A year after the launch of 988 Suicide and Crisis Lifeline, many Florida residents are still unaware of its existence, and about 25% of calls in the state go unanswered.
When you dial 988, it directs you to one of about 200 crisis call centers across the country, depending on your area code. Counselor Brenda Mann-Kelly of the Fort Lauderdale Crisis Center receives calls from area codes 754 or 954.
Over the past year, Mann-Kelly and staff at 13 Florida crisis centers have responded to more than 82,000 calls to 988 after the National Suicide Helpline underwent a change to its 10-digit number to 988. This is the fifth-highest state-level call in the US.
When Mann-Kelly answers the calls, she may only have a few minutes to answer and save a life.
However, Florida Crisis Centers are not answering calls.
Florida had an average response rate of 75% in June, up from an average of 52% in October 2022. In some states, such as California, Mississippi, and Nebraska, response rates were well over 90%.
Over the past year, at least 48,000 calls to 988 from Florida cities went unanswered from state crisis counselors and had to be redirected to the national emergency network, where counselors are less familiar with local services, according to Vibrant Emotional Health, the administrator of the rescue line.
Expectations weren’t high
Florida mental health advocates predicted that deploying 988 to the state would be difficult.
Some states have created special ways to pay for additional staff and technology upgrades to support their 988 calling systems. Florida has relied on a patchwork of funding, with some counties more prepared than others for projected volume increases.
“We’ve made a lot of progress, but there’s still a lot to be done,” said Gail Giese, president of the Florida Mental Health Advocacy Coalition. “We’re doing better than some states and worse than others.”
For Mann-Kelly, the calls don’t stop. With mental illness on the rise, a hotline operator spends most of their workday finding the right intervention for callers in a crisis, assessing whether they just need to listen to someone or are actively trying to kill themselves. She can send a list of nearby therapists to an anxious caller, send a mobile crisis team, offer inpatient services, or even connect them to 911 or emergency services if they mention guns or pills.
“Every call is different, but most of the time people are overwhelmed and in distress,” she said. “People have problems with relationship dynamics and feelings of isolation. Many people feel very alone in this interconnected world, and things have gotten worse since COVID.”
988 is not just for emergencies
A person does not need to be in crisis or suicidal to call 988 and speak with a counselor. Helpline is a free service available at any time of the day or night for anyone who needs support. Much of the transformation of the National Suicide Rescue Line has been to reduce reliance on law enforcement or emergency departments to deal with mental health crises.
Nationwide, the 988 Lifeline faced record demand last year.
Since its launch in July 2022, more than 5 million calls, chats and texts have been redirected to 988, up 2 million from the previous 12 months prior to triple digits and federal investment. Now, the federal government and Lifeline partners have announced the addition of Spanish-language text and chat services, as well as dedicated services for LGBTQI+ youth and young people, from July.
Mann-Kelly, 58, says switching to 988 has allowed her to answer Broward calls as a support specialist, people with “life experience” who are prioritized as call recipients. She can now let callers know that she was once in their place, also in crisis mode and currently recovering from mental illness.
“The benefit is that people feel connected to me,” she said. “They may call it a feeling of embarrassment, but once I open myself up, it will make the process easier and help me get rid of the escalation faster.”
Florida needs a lot more mental health services
The national mental health network still has many challenges to overcome. Some of the biggest challenges are the need to inform a three-digit hotline, as well as long-term funding to increase the staff of crisis centers. In May, the federal government provided another $200 million in new funding, which states will receive later this year, to build local capacity for 988 emergency and related crisis services.
Mental health experts say Florida needs a lot more than just extra staff at crisis call centers. The state also needs more resources, especially places to refer adults, teens, and children with mental health problems.
Francisco Isaza, COO of 211 in Broward, a local call center for 988, said his crisis counselors can offer some resources to callers but admits there are gaps. “The purpose of 988 is not just a call center number, but a help system that is designed to support people in times of crisis,” he said. “Treatment and support services must be available. The vision must be to create a robust system of care so that anyone experiencing a mental health or substance abuse crisis can receive the full spectrum of support.”
State legislators have taken proactive steps and created the Commission on Mental Health and Substance Use Disorders to review how 988 operates in the state, identify any shortcomings in mental health services, assess the state’s crisis response capabilities, and recommend changes. Florida Gov. Ron DeSantis included more money in this year’s budget to expand mobile response teams that could answer the 988 call.
Some counties need more mental health beds, others need more mobile response teams or mental health counselors.
“Need will always outweigh the services available,” says Mann-Kelly, who spends her free time in support and therapy groups to maintain her mental health. “At Broward, we have a continuum of mental health services, but we always need more.”
FloridaToday.news Health Correspondent Cindy Goodman can be contacted at [email protected].