
You call the 988 Crisis Lifeline. After that, where do you go? Study shows drop in options.
More than 150,000 calls, texts and chat messages have been answered by counselors working for the 988 Wisconsin Lifeline since the National Suicide Prevention Lifeline shifted to a three-digit number in July 2022.
But what do people do once they hang up — not just in Wisconsin, but across the country? For people who need more support once their call ends, finding a crisis center might be harder to come by today compared to when 988 first launched.
That's according to a new national study published in JAMA Psychiatry. It found that, despite increases in calls and messages to 988, the number of community crisis facilities has mostly decreased since the launch of 988.
The report also highlighted a slight uptick in peer-support services, in which people facing behavioral health challenges are paired up with counselors who have overcome similar challenges. While facilities in general decreased, peer-support services saw an increase.
Wisconsin was a bit of an outlier. It saw neither an increase nor decrease in crisis community centers — although it did see a jump of more than 5% in peer-support services.
Jonathan Cantor, a policy researcher at American nonprofit think-tank RAND, which conducted the study, told the Journal Sentinel that the success of 988 depends on whether people have follow-up access to crisis facilities. In other words, the volume of calls can only do so much if a caller has nowhere to go with after it.
"There's been this large increase in engagement with 988, but 988 is just one component of the broader crisis infrastructure," Cantor said. "We wanted to see if there was any change in the availability of crisis services after the launch of 988 because there was this increased demand. But we really didn't see any except for peer-support services."
Wisconsin's current and developing crisis facilities run counter to some of the national trends outlined in the JAMA report.
Caroline Crehan Neumann, crisis services coordinator for Wisconsin Department of Health Services, told the Journal Sentinel that many of the people who receive support in the state from talking with a Lifeline counselor are not simply left to their own devices once the conversation ends.
Rather, they are are set up with one or more referrals to explore ongoing behavioral health services, such as therapy, local support groups, or financial assistance support.
That's been helped by the growth in staff at Wisconsin Family Services, the organization that hires and trains 988 Wisconsin Lifeline counselors. Currently, 988 Wisconsin Lifeline is staffed by 74 counselors, a 37% increase since last December.
"This data shows us that 988 is not only for immediate support but also for ongoing, local care," Crehan Neumann said. "The data also gives us insight into why people are looking for support."
While the RAND study found a small but significant decrease in mobile crisis response and suicide prevention services, Cantor said that Wisconsin's mobile crisis slightly increased, making it "relatively stable" compared to the rest of the country.
Mobile crisis response is a type of intervention that allows for face-to-face counseling services to take place in someone's home, neighborhood or community. The idea is to avoid unnecessary emergency department visits and hospitalizations, which can themselves be traumatizing.
Access Community Clinics, which provide mobile crisis response, have cropped up in recent years across Milwaukee County and Dane County.
That tells Cantor that researchers need to continue tracking changes in the future to determine where unmet needs are. The hope is that these conversations pave the way for the creation of more crisis facilities across the country.
Crehan Neumann said plans are in the works to use 988 data to better understand the impact the three-digit number has had on people's emotional and mental wellbeing. A consumer satisfaction survey went out a few months ago to 988 chatters and texters to learn more about their interactions with counselors.
"988 is here and so, for best success, we're going to need a coordinated crisis services system where, once you call 988, counselors can help you identify where to go," Cantor said.
This article originally appeared on Milwaukee Journal Sentinel: More Wisconsinites are calling 988, but crisis services have not grown
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