988 is fast, but expanding mental health care in NC is not

A Pew Research Center survey of American teens found that 13% had experienced at least one major depressive episode in the past year, up from 8% in 2007.

A Pew Research Center survey of American teens found that 13% had experienced at least one major depressive episode in the past year, up from 8% in 2007.


The new National Suicide Prevention Lifeline — 988 — went into operation in mid-July, replacing the previous 10-digit number offered by most states. North Carolina saw an immediate increase in calls.

Advocates say this shows two things: The new number is easier to use, and the state still needs more mental health care providers, especially for young people.

Below are answers to some frequently asked questions about 988.

How it works?

988 is manned 24 hours a day by trained counselors who can be reached by calling or texting. When a call or text arrives at 988 from North Carolina, the counselor responding is likely to be in North Carolina as well, although if all North Carolina counselors are busy, the call will be transferred to a counselor in another state.

The hearing impaired can access Lifeline by calling 711 and then 988. Spanish-speaking counselors are available at 1-888-628-9454. From 3 p.m. to 2 a.m., counselors with training are available to help support LGBT callers 25 and under.

North Carolina’s 988 call center is located in Greenville and is partnered with REAL Crisis Intervention, Inc. It was established with $1.8 million in grants from the federal Community Mental Health Grant Program and the Substance Abuse and Mental Health Services Administration.

Anyone experiencing mental health distress, or concerned about a loved one in distress, can call or text the number or use the chat available at 988lifeline.org/chat. This service is free and confidential.

What happens if I call or text 988?

Usually within seconds, the counselor will respond and help determine the best way to help solve the caller’s problem. If the person has harmed themselves and is in need of immediate medical attention, or is in imminent danger of harming themselves, the counselor can call for assistance from EMS or law enforcement through a local dispatcher.

However, according to the Substance Abuse and Mental Health Services Administration (SAMSHA), less than 2% of calls require calling emergency services. Most people need to understand authorized and information on how to find additional services nearby.

Counselors are trained in de-escalation, and often a conversation is enough to resolve an immediate caller crisis, said Renee Ryder, assistant director for policy and programs at the NC Department of Health and Human Services.

The counselors may then share the names of providers and agencies that can help support the caller, such as behavioral health care, veterans services, and housing.

Calls, chats, and texts are not tracked. For some people, contacting the emergency services can be distressing and dangerous, and whenever possible, Lifeline recommends alternative options such as collaborating on a safety plan, using mobile crisis teams, cooperating with loved ones or specialists, or supporting the individual to get to a crisis stabilization unit or emergency department. or urgent care.

What was the response to switching to 988?

In the second half of July and August, the last months for which statistics are available, NCDHHS says calls to a North Carolina suicide prevention line rose from an average of 93 per day under the old 10-digit number to 160 daily using 988.

The Department of Health and Human Services said the largest increase in users is among young adults, with a marked increase in calls from children ages 8 to 12.

DHHS’s Ryder said that’s likely because 988 is easy to remember and its text and chat options, which particularly appeal to young people.

Ryder said the state hopes the availability of the 988 service will help reduce child suicide, which has been on the rise. A report released in June by the Child Fatality Task Force showed that suicide was the fourth leading cause of death among children ages 17 and under in 2020. Among children ages 10 to 14, suicide was the leading cause of death in that general.

Can you get long-term help by calling 988?

Call center counselors cannot provide long-term assistance, but they do have a list of services offered in the areas where the callers live. The problem is that there aren’t enough service providers in North Carolina, and the increase in calls since the switch to 988 has highlighted this problem.

Nationally, researchers say that in 2019 and 2020, nearly 21 percent of adults — more than 50 million people — suffered from a mental illness. More than half of them did not receive treatment. More than 16% of young people between the ages of 12 and 17 reported having experienced at least one major depressive episode during the previous year.

North Carolina ranks 12th in the nation in prevalence of adult mental illness, but 38th in the country in access to mental health care, according to the nonprofit Mental Health America.

NC DHHS said in March that 91 of the state’s 100 counties have a shortage of mental health care providers, whether at the county level, in a specific area, or among a specific demographic. Patients may have to wait weeks or months for a first appointment.

What is being done to improve access to care in NC?

NC DHHS said it continues to increase the use of certified peer support professionals, with more than 4,000 now available in North Carolina. The state recently awarded nearly $4 million in grants to eight community service providers to increase the use of certified peers.

The state has also awarded more than $4 million in grants to fund 15 mobile units across the state to provide screening, evaluation, treatment, primary care, and recovery support services.

The agency also said it is funding addiction medicine fellowships, professional development grants, continuing education courses and provider training, and is starting an Outreach, Response, Engagement, and Stabilization (MORES) pilot program funded through the Duke Endowment and Mental Health Block Grant in seven counties.

Some private insurance companies are trying to help. In July, Blue Cross and Blue Shield of North Carolina said it would invest $2 million to support 11 organizations across the state to improve access to care in rural and marginalized communities and in areas where providers are scarce.

The company said the funding is part of its efforts to address racial, health and geographic disparities in North Carolina and supports the company’s goal to improve access to behavioral health care in rural and disadvantaged communities by 25% within five years.

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Martha Quillen is a general assignment reporter for The News & Observer who writes about culture, religion and social issues in North Carolina. She’s held jobs across the newsroom since 1987.

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