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St. Louis Post-Dispatch
St. Louis Post-Dispatch
St. Louis Post-Dispatch Editorial Board

Editorial: National call system for mental health crises is having its own crisis

The newly established 988 national hotline, a 911-style emergency call system for people contemplating suicide or other mental health crises, has hit a pretty major acceptance snag. The system is barely a month old, yet there’s already a movement afoot to boycott it. Some users say it can make existing mental trauma even worse.

Despite being advertised as a way for people in crisis to call and talk to a professional, users warn that 988 counselors could wind up alerting police, who have the power to track down callers and take them to mental health facilities where they are involuntarily committed.

That’s a significant potential flaw that should have been anticipated long before the 988 system went live on July 16. The National Suicide Hotline Designation Act was enacted in 2020 to address a growing problem with people in crisis who haven’t been able to get the help they need. Easy access to guns by people contemplating suicide has made it even more urgent to establish a quick way for people to get help by phone. The National Alliance on Mental Illness says one in four fatal police shootings between 2015 and 2020 involved people with a mental illness. Millions of people a year show up in hospital emergency rooms seeking help for mental health crises, overwhelming hospitals and very often leading to delays or the neglect of people needing help.

That’s what made a 988 system seem like a popular alternative. The Federal Communications Commission established an exclusive nationwide number that should route callers either by phone or text to a mental health professional.

The reception some callers are getting doesn’t appear to bode well, and people are taking to the internet to voice their complaints and warn others away from using the system. On Instagram, Kaiser Health News reported, one user posted: “988 is not friendly. Don’t call it, don’t post it, don’t share it, without knowing the risks.”

Another post stated: “Hotline staffers use a set of suicide screening questions to decide whether to initiate an ‘active rescue.’ The [system] calls the police on approximately 20% of callers,” with geotracking technology revealing where the caller is located. Police are not necessarily equipped to de-escalate such crisis situations and can make it worse by barking orders and even drawing their firearms if the person in crisis is holding a weapon.

Some 988 users complain of getting an unhelpful or unempathetic reception. The prospect of involuntary commitment — plus a substantial medical bill — is adding to the public skepticism.

Starting in the fall, system administrators say they’ll begin requiring a supervisor to concur before a crisis counselor can notify the police. That should help, but social media sites are filling up now with warnings to stay away, which suggest that further delays could cause a system established with the best of intentions to fail for lack of public acceptance.

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