A new 9-1-1 for mental health is on the way

It will be a while before people know 9-8-8 like they know 9-1-1

Come July, Americans experiencing a mental health crisis can press three digits on their phones, “9-8-8,” and reach the suicide prevention hotline. 

The vision: The new, easy-to-use number is being billed as the “911” for mental health care. It’s a dramatic revamp of the system that builds on the current crisis line, where Americans can call, text or online chat call centers nationwide and receive counseling. The ultimate goal is to be able to dispatch mobile crisis teams immediately to anyone in need, no matter where they live.

But there’s a broad recognition that it’ll take time to scale up such services, say advocates, lawmakers and those intimately involved in 988 efforts.

Gearing up: Last week, Rep. Tony Cárdenas (D-Calif.) introduced bipartisan legislation to provide federal funding and guidance for states to rev up their 988 crisis response infrastructure. Lawmakers put an increase of over $77 million toward such efforts in the long-term government funding bill passed earlier this month. And the Biden administration plans to request nearly $700 million for launching 988 in its upcoming budget.

  • “This is a once-in-a-generation opportunity to fundamentally transform part of the mental health system that for far too long has been underfunded and undersupported,” said Hannah Wesolowski, the chief advocacy officer at the National Alliance on Mental Illness. “There’s a lot to happen between now and calling it a success.”

The efforts to prep for the new, three-digit hotline come amid a growing focus on mental health in Congress and the Biden administration. 

  • The pandemic further exposed the barriers to quickly and easily accessing mental health treatment.
  • The surgeon general has sounded the alarm about a crisis in youth mental health.
  • Suicides increased 35 percent from 1999 to 2018, before declining slightly the next two years.

National Alliance on Mental Illness:

Established in 2005, the National Suicide Prevention Lifeline is comprised of over 180 independently operated and funded local call centers, as well as nine national backup centers. Its current 24-hour hotline can be reached at 1-800-273-8255, but will also be available at “988” starting July 16. 

In 2020, the Lifeline received over 3.3 million calls, texts and online chats. 

  • But it can only handle responding to roughly 85 percent of calls, 56 percent of texts and 30 percent of chats, per a report from the federal government, which cited a December 2020 analysis.

And yet, the number of user contacts may swell to 7.6 million by July 2023, after the new three-digit number is operational for a year. That’s according to the report late last year from the Substance Abuse and Mental Health Services Administration (SAMHSA), which oversees the grant support mechanism for the hotline.

  • “Without proper resourcing, the supply-demand gap is likely to be exacerbated by the creation of 988,” the report states.

John Draper, the executive director of the Lifeline, says the network has been “historically underresourced.” There’s been a reliance on states and counties to fund the local call centers — as well as volunteers to help man the phone lines. He said the hotline recently received tens of millions of dollars from SAMHSA, which it’s planning to use to shore up national chatting and texting capabilities.

Federal efforts are intensifying as July 16 looms.

At SAMHSA … the agency has been focused on ensuring those who call, text or chat the Lifeline get responses quickly, and helping local areas expand their capacity to dispatch crisis teams. 

  • We really see this as really a journey and a start of a new phase with respect to 988 implementation,” John Palmieri, who is leading SAMHSA’s portion of the transition to 988, said in an interview.

In Congress … Last week, Cárdenas introduced the 988 Implementation Act — a bipartisan bill to authorize a total of several billion dollars for the hotline and mental health care. The legislation would fund the 988 hotline and mobile crisis teams, create an educational awareness campaign and increase funding for workforce training.

  • “The current system is going to be tested like it’s never been before,” Cárdenas told The Health 202.
  • The hope, per Cárdenas, is to include his legislation in Congress’ broader mental health efforts, as multiple committees work to craft packages in the coming months. That traction could serve as a push for state and local governments to put more of their own dollars toward 988.

The Post is looking to speak with families with a child currently struggling with suicide. Your story can help us understand this difficult issue. We recognize this is a sensitive topic and respect your privacy. We won’t publish any part of your response without contacting you first and getting your permission. Here’s how to share your story with us.

Fauci predicts BA.2 could cause uptick in cases — but doesn’t anticipate a surge

BA.2 will likely cause an increase in the country’s coronavirus cases, similar to Europe and the United Kingdom. But the omicron subvariant isn’t expected to cause a massive surge, Anthony Fauci, Biden’s chief medical adviser, said yesterday. 

