• Fri. Nov 25th, 2022

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


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


A new national suicide prevention rescue line — 988 — went live in mid-July, replacing the previous 10-digit number that most states were offering. North Carolina saw an immediate spike in calls.

Advocates say that shows two things: the new number is easier to use, and the state still needs more mental health providers, especially for youth.

Here are answers to some frequently asked questions about 988.

How does it work?

988 is staffed 24 hours a day by trained advisors who can be reached by phone or text message. When 988 receives a call or text message from North Carolina, the answering advisor is most likely located in North Carolina as well. However, if all NC counselors are busy, the call is routed to a counselor in another state.

The hearing impaired can reach the Lifeline by calling 711 and then 988. Spanish speaking consultants are available at 1-888-628-9454. Counselors are available from 3pm to 2am with training to support LGBTQ callers under the age of 25.

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

Anyone experiencing psychological distress or concerned about a loved one in need can call or text the number or chat at 988lifeline.org/chat. The service is free and confidential.

What happens when you call 988 or text?

Typically, an advisor will respond within seconds and help determine the best way to resolve the caller’s problem. If the individual has self-injured and needs immediate medical attention or is in imminent danger of self-injury, the counselor can request help from emergency services or law enforcement through a local dispatch center.

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

Renee Rader, associate director for policy and programs for the NC Department of Health and Human Services, said counselors are trained in de-escalation and often one conversation is enough to resolve the caller’s immediate crisis.

Advisors can then share the names of vendors and agencies who can assist the caller, such as B. behavioral medicine, veterans services and shelters.

Calls, chats and SMS are not tracked. For some people, contact with emergency services can be traumatic and dangerous, and Lifeline recommends alternative options where possible, such as working together on a safety plan, deploying mobile response teams, working with the person’s family or professionals, or assisting the person for help to get to a crisis stabilization department, emergency room, or emergency care.

What was the reaction to the switch to 988?

During the second half of July and the month of August, the final months for which statistics are available, calls to North Carolina’s suicide prevention hotline declined from an average of 93 per day below the old 10-digit number to 160 per day with it, according to the NCDHHS 988

According to DHHS, the biggest increase in users is among youth, with a notable increase in calls from children aged 8 to 12.

DHHS’ Rader said this is likely due to the ease of remembering 988 and the text and chat options, which appeal particularly to youth.

Rader said the state hopes the availability of the 988 service will help reduce child suicide, which is on the rise. A June report by the Child Fatality Task Force showed that suicide was the fourth leading cause of death among children under the age of 17 in 2020. It was the leading cause of death in children aged 10 to 14 this year.

Can you get long-term help by calling 988?

Call center advisors cannot provide long-term assistance, but they do have a list of services available in callers’ residential areas. The problem is that North Carolina doesn’t have enough carriers, and the increase in calls since the switch to 988 has highlighted this problem.

Nationwide, researchers said that in 2019 and 2020, nearly 21 percent of adults — more than 50 million people — had some form of mental illness. More than half were not treated. More than 16% of adolescents aged 12 to 17 said they had experienced at least one major depressive episode in the past year.

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

NC DHHS said in March that 91 of the state’s 100 counties have shortages of mental health providers, whether statewide or just in a specific area or among a specific population. 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 specialists, with more than 4,000 now available in North Carolina. The state recently awarded eight community providers a nearly $4 million grant to increase the use of certified peers.

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

The agency also said it funds addiction medicine grants, professional development grants, continuing education courses and provider training, and is launching a Mobile Outreach, Response, Engagement and Stabilization (MORES) pilot with Duke Endowment funding and a mental health block grant for seven counties.

Some private insurers try to help. In July, North Carolina’s Blue Cross and Blue Shield announced they would invest $2 million to support 11 organizations across the state to improve access to care in rural and marginalized communities and in areas with shortages in providers .

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 of increasing access to behavioral health care in rural and underserved communities by 25% in five years.

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Martha Quillin is a general reporter at The News & Observer, writing on North Carolina culture, religion, and social issues. Since 1987 she has worked in the entire newsroom.