Jul 20, 2022

988: The Hotline Worth Talking About

Is it safe? Secure? Anonymous?

Introduction

Former President Donald Trump signed a law designating a three-digit number for all mental health crisis calls in 2020. John Draper, the director of the National Suicide Prevention Lifeline, says that America is “on the precipice of launching the largest mental health and suicide prevention service in this nation’s history”. Despite this launch, the original hotline 1-800-273-TALK still works.

Benefits of 988

A simple number - short and memorable

More accessible and easier to reach out to help during a crisis

You will be connected to people with prior crisis training and mental health professionals.

People previously connected to 911. This is an issue as cops will be the ones answering the phone, and not all of them are fully trained to know the difference between a mental health crisis and a potential criminal. (Think about a person going through a panic attack or a schizophrenic episode)

An increase in awareness

This new crisis line is the first major investment the federal government has made for mental-health-related services (roughly $432 million)

An average conversation through the phone could range up to 40-60 minutes.

Calling 988 instead of 911 ensures that they have your full attention when you need help. They will talk you through the process and make sure you’re feeling safe and better before moving on.

The issue - non-consensual tracking and forced intervention

Mad in America mentions in 2020 that “suicide hotlines bill themselves as confidential, even as some trace your call”. The National Suicide Prevention Lifeline (NSPL) has said repeatedly that the call is anonymous and confidential, further mentioning that tracking and forced intervention are very rare. However, though the intention behind 988 is to link callers to local crisis centres, the infrastructure is not able to do that without tracing. So, right now, this is done by area code, with 988 acting as a shortcut to the NSPL, which openly uses geolocation & engages in non-consensual active rescue.

Draper also stated that call-tracing and precise geolocation were needed just in case a person is about to commit suicide or needs “life-saving”. The location will be routed to the cops so that they can make a final decision about whether or not to intervene. This is an issue as cops may not have had crisis training, which implies that it could be hard for them to differentiate between a person going through an episode versus a person who could be viewed as a potential threat.

In addition, it is quite detrimental to get the police involved, as cops are often shown to kill people with actual or assumed mental illnesses at very high rates, with these issues being even more prevalent when the person in crisis is a person of color, a trans person, an immigrant, and/or a member of other marginalized groups often facing violence at the hands of police.

Cops

Director of ProjectLets, @stefkaufman on Twitter:

"I don’t think people understand the reality of what happens when police show up to your house for a wellness check or “safety” intervention. If you survive, it’s enough to traumatize you + stop you from *ever* sharing your truth again. Forced into a life of emotional isolation. And that’s if you’re lucky. If you’re lucky to survive. This is not a gamble I want ANYONE to have to take. It cannot be an option. That’s what we need. A world where this is not a fucking option.

The day I was restrained by 5 cops on my front lawn, one of them said to me: “You can get in the ambulance like a good girl, or we will take you by force.” I’ll never forget it because it sounded exactly like what one of my rapists said to me. Comply or I’ll do it with force.

The fight for bodily autonomy is inherent to Disability Justice, Mad liberation, and police abolition. Most importantly: We will never truly have bodily autonomy without abolition. Cops, abusers, & psychiatrists have all used the same words and strategies against me & many others."

The Ultimate Debate - so… is 988 a good thing or a bad thing?

While there is a major issue of privacy with this 988 hotline, we should also acknowledge how hard mental health professionals and advocates fought for this hotline, aiming to make crisis help-seeking easier. This hotline has yet to gain trust from American citizens, as well as changing much of its model into a truly anonymised one, in order to ensure 100% privacy if that’s what they stated, to begin with, and to build funding and financial support.

Alternatives suggested by professionals

Therefore, many professionals have come up with alternatives

When it comes to mandated reporting in schools, we can follow the precedence of sexual violence reporting procedures. Most colleges now- though definitely not all simply reach out to the student with a list of potential resources, including easy-to-discern info about confidentiality and precisely what each resource can do for the student, as well as the potential ramifications of those resources. This includes engaging hospitals, police, housing departments, counselling, LGBTQ centres, and more. We could do something very similar for people in mental health crises; meaning, if a mandated reporter gets knowledge of someone in a crisis, they should be presented with transparent resources that clearly outline multiple paths forward, giving them clear choice and agency. Those resources should also be presented to all students/staff/faculty as part of training, just like sexual violence resources. For example, callers could be emailed or texted transparent resource lists w/info on consent & ramifications. And there should be web pages with this information easily accessible.
For people with preexisting mental health issues, there is the choice of having a psychiatric advanced directive, where they work with a friend or trusted professional to create a plan for treatment that could be taken in crisis, involving medical care and therapy, as well as non-medical care, like a list of loved ones to call, a list of activities that make you feel grounded etc.
Crisis lines that are *truly confidential* like TransLifeline and SamaritansNYC. If people can be truly honest with someone over the phone without fear of non-consensual interventions, that's a huge step.