New 988 mental health line is meant to save lives

Everyone knows that 911 is the number to call if there is a medical emergency. Now mental health advocates hope that the new ‘988’ national suicide hotline becomes just as well known. The new hotline went live in mid-July and the transition is expected to bring a lot more calls with the hope that many more lives will be saved.

The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded the grant to administer the new 988 dialing code to Vibrant Emotional Health. Vibrant has administered the National Suicide Prevention Lifeline since its creation in 2005, according to a SAMHSA press release. The new grant will allow them to greatly expand services.

Calls will be diverted to call centers around the country. On Cape Cod, those calls will go directly to The Samaritans on Cape Cod and the Islands, a local suicide prevention organization.

“We are one of five centers currently answering calls for 988,” said Samaritan Executive Director Stephanie Kelly. “We were already doing the National Suicide Prevention Lifeline, anyway, so it was a transition but not something completely new. The way it works, if anybody calls from a 508 or 774 area code, they are going to be routed to our call center.”

The phone calls will be answered the way they always have been, she said. The person answering the call will still provide supportive listening and referrals to resources for help.

“The 988 line is going to be a great resource that will open up access to care and counseling for a lot more people,” said psychiatric mental health Nurse Practitioner Bea Forrest, NP, who is the director of Behavioral Health Operations – Hospital-Based at Cape Cod Healthcare. Active listening, like The Samaritans do, can decrease someone’s imminent danger by 80 percent, according to studies she has reviewed. She also believes the simpler three-digit number will strengthen crisis care.

“When you are in an acute situation, you’re dealing with enough information,” she said. “Are you going to remember what the 1-800-273-TALK number is? You would have to look that up. But you can remember 988.”

Three Categories of Callers

The majority of calls that come in to The Samaritans are from people who are experiencing a suicidal crisis, but very few of them are what they consider at imminent risk, Kelly said. One of the most important things The Samaritans do regarding prevention is to reach people before they get to that crisis stage.

Callers fall into three categories, she said. The most common call is from someone who is lonely and feeling disconnected. Those callers might have thoughts about suicide, but they aren’t at imminent risk. Mostly they just need someone to listen to them and provide hope.

The second type of caller is a little more acute. They might need more than just listening. They might also need referrals to resources. In that case, the person answering the phone gets permission from the caller to do a three-way call with an on-call supervisor.

The rarest form of caller is when someone is actively suicidal, Kelly said. The Samaritans collaborate with those callers to get them to agree to let The Samaritans call 911 while still on the line with them. It’s a collaborative call, not a coercive one, and a senior level person at the organization is the person who helps with that decision, not a volunteer.

“Any time I have been involved with a 911 call, they have given me their location,” she said. “They want help."

“We have an on-call supervisor on twenty-four/seven every day, so if there is a difficult call, or we have someone who is at imminent risk, that volunteer or call taker is able to immediately get in touch with the on-call person who has a handle on all different kinds of ways we can help the person. Sometimes we can help them think of more reasons for living or do safety planning. Other times, we might need to go even further than that.”

24/7 Answering and Other Upgrades

One of the biggest changes that the new 988 line brought was that The Samaritans went back to answering phone calls 24 hours a day, seven days a week, beginning on July 16, the day 988 went live. That meant that for the first time in their history, they have hired people to supplement what has always been a volunteer caller system, Kelly said.

The other change is a major upgrade in the technology of their calling system. Volunteers or employees are now able to answer calls remotely.

Aside from being able to answer a much higher volume of calls, for Kelly, one of the best parts about the new system is how seamless it is. In the past, when a caller was at higher risk or imminent danger, volunteers used to refer the caller to Day Code, their emergency services provider. That meant the person in crisis had to hang up and make an additional phone call.

“It never felt like enough because people have a hard enough time making one call,” she said. “Now we have a new one-connection policy and the technology to be able to make the call with the caller and, with their permission, talk to the intake person at Day Code. The reason that is so important is that it reduces the number of people that automatically end up coming into contact with law enforcement.”

One of the other important services the 988 dialing code does is provide help to family members who are worried about a loved one at risk. The Samaritans tell the family member what to look for and how to keep the person in crisis safe. They also offer resources and support to the family member.

The family help component is an important service that Cape Cod Hospital and Falmouth Hospital can’t provide to those in crisis, said Forrest.

“You can’t come into the Emergency Room and say, ‘I’m really worried about my brother. What can you do for him?’” she said. “This will provide them with resources where they are at, because mental health doesn’t just affect the person that’s experiencing it; it’s experienced by the family, by friends, by co-workers. So, increasing this access to care is really going to be a significant resource for a lot of people.”

On Saturday, September 10, 2022, The Samaritans held an event called “A Beacon of Hope: Honoring 45 years of The Samaritans on World Suicide Prevention Day,” at The Cultural Center of Cape Cod in South Yarmouth. It offered a chance for The Samaritans staff to educate people about the services they provide.

Those services include:

• Non-judgmental active listening to a caller in need on the crisis line
• Services to older adults in their Senior Outreach program
• Safe Place support groups for those who have lost someone to suicide
• Second Chance support program for suicide attempt survivors

The keynote speaker was suicide survivor and prevention advocate Kevin Berthia. In 2005, when Berthia was 22 years old, he planned to jump off of the Golden Gate Bridge. He was standing on the railing of the Golden Gate Bridge, when California Highway Patrolman Kevin Briggs saw him. Sergeant Briggs stood on the side of the bridge and mostly just listened to Berthia for 92 minutes.

“And Kevin came back over the railing,” Kelly said. “That’s what saved him. Kevin said, ‘It wasn’t what he said to me. It was that he listened to me.’ And that’s what The Samaritans do.”