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Federal 988 ‘solution’ problematic locally

In 2020, responding to increasing suicide rates, Congress passed the National Suicide Hotline Designation Act, creating an emergency number – 988 – that works nationwide to connect individuals in crisis with mental health resources. During late 2020 and 2021, the Federal Communications Commission, after conferring with the Substance Abuse and Mental Health Services Administration, the Dept. of Veteran Affairs, and the North American Numbering Council, established rules compelling phone service providers to connect calls to 988 with the National Suicide Prevention Lifeline.

However, crisis intervention hotlines already existed in Lehigh County (610-782-3127) and Northampton County (610-252-9060). In fact, the new national hotline – while making it easier for people in underserved areas of the country to use a memorable number – will not route most Lehigh Valley residents to the closest support network.

As noted above, people who dial 988 will be connected to the National Suicide Prevention Lifeline network. Lisa Cozzi of Lehigh County Crisis Intervention explains why dialing 988 will result in a circular effort to get help.

“Lehigh County Crisis Intervention is not currently a member of the Lifeline network,” she said. “Individuals who call 988 from Lehigh County will be connected to the Family Service Association of Bucks County [which will also cover] Northampton, Berks, Schuylkill, Dauphin, Lebanon and Delaware counties […] The Family Service Association is not a licensed Crisis Intervention provider and must refer all [Lehigh County] emergencies back to Lehigh County-based services, including mobile visits.”

“We are not advertising the 988 number, and are asking our stakeholders to continue providing the local crisis number [610-782-3127] to all individuals in need,” she added.

Lehigh County, however, is working to ensure smooth transitions where necessary.

“We are pleased that individuals across the country now have easy access to Lifeline,” Cozzi said, “and we will be working with Family Service Association of Bucks County to coordinate services and share information about local mental health resources.”

Becky Bartlett, a public information officer with Northampton County, said that the county’s mental health task force is currently discussing how actively to promote the 988 number. She confirmed that the 988 routing for Northampton County is the same as for Lehigh County – to the national Lifeline, then to Bucks County Family Service Association, then back to local resources.

“Full implementation of 988 will not occur until next summer,” she said, “so we are being cautious […] We continue to advertise the full Lifeline number as well as our local county crisis number.”

Outside the Lehigh Valley, the federal 988 “solution” may still be inadequate.

Eighty-eight percent of the U.S. population lives in counties (like Northampton and Lehigh) that have dedicated crisis intervention services. Roughly 50 percent of U.S. counties do not have these dedicated services.

“What happens when someone accesses the hotline and no crisis team is available?” Dr. Roy Perlis of Harvard Medical School asked in a recent JAMA editorial. “The safety net may be local police officers, whose level of training to respond to such crises can vary widely.” Perlis argues that mobile crisis intervention units, funded by block grants through SAMHSA, may better serve Americans living in rural counties without dedicated crisis intervention centers.

press IMAGE courtesy national institute for mental health