Crisis Call Centers Worry About 988 Money

Still to come are details about a unified platform system that could integrate 988 call, text and chat capabilities and are being worked out by National Suicide Prevention Lifeline administrator Vibrant Emotional Health, said National Association of Crisis Center Directors President Pat Morris. Vibrant will provide the tech, but it's ultimately up to each state with Lifeline centers to provide funding mechanisms, Morris said. That integrated platform could be "the big game changer," said Meryl Cassidy, executive director of Long Island's Response Crisis Center. Specifics about the platform mightn't be complete until the end of 2022, well after 988's deadline, she said.

All 988 network providers need to be on the same tech platform to accommodate Lifeline's current and future needs, said Vibrant CEO Kimberly Williams. Not all call facilities will be able to transition to the unified platform in the short term, she said. "The focus now is to build a platform alongside our state and center stakeholders that will meet the needs of all centers in the 988 network and evolve to meet the service needs of people seeking care across all service channels for years to come," she said in a statement.

The initial buildout of the unified system tool set and functionality shouldn't cost states or call centers anything, Williams said, saying Vibrant is developing ways to reduce the cost of implementation, with the goal of no out-of-pocket costs. That may require additional funding from the federal Substance Abuse and Mental Health Services Administration, she said. Call centers will need to spend time setting up and learning the system and inputting data, Williams said, noting centers also might need to upgrade their internet connections and possibly work stations.

Jennifer Battle, who oversees Texas' Harris Center Crisis Line that provides crisis line services for 34 counties, said swaths of people likely don't call into such operations because they don't like communicating that way, and opening 988 to text should be more accommodating to that preference. She said Harris Center Crisis Line has had text capabilities on and off for several years, contingent on funding resources, plus a chat feature accessible through its website. Neither is used heavily, though they haven't been heavily marketed, she said.

Being "immediately overwhelmed" by 988 traffic in July seems unlikely, though significant marketing of the three-digit option could change that, said Battle. If volume does sizably ramp up, some federal investment might be needed atop state resources, she said.

The same people who answer Harris Center's crisis line also deal with texts and chats, with a training modifier, Battle said. She said all the various access points involve some of the same generalized skills, but texting with people in a crisis has some differences with phone calls. Battle said the average length of time on a crisis call is 25 minutes, while text interactions are closer to an hour. Those text interactions are sometimes asynchronous, with gaps of a couple of minutes, she said. Those differences create resource questions because texting can tie up a staffer more than a phone call will, she said.

Morris, director of behavioral health at Volunteers of America (VOA) of Western Washington that handles crisis calls from eight counties, said the state's HB-1477, signed into law earlier this year, imposed a tax on radio access lines, interconnected VoIP service lines and switched access lines, effective Oct. 1. That funding should start flowing to crisis centers starting early next year and let them do whatever tech modifications and staff expansions are needed, she said. VOA is looking at doubling its call center staff in anticipation of 988, and "should be positioned fairly well" to handle 988 traffic come July, she said.