Two Years In: Is 988 Actually Helping People Facing Mental Health Crises?
Curt and Katie check back with the now two-year-old program and identify what’s working and what’s not with the crisis hotline. There is data that it is 98% but there are also concerns that have been raised. We look at reports of data sharing without transparency, increases in police involvement and involuntary hospitalization, and inconsistently (and potentially inadequately) trained hotline workers. We also explore what therapists can do to support clients who might need this resource.
Click here to scroll to the podcast transcript.Transcript
In this podcast episode we talk about what is work and what is not working with 988
Katie became concerned about data use and how well 988 is working after seeing some articles from Mad in America. Curt and Katie thought it would be good to dig a little deeper into what is actually happening with this newer crisis hotline.
What are concerns being raised about 988 at this point?
“For us as mental health professionals, confidentiality has a very strong and big meaning to it. Which is by law: what we talk about does not warrant us sharing this information to anybody else, unless there is specific exemptions to these laws. But there is no informed consent that comes into when somebody calls into 988, that explicitly says, here is some of the reasons that we may share this information…If you are in a crisis and you need to get a hold of somebody, 988 is a resource. It’s confidential. It’s not the same kind of confidential that you and I have, because the people who are staffing the lines are not mental health professionals…988 is not providing therapy… Yeah, it’s confidential, but they’re not bound to confidentiality in the same way that mental health professionals are.” – Curt Widhalm, LMFT
- Data sharing with a lack of transparency
- Different definitions of confidential and confidentiality
- There is not really a guarantee that you can remain anonymous
- Increase of involuntary hospitalization and police involvement
- Lack of infrastructure and lack of local resources to manage crisis response
- Callers may be routed to the call center nearest to their area code, not current location
- Not advertising 988 in high population areas because they will get calls no matter where their community members are due to their area codes
- Training of the hotline workers is inconsistent and may not be sufficient
- Lack of funding to make improvements and develop new resources
What are the risks when someone calls 988?
“I think that there is probably some benefit to being able to serve someone in the location where they’re having a crisis…But I think the challenge for me is that if there’s not infrastructure and support to help someone in crisis, this gives more fodder for police or other emergency services that may not have the mental health training to to support a mental health patient or a caller in crisis…If we’re just supporting more police work, I don’t think that’s what this was for, and I don’t think that’s how it’s going to help people.” – Katie Vernoy. LMFT
- The call center staff may not have training to deal with the caller’s issues
- Responses on the call line may be overly focused on psychoeducation
- Lack of time for each caller (without assurance that callers get time to talk through the concerns that led them to call)
- There is a possibility that there will be responses that are truly unhelpful to the caller
- Incarceration or involuntary hospitalization
- Inconsistent follow up if calls are dropped or callers disengage
What should therapists be aware of as they navigate 988 at this time?
- They are reporting a 98% success rate, so this is a resource worth considering
- Make sure your clients understand what to use 988 for
- Help your clients to assess the risks and benefits of calling
- Work to increase the transparency about data sharing, confidentiality and anonymity
- There is advocacy needed to improve 988 as a resource
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
Psychiatric Detentions Rise 120% in First Year of 988 – Mad in America
“Confidential” 988 Conversation Records Shared with Corporations – Mad in America
Lifeline Crisis Chat: Coding form development and findings on chatters’ risk status and counselor behaviors – Suicide and Life-Threatening Behavior
Comparing Models of Helper Behavior to Actual Practice in Telephone Crisis Intervention: A Silent Monitoring Study of Calls to the U.S. 1–800-SUICIDE Network – Suicide and Life-Threatening Behavior
NENA Suicide/Crisis Line Interoperability Standard
988 Suicide and Crisis Lifeline Data Access & Requests to Collaborate on Research (L-DAC) – 988 Suicide and Crisis Lifeline (there is no longer the ability to collaborate)
Taking a Look at 988 Suicide & Crisis Lifeline Implementation One Year After Launch – KFF
Implementation of the 988 Suicide & Crisis Lifeline at the State-Level: Estimating Costs of Increased Call Demand at Lifeline Centers and Quantifying State Financing – National Library of Medicine
Challenges to Just and Effective 988 Implementation – CLASP
988 lifeline sees big increase in calls for help a year after launch – APA
New Report Calls for Research on 988 Crisis Line Effectiveness, Caller Demographics, and More – APA
Relevant Episodes of MTSG Podcast:
What Therapists Should Know about the Rollout of 988
Is AI Smart for Your Therapy Practice? The ethics of artificial intelligence in therapy
Is AI Really Ready for Therapists? An interview with Dr. Maelisa McCaffrey
Revisiting SEO and AI – Ethics and best practices: An Interview with Danica Wolf
Risk Factors for Suicide: What therapists should know when treating teens and adults
Psychiatric Crises in the Emergency Room, An Interview with Kesy Yoon, LMHC and James McMahill, LMFT
Liability Hot Potato: Defensive Therapy practices that give clients inadequate care
Preventing Client Suicide, An interview with Norine Vander Hooven, LCSW
Modern Therapist Reflections on Preventing a School Shooting
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
… 0:00
(Opening Advertisement)
Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm And Katie Vernoy.
