHT be fentanyl, I couldn’t help thinking that these are people with broad authorization to shoot anybody they think might be a threat to life and limb.
Ruckus
@Mel:
“Dementia is a terrible, terrible disease.”
Yes it is. I’ve had 2 older relatives, my grandmother with dementia and my father with Alzheimer’s. And yes, the are terrible and yes they are quite different. The care is difficult and mentally stressful. Sometimes more stressful for the care givers than the ill person.
Today we have tools that we didn’t have 30-40 or more years ago. Medications that help some people. We have far better phone systems (and yes that can make them worse – in the case of suicide calls and the police) than we had when I worked in a mental health clinic. I took one suicide call in 4 yrs. All I could do was talk to the woman, be understanding, often be minimally helpful. The day I took that 45 minute call there were 2 of us in the office. Me, a mid 20s guy working towards being a doctor, and a woman/mother about 45 yrs old with more empathy than any 2 other humans I’ve ever met. That call was the most difficult I’ve ever had. The woman on the other end was nice, polite and seemingly at the end of her story. At the end of the call, she thanked me and hung up. I have no idea if I helped her or if she committed suicide. It almost broke me. Back then there really was nothing we could do if we couldn’t keep them on the line for approximately 2 hrs. The first hour to justify calling the cops and the second as the minimum to trace the call. The lady in the office had this to say because I was almost in tears because I hadn’t been able to do anything – “You gave her 45 minutes. That is 45 minutes better than nothing.” That didn’t feel as good as it sounded.
Humanity is a wildly ranging thing. We have an organ that can think, justify, act, communicate, be stupid, be vengeful, happy, sad, deranged, damaged, different – that keeps us alive and sometimes fails. It is the culmination of our nature, our upbringing, our selves and of our surroundings. It can do good, great, not so good or great, and horrible. It gives some the ability to crate beauty and others the ability to create disaster. It provides us with skills to live, most often the will to live. And sometimes reasons not to.
Sister Golden Bear
@olster:
Microsoft Help: “You are in a helicopter.”
Ruckus
@gene108:
When I was a mental health counselor I had a client that walked into the office requesting a session. He was about 18, about the size of the front line of a HS football team. That was one of the scariest 50 minutes of my life. This guy spent his days playing basketball and ridding his bicycle. He was nervous, which of course set off all my internal alarms the more he spoke. I wasn’t sure that I would get out of that room alive. We sat, talked, listened, discussed. My radar was on high alert and yet, other than how he initially presented, he was the perfect client. You never know how a session is going to go. You never know how a client/patient is going to act/react.
SamIAm
@Andrya:
O agree 100 percent. Very sorry that you had to endure that
SamIAm
@karen marie:
How is that reaction called for? This is not an all or nothing situation. I really don’t understand your reaction whatsoever