The nation’s top infectious-disease expert said BA.2 seems more transmissible than the original omicron strain and that it may eventually take over as the dominant variant. Yet, the cases don’t appear to be more severe, and BA.2 doesn’t seem to evade vaccines or prior infection, Fauci said on ABC’s “This Week.”

Keep relaxed restrictions — for now. With cases remaining low, Fauci said he doesn’t expect the variant to trigger the nation to ramp up restrictions, but said the country should remain flexible.

  • The subvariant is responsible for roughly a quarter of U.S. cases. Surgeon General Vivek Murthy said on “Fox News Sunday” that the country’s focus “should be on preparation, not on panic.” He argued that Congress must pass additional aid to sustain the availability of tests, treatments and boosters.

Meanwhile … some states are moving to close mass coronavirus testing sites and pull back on daily case reporting in the coming weeks. 

  • For instance: State health departments cited sharp drops in demand for testing as a factor in their decision for the closures, as well as widespread availability of at-home rapid tests and declines in daily cases nationwide, the New York Times reports.
  • Even so, public health officials expressed concern that closing the sites could lead to gaps in virus surveillance and leave states scrambling to meet a renewed demand for tests if a new surge arrives.

CDC: Black adults four times as likely to be hospitalized during omicron wave than White adults

At the height of the omicron surge this winter, hospitalization rates among Black adults reached the highest level for any racial or ethnic group since the onset of the pandemic, our colleague Akilah Johnson reports. 

  • Unvaccinated people were 12 times more likely to be hospitalized during the high-transmission period than those who were vaccinated and boosted, according to a report released Friday by the Centers for Disease Control and Prevention.
  • Only 39.6 percent of Black Americans had received the initial series of shots as of Jan. 26, and less than half of that group got a booster dose once eligible.
  • In the Black community during the omicron wave, there was a greater share of hospitalized patients who had been vaccinated compared with the delta surge.

Public health experts said the hike in hospitalizations could be a consequence of health disparities among communities of color that put them at higher risk for some preexisting conditions. 

  • Even if they’re not deathly sick from covid, they still may have a jump in their glucose or not as good control of their hypertension,” said Teresa Y. Smith, an emergency physician at SUNY Downstate in Brooklyn.

The Morbidity and Mortality Weekly Report from the CDC:

From our reporters’ notebooks

Might not be time for change yet: The House is hitting the snooze button on the Senate’s plan to permanently have daylight saving time, our colleague Dan Diamond writes.

  • “It could be weeks — or it could be months” before House Democratic leaders decide whether to tee up a vote on adopting the change, said Rep. Frank Pallone Jr. (D.-N.J.), who chairs the House Energy and Commerce Committee and noted that a similar plan quickly lost public support in the 1970s.

Any delay could be costly to daylight saving time advocates, given that interest in eliminating the biannual clock adjustment tends to peak only twice a year — when we spring forward and fall back, say political scientists who have studied how Congress approaches the policy. The House will be in recess in November when the clock next changes.

What’s next? Pallone said he’s considering whether the United States should adopt permanent standard time, which is favored by health experts who say it’s more natural for our bodies. He also admitted, half-jokingly, that some lawmakers have suggested just splitting the difference and moving everyone’s clock forward 30 minutes.

The House is out this week.

Today: The Senate Judiciary Committee will kick off four days of confirmation hearings for Ketanji Brown Jackson, the first Black woman to be nominated to the Supreme Court and Biden’s pick to replace retiring Justice Stephen G. Breyer

Meanwhile, on Wednesday: The Senate HELP Committee will consider ways to strengthen federal mental health and substance use disorder programs. The Senate Special Committee on Aging is meeting to examine home-based health-care services.

  • Twenty-nine percent of nursing facilities reported experiencing staffing shortages, a trend that has been steadily growing for years but was exacerbated by the pandemic, according to an analysis of CDC data by the Kaiser Family Foundation.
  • The country’s two most widely used vaccines were 94 percent effective in preventing mechanical ventilation or death for people who received a booster shot, our colleague Katie Shepherd reports, citing a CDC study released Friday. 
  • Supreme Court Justice Clarence Thomas was hospitalized on Friday evening “after experiencing flu-like symptoms” and is being treated for an infection. He’ll likely be released within the next day or two, The Post’s Robert Barnes writes.

Thanks for reading! See y’all tomorrow.

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