Curt Widhalm 0:15
Welcome back, modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the things that go on in our field, the things that happens around mental health. This one is potentially a little bit more public facing podcast, because now that 988 has been out for a couple of years, and we have done a previous episode right around the launch time when 988 rolled out nationally, we will include a link to that in the show notes. We had outlined a couple of years ago, some concerns that were going to be there and we were right.
Katie Vernoy 0:54
Why did we have to be right? Oh, that’s so sad.
Curt Widhalm 1:00
So a little bit of background, 988, is the national three digit telephone number for people who are experiencing mental health crises and was a very intelligent let’s take the national suicide prevention hotline number that was 10 digits long. Let’s put it down to three digits. Let’s make it readily available, and it is now part of the standard of practice for many therapists who are working with suicidal clients to have this be part of a safety plan. And in this episode, we are going to talk about what is going well with 988, what is still correct after two years of the sky is falling from two award winning podcasters. And this starts with, I guess, just a little bit of background, if you look at the numbers behind SAMHSA, behind 988, they are saying that 98% of their calls received or their texts through their various platforms are being successfully handled.
Katie Vernoy 2:10
So, that’s a positive.
Curt Widhalm 2:11
That is a positive.
Katie Vernoy 2:12
Before we go too far, I do understand that the Canadian line is also 988, so we’re really limiting this to the the United States 988.
Curt Widhalm 2:23
Our interest in this was renewed when Katie sent me an article from Mad in America by Rob Wipond. This is from June 8, 2024, and the article is titled, ‘“Confidential” 988 Conversation Records Shared with Corporations’…
Katie Vernoy 2:43
Oh.
Curt Widhalm 2:47
Interested us in like, what’s really going on with 988? And Rob Wipond has done most of the research for us. So we’re going to reference a couple of articles that Rob has done, as well as some of our other research. You’ll find all of our show notes over at mtsgpodcast.com, but it’s very, very I don’t know, 21st century with where the hell isn’t our data being sold, and especially with such sensitive areas around mental health crises and just, damn it!
Katie Vernoy 3:20
Yeah. Well, I think digging into it, there’s there’s the potential that some of the this call is being recorded for research and evaluation and customer service, monitoring, whatever blah blah blah. That that is giving folks permission to potentially sell data. I don’t know if did you read that they were selling data. I know that they’re certainly taking research proposals for pretty intense data that’s gathered, but I was just concerned because I don’t think people really understand how much data is gathered. So in looking at it, I saw, and I’ll link to a lot of stuff. I went down a rabbit hole. So I’ll link to a whole bunch of stuff in the show notes over at mtsgpodcast.com. But I think there’s, you know, no, you know, research grants that can look at, you know, suicidality, and, you know, you can get some anonymized, de-identified data around demographics, around what interventions were used, that kind of stuff. I saw something where there’s, you know, a higher level request to get really kind of restricted data. And so my assumption is this is data that people are not necessarily realizing that’s being shared, because it’s, I’m assuming, a little bit more intense in how much is shared. They talked about transcripts and recordings being shared, and some of this is for research. And there was, you know, well, there we can talk about that, if it makes sense. But to me, the concern is, is in the article from Mad in America, there was an implication that the corporations were using this for AI. And and whatever AI is coming. We’ve got a lot of episodes on AI. We’ll share that in the show notes as well. But I think if people are not aware that this quote, unquote, confidential line is being used in this way, and that their their their data is being shared even anonymized, the concern that the the Mad in America authur put forth was, if you’re talking about suicidality or mental health concerns, you’re going to talk about people and places, and you’re going to provide your own identifying information that theoretically could get a little closer to home than you expect. So to me, I feel like it’s the lack of transparency and the use of data from folks who are at a most vulnerable state. That really is bothering me about this. I think that the research may be great, the use of AI to try to help because, you know, crisis counselors, all people are have a really hard time predicting if someone will complete suicide. So maybe there’s some some beneficial things happening here. But I feel like the callers aren’t really aware of what they’re signing up for. And that’s that’s separate from they’re gonna find you if they’re worried about you, and that’s that’s another issue. But you know, you call in anonymously, that doesn’t mean that they don’t necessarily know your IP or your geolocation. So.
