Massachusetts public health officials and leaders of suicide prevention organizations say they've seen a jump in calls to the national hotline for people in mental health crisis since the switch to the easy-to-remember 988 number took effect over the summer.
The National Suicide Prevention Lifeline, which previously had a 10-digit phone number, became the 988 Suicide & Crisis Lifeline on July 16.
There are five nonprofit call centers in Massachusetts that answer calls made to the lifeline from within the state, along with any that get funneled from other states when centers in those places can't pick up. State health officials say overall, calls to the five centers from the national lifeline have gone up 30% since 988 took effect. Some centers have seen even sharper increases individually.
To help with the increase in calls, Massachusetts has boosted funding to the call centers. According to the state's Executive Office of Health and Human Services, funding previously ranged from $600,000 to $800,000 per year. In the current fiscal year, the centers are receiving $17 million from the state, as well as $2.5 million from the federal government.
The rate of calls the centers have been able to answer has also gone up significantly because of that new funding and increased staffing. When a call coming in from the lifeline can't be picked up in the local center, it gets automatically diverted to a different one.
Samaritans Southcoast, which covers the New Bedford and Fall River areas, reports it's been able to answer 76% to 85% of calls in each of the last few months, versus 28% to 38% of calls in the same period last year.
Anyone can call the lifeline to talk about a mental health issue they're experiencing, from loneliness to suicidal thoughts or actions. Lifeline staff members and volunteers are trained to "befriend" callers by offering non-judgmental listening.
One change that's taken effect with the switch to 988 is that call-takers in Massachusetts ask people who are at significant risk of suicide if they want to be connected with an emergency services program. Those are mental health providers in different regions of the state that offer assessment — including from mobile crisis teams — and referrals to treatment.
Kathy Marchi, executive director of Samaritans, Inc. in Boston, said about 4% of callers accept that "warm handoff" to an emergency services program, and they're directly connected during the call.
WBUR's All Things Considered host Lisa Mullins spoke with Marchi and Christine Rizza, training development manager for Samaritans Southcoast.
Highlights from this interview have been lightly edited for clarity.
On the sharp increase in calls some centers are experiencing:
Christine Rizza: "Just to give you an idea, from April 1 until July 16, we had 754 calls. July 16 to [Oct. 26], we have received 2,639 calls. So it has increased dramatically. ... A lot of people who are calling are saying they're trying this number out for the first time. They wanted to see what it was all about. So it's getting a lot of new people that didn't previously call in with the long 800 number."
Kathy Marchi: "[The number is] certainly easier to remember. There has been all kinds of promotion, although we still think there's more to be done — that we'll see a further increase as promotion continues. And I think, you know, coming out of the pandemic, more people are looking for ways to find support for mental health concerns."
On what the centers, traditionally manned by volunteers, did to prepare once they heard the change to 988 would be coming:
Rizza: "We [had] three staff members at that point, and we had to hire overnight staff, managers and people to take calls all day long. So we are now at about 45 people and [are] bringing on a brand new group of people. We have about 14 people coming through in our November training."
On how call takers handle calls with people at imminent risk of suicide:
Marchi: "One of the things we do on every call — I believe all the centers are the same in this — [is] we establish the connection and the compassionate listening and nonjudgmental listening, validation of what [the caller is] experiencing. We assess for risk of suicide. And then, depending on the level of risk, we have a rate of about 90% of deescalating imminent-risk callers. So being able to safety plan with them and come up with a way for them to stay safe ... which is sometimes discussing ways for them to access support or help outside of the helpline. So is it [to] call a therapist, call a friend, call a family member, go to the emergency room."
Rizza: "The only time we send the police or rescue is if they, number one, agree and it's an imminent [risk they're facing]. Or if they are in the act of [attempting] suicide, or in that act, possibly harming somebody else. But we are very confidential. People can tell us things and there will be no repercussion."
On why some people in mental health crisis don't call 988:
Marchi: "I think that [often] people don't call ... because, you know, we can be hard on ourselves, right? Thinking that my problem is not big enough or my struggle isn't one that someone could help with. But so often, callers tell us they experienced such relief to be heard, to be validated, to have support that was just there, nonjudgmentally listening. Oftentimes, you know, when we reach out to a friend or family member when we have a problem, our friends and our family are trying to help us solve the problem. They're trying to help us feel better. But our centers are not designed to help you problem solve ... but rather to say in this moment, how you're feeling is valid. And we want to provide that opportunity for people to unburden that struggle that they're managing alone."
Rizza: "My experience is when people call this line and they get somebody who is listening, compassionate, empathetic, not putting in their opinions, it's amazing how well that can work for somebody. Too often there is a stigma around talking about the thing that is bothering you — the bad thing. Or they may have worn out the people in their circle with their problems. They can call us any time, as many times as they want, to get that out."
Resources: If you or someone you care about is feeling suicidal or experiencing another mental health crisis, you can reach the 988 Suicide & Crisis Lifeline via phone call or text. You can also be connected with a lifeline call center by calling Massachusetts 211.
This segment aired on November 1, 2022.