Help for Washingtonians in crisis is just three digits away: 988

Intervention at the right time, by the right person, may prevent suicide or calm a crisis. When someone is in immediate danger, dialing 988 offers immediate support. That’s why nationwide, states are launching quick-dial crisis hotlines.

Washington is going an important step further: 988 will also serve as an entry point for follow-up care and services.

The 9–8–8 line launched Saturday, July 16, 2022. 250+ languages are supported, and operators can direct callers to specific resources for veterans, non-English speakers, Native & Indigenous people, and more. Calls to the lifeline are private. Deaf, hard of hearing, and TTY users may use a relay service or dial 711, then 1–800–273–8255. Text and chat options are also available.

988 is just the beginning

Washington passed HB 1477 in 2021 to establish 988 as the number to call and to improve access to behavioral health services. New technology will ultimately support calls, the capability to respond, and link callers directly to needed services.

Megan Celedonia, behavioral health crisis system coordinator for Gov. Jay Inslee, says Washington is among only a few states in the country using 988 as an opportunity to significantly expand access to crisis services. HB 1477 provides resources for the state to build new infrastructure that will eventually allow 988 to dispatch crisis units or directly connect callers to local providers, even helping to schedule appointments.

“When this work is complete, 988 will give Washingtonians a place to call, someone to respond, and a place to go for care,” Celedonia said.

The 988 lifeline is now operational, but HB 1477 has more in store. Future improvements will establish more culturally competent supports, and more seamlessly connect callers with available services.

In 988, people are finding real help

The lifeline is already helping Washingtonians. Since the three-digit 988 code launched, crisis call centers have reported a 50% increase in calls. Calls to the lifeline last an average of 20 minutes.

Since July 16, texts and calls to 988 nationwide now reach accredited National Suicide Prevention Lifeline (NSPL) call centers. Washington state has three NSPL call centers, each serving a different region and staffed 24/7 with trained operators. Operators take the time to help callers navigate crises related to behavioral health or substance use, and they also introduce callers to local behavioral health services.

Gov. Jay Inslee, Department of Health Secretary Dr. Umair Shah, U.S. Health and Human Services regional director Ingrid Ulrey, and other state leaders went to Everett to visit one of the state’s three regional call centers on Thursday.

Gov. Jay Inslee is joined by local and state legislators, health experts, and staff of the Volunteers of America Western Washington Behavioral Health Call Center to announce the launch of the 988 crisis lifeline. Each individual pictured was important to its implementation.

The Everett call center serves most of western Washington and is operated by Volunteers of America of Western Washington. Crisis Connections operates the King County center and Frontier Behavioral Health operates the Eastern Washington center.

The increased call volume means more people are being connected to help. Susan Gregory, program manager for 988 Regional Crisis Line, says the Everett location has handled the increase in calls smoothly.

“Before 988 launched, we hired enough trained counselors to quadruple our staff,” said Gregory. “We went from 35 to 135 counselors. We’re seeing a big increase in calls and we expect even more in the future. On average, our callers experience no wait times, and we take all the time they need to listen to their situation.”

The Volunteers of America Western Washington Behavioral Health Call Center in Everett serves Western Washington, and it’s also a backup location for calls to crisis lines elsewhere in America.

Responding to crisis calls with crisis experts

The new system will help people in crisis get the right kind of help. First responders are not always the right responders for every crisis. Police officers may be well-trained in de-escalation and crisis counseling, but a police response may add anxiety to someone already in crisis. 911 operators are skilled in talking people through physical emergencies and coordinating with first responders to help, but they are not behavioral health counselors.

It’s a step that many emergency response agencies are looking forward to.

Pacific County’s PACCOM emergency dispatch received more than 13,000 calls in the first half of 2022. Sixty of those calls pertained to suicide. Dispatchers practice de-escalation, but many eagerly await an enhanced system for crisis calls.

