988 Not Likely to Get Big, Coordinated Public Outreach Push Before Launch
With three months to go before the National Suicide Prevention Lifeline begins accepting calls and texts via 988, promotion and efforts at raising public awareness will be decentralized, with a national campaign geared to the public possible next year. 988 services are to be available nationwide effective July 16. The federal Substance Abuse and Mental Health Services Administration (SAMHSA) told us 988 won't be available nationally before then, so it recommends not promoting its use to the public in advance.
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There are concerns the various call centers that make up Lifeline will lack the capacity to deal with the expected jump in call and messaging volume after July 16, said Hannah Wesolowski, National Alliance on Mental Illness chief advocacy officer, noting SAMHSA estimates that Lifeline traffic could more than double from FY 2022's projected 3.3 million calls, texts and chats to 7.6 million in FY 2023. The possible shortfall in capacity means promotion and public outreach this year will largely be up to mental health organizations and individual states, she said. "There's a real need for these services and we want everyone to have them, but we don't want the system to collapse before it's even off the ground," she said. "July 16 isn't going to be this magical day where everyone starts hearing about it."
Aside from individual state efforts, whose aggressiveness will depend on how ready the state's call centers are for that added traffic, mental health organizations will be contacting mental health providers, primary care physicians, university health centers and school counselors in a word-of-mouth effort, Wesolowski said. A coordinated national campaign promoting 988 might be in the cards in 2023, depending on SAMHSA funding, she said. The FCC "has been working closely with its federal partners, including [SAMHSA] and the Veterans Administration, to coordinate on messaging and outreach efforts," a spokesperson said.
988 could be "the linchpin and catalyst for a transformed behavioral health crisis care system in the same way that 911 spurred the growth of emergency medical services in the United States," SAMHSA said in its FY 2023 budget request for $696.9 million for 988 and Behavioral Health Crisis Services. Its request includes funding for "targeted 988 national messaging." The expanded SAMHSA funding "will be a major ask" of the mental health community as Congress works on appropriations this fall, Wesolowski said.
Educating key audiences before the July 16 transition is necessary but "it’s critical that there is not widespread promotion encouraging the public to dial, text, or chat 988 until the nationwide transition takes place and staffing and technology capacity needs are met," per 988 messaging for the mental health community developed by SAMHSA, Lifeline operator Vibrant Emotional Health and the National Action Alliance for Suicide Prevention and released last week. Before July 16, the groups said, 988 outreach should focus on "individuals who have a role to play in suicide prevention and/or crisis response -- and policymakers, rather than the public at-large." SAMHSA told us in coming months it "will provide additional resources for 988 partners to use when communicating about 988 to their audiences, such as content and graphics for social/digital sharing."
There has been concern for years, as Congress was passing enabling legislation and then the subsequent FCC proceeding, about talking about 988 with the public before it's active, said Maeghan Gilmore, Association for Behavioral Health and Wellness senior director-government affairs. The aim was to avoid people being "frustrated that 988 wasn't up and running right away," she said. She said any campaign will have to be sustained well after the July unveiling to keep the number in people's awareness. Echoed NAMI's Wesolowski, the overall goal of making 988 "as normal and household as 911" will take years.