What Is the 988 Suicide and Crisis Lifeline, and Why Is It Controversial?

Suicide is a worrying public health problem and a leading cause of death in the United States. Almost 46,000 people died by suicide in the US in 2020, which equates to one death every 11 minutes.

Key takeaways:

Besides those who died by suicide, an estimated 12 million adults seriously contemplated suicide, and more than 3 million made self-injury plans. There were also more than 1 million suicide attempts.

Suicide does not discriminate. It can affect people of all ages, races, sexualities, religions, and walks of life. It's also a myth that only people with mental health problems experience suicidal thoughts or attempts. Trauma, grief, illness, job loss, and relationship problems can all lead to suicidal thoughts.

The good news is that suicide is preventable, and help is available. The 988 Suicide and Crisis Lifeline is a new, three-digit number that will make it easier for people in crisis to access suicide prevention and mental health crisis counseling. However, some experts are warning against using the number. Here's what you need to know.

What is the 988 Suicide and Crisis Lifeline?

The 988 Suicide and Crisis Lifeline is a free, confidential suicide prevention and crisis counseling telephone and messaging service launched in the summer of 2022. It replaced the National Suicide Prevention Lifeline, which had a 10-digit number. The new three-digit number is intended to make it easier for people in crisis to access suicide prevention and mental health crisis counseling.

The Lifeline connects anyone in suicidal crisis or emotional distress to a national network of more than 200 crisis centers staffed by trained counselors who provide free and confidential emotional support 24/7. The caller is routed to their nearest crisis center to receive immediate counseling and local mental health referrals.

How many people use the lifeline?

Since the introduction of the 988 Suicide and Crisis Lifeline number, calls have nearly doubled compared to the previous year, according to the US Department of Health and Human Services (HHS). Only a small percentage of these calls were abandoned, and most were connected to a crisis center within a minute.

The HHS released performance data for the new 3-digit number. In August, just over 360,000 calls, chats, and text messages were routed to a call center. On average, people who reached out to the Lifeline talked to a counselor for about 18 minutes.

The data shows that the 988 Suicide and Crisis Lifeline is being used as intended and quickly connects people needing help to counselors. The HHS is also improving the system based on callers' and crisis center staff feedback.

What are the critics saying?

Some experts and advocates warn against using the new 988 Suicide and Crisis Lifeline number because they believe it can be harmful.

Social media posts have commented that when people call the 988 number, a person risks police involvement, involuntary treatment at emergency rooms or psychiatric hospitals, and the emotional and financial toll of navigating the mental health system.

Other posts have relayed similar concerns, suggesting that law enforcement officers come to check on people at risk of suicide without their consent. A further concern is that those from minority populations are more likely to be subject to involuntary commitment or 5150 holds when a person is detained for 72 hours for evaluation. During this time, doctors determine if they are a danger to themselves or others.

When police officers respond to a crisis call, the best course of action isn't always clear. Sometimes, officers can provide resources and support that can help de-escalate the situation. But in others, police involvement may worsen the circumstances by taking the person to an emergency room or psychiatric hospital. This can cause further trauma, particularly for people from minority groups who may have had previous negative experiences with law enforcement.

Another concern is that police presence can be dangerous, as 1 in 5 fatal police shootings in 2019 involved someone with mental illness. It's been even higher in other years.

Studies show that suicide rates increase drastically in the months following discharge from psychiatric hospitals. Furthermore, people forced involuntarily into these facilities are more likely to attempt suicide than voluntary admittances. The action also means that people are less likely to seek out mental health services in the future because of the stigma and fear associated with involuntary commitment.

There are other concerns that psychiatric treatment is expensive, and involuntarily committed people may be stuck with the bill. Even if insurance covers part of the cost, the out-of-pocket expenses can be significant. In some cases, people may even lose their job because of the time they need to take off from work to receive treatment.

Because of the range of negative outcomes that can result from involuntary commitment, some experts are urging caution when using the United Nations has called forced mental health treatment a human rights abuse and asked for its ban.

The 988 Suicide and Crisis Lifeline is a new resource that can help people in crisis. However, some concerns about its potential negative effects include involuntary commitment, police involvement, and emotional and financial impact.

If you or someone you know needs help, there are several alternatives to the 988 crisis line, including Blackline, Trans Lifeline, Wildflower Alliance, and Project LETS.

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