“Dispatchers tell me it’s difficult to take calls related to suicide,” said PACCOM Director and 911 Coordinator Edward Heffernan. “Many are looking forward to the implementation of the 988 crisis line.”

“Whether people call, text, chat, or search online, 988 is there for them,” said Laura Evans, director of national and state policy for Vibrant Emotional Health. “988 connects callers to someone understanding and willing to talk, no matter their background or culture or intersecting identity.”

“The average call to 988 is 20 minutes long,” Evans continued. “That’s not quite how 911 works — emergency dispatchers are trained to quickly interpret calls, coordinate a response, and move on. Crisis calls take a long time, and sometimes callers just need someone to talk to.”

Investing in solutions

Recent state budgets have invested millions into behavioral health, expanding bed capacity, funding crisis response teams, building crisis stabilization centers, improving provider rates, and scaling other resources to meet the need. Local governments statewide are also building new resources to help people in crisis.

In Ferry County, counselors from the NorthEast Washington (NEW) Alliance often accompany police officers to crisis calls. These counselors are specifically trained in suicide prevention and substance abuse.

The NEW Alliance serves Stevens, Ferry, and Lincoln counties with counseling and other behavioral health support services. The alliance and its contractors accept Medicaid for services and offer flexible discounts for qualified persons. Affordable, accessible, personal help is available for locals around the clock thanks to this group.

In 2019, Olympia became the second city in the nation to create a mental health crisis response unit. Crisis Response Unit (CRU) mental health specialists help people in crisis through counseling, conflict mediation, harm reduction strategies, and service connections.

“Relationships are key, and we spend a lot of time building them. We have relationships with shelters, counselors, and service providers,” said Olympia Police Lt. Amy King, acting lead for the department’s community policing program. “Hospitals aren’t the best place for someone in crisis. Almost always, it’s better to get people into a more supportive setting.”

Gov. Jay Inslee visited the Chief Seattle Club in the Pioneer Square neighborhood of Seattle in June. Chief Seattle Club is a supportive housing facility specifically for American Indian and Alaskan Native people experiencing homelessness or crisis. Among the facility’s planned amenities is a sweat lodge-style room, still under construction at the time of this photo, to offer residents spiritual and cultural connection in addition to stabilizing shelter and supports.

The vision for HB 1477 is to connect local responders and service providers to lifeline operators. As these resources become more commonplace, 988 will help them become more accessible.

Culturally competent counseling

The national suicide rate has increased 30% in 20 years. Had the rate held steady, 13,700 fewer Americans would have died in 2020.

Stressors and circumstances are unique to each group and to each person. Culturally competent supports can often better address those unique circumstances.

For example, veteran callers may benefit from military-centric resources where they might find support from fellow vets or qualify for programs by virtue of their service. Upon dialing 988, current or past-duty service members callers will be directed by a phone menu towards resources just for them.

A Native and Strong Lifeline is also operational — this lifeline is dedicated to American Indian and Alaskan Native populations. Historical trauma, disproportionate poverty, and other factors contribute to an increased risk of suicide for Native populations. Native and Strong Lifeline operators are all tribal members or descendants, and they receive specialized training to help American Indian and Alaska Native people through crises.

Youth prefer text and online chat to calling, and 988 now supports both. For youth battling thoughts of suicide, professional counseling is just a text away. The suicide rate for teenagers was already increasing before the pandemic, then the CDC discovered a 31% increase in emergency room visits among adolescents ages 12–17 years in 2020 over the prior year. 988 is a big step to increase the accessibility of care, and it’s a timely one to help youth struggling after a traumatic pandemic.

Calling 988 will be an entry point for callers of any background or identity to discover that help is available. There are people out there that understand cultural context and are ready to help.

Gov. Jay Inslee visited residents and case managers at the YMCA Arcadia in June. The Arcadia is a supportive housing facility in Auburn specifically for youth with a disabling condition, including behavioral health issues or substance use disorder. The Arcadia received $1.21 million from the Housing Trust Fund in 2015.