Curt Widhalm 6:18
There’s so many things that we uncovered in this that I don’t know that we’re going to do any of these areas particular justice in this episode, and maybe we’re going to end up having some follow up episodes on this, but…
Katie Vernoy 6:30
And we may, and if anybody wants to call and talk to us about this, we would love to do some interviews on this. We wanted to get this information out. And so we’re going based on some concerns. But yeah, I could see a series on this where we actually talk to folks. You know, if you’re a 988 crisis worker and hotline worker and want to talk to us, or someone that’s working both sides behind the scenes, or have a program, or you called and you want to have us share your story, I think that there’s, there’s more that we can talk about here. So so I am, I’m fully aware that this is just touching the surface and starting the inquiry here.
Curt Widhalm 7:05
As a skeptic, as somebody who pokes and prods around a lot of things, but also as somebody who’s very much based in laws and ethics, I don’t have problems with the sale of or even the giving away of aggregated, anonymized data. That would be things like number of calls, demographic information in broad swaths, even down to areas like by ZIP codes that is generally uncontroversial and is even allowed within things like HIPAA, as far as data being able to be given out to places. I don’t have any problems with that kind of stuff. Further, I wouldn’t have problems with the content of calls being coded into certain ways. We’ve received X number of calls about direct threats, or in the moment kinds of I have a weapon I am in the middle of, you know, this is my very last call, unless you know you’re able to talk me out of this. If those kinds of calls are codified and being given to researchers, I wouldn’t have problems with that. Where this article by Rob Wipond points out is that there’s not much transparency from either SAMHSA, who’s the federal oversight of 988 or a company called Vibrant Emotional Health, which is the administrator of the 988 system. This is a nonprofit organization that runs the 988 program and amongst some other things, but when you were talking about confidentiality, just about every 988 website that I’ve come across, whether it’s the national one, whether it’s down to the local administrators out of it, there’s a couple here in the Los Angeles area that route all of the Los Angeles, you know, area code phone calls to them. We’ll come back to that point in just a little bit. But every single one of these websites say, would you reach out to us? There is, this is confidential.
Katie Vernoy 9:21
Yeah.
Curt Widhalm 9:22
And part of the lack of transparency problems in that is for us as mental health professionals, confidentiality has a very strong and big meaning to it. Which is by law: what we talk about does not warrant us sharing this information to anybody else, unless there is specific exemptions to these laws. But there is no informed consent that comes into when somebody calls into 988 that explicitly says, here is some of the reasons that we may share this information. And I think that this is some of the transparency problems that end up happening is when you and I say, Hey, I’m not available 24 hours per per day if you are in a crisis and you need to get a hold of somebody, 988 is a resource. It’s confidential. It’s not the same kind of confidential that you and I have, because the people who are staffing the lines are not mental health professionals. What 988 is not providing therapy, which is where confidentiality amongst other healthcare services, but they’re kind of skirting this line where they’re not saying, Yeah, we are covered entities under HIPAA or anything like that. And so there’s some subtle legales in this where it’s like, yeah, it’s confidential, but they’re not bound to confidentiality in the same way that mental health professionals are.
… 10:50
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Katie Vernoy 10:53
To make sure we get to the other points. I think, just to wrap that point up, is to me, there is some probably some more digging to do and more understanding to do around what is this data being used for? How aware are callers that their their actual voices or the transcripts of their calls might be used for research purposes? And and I think, for therapists to understand like you’re not you’re not sending someone to another mental health provider, you’re sending someone to a crisis line that we’ll go into at this point has some different structure infrastructure problems that may or may not be helpful to your client. So okay, so confidentiality, anonymity, those types of things cannot be guaranteed for callers, and part of it is if someone is an imminent risk for suicide we do have the ability to break confidentiality. I think that’s one way they’re skirting around it. But the other thing is that, yes, they’re taking great pains to not be HIPAA compliant and not follow those rules. They’re not a mental health provider. But the other thing too, and this was the other article on Mad in America was that you could call and if you’re talking about big emotions, those types of things, they’re going to get, they’re going to go to are you basically, are you going to, quote, unquote, commit suicide? Are you going to kill yourself? Whatever those things are, and if you are, I don’t know, but from the stories that were discussed in this article, if you are not able to say definitively, no, I’m not going to kill myself, or if you don’t answer completely, or those types of things, they can figure out where you are and whether it’s from your IP address or your geolocation, those types of things, like they have resources to find you, and so you’re not anonymous. They can actually find you and involuntarily commit you, or try to convince you to voluntarily go to a hospital. And so what is very concerning is that the whole point of 988, and I’m moving on to a different issue so hopefully this is a decent enough transition that our listeners will follow. But, but the point of 988, was to try to become more informed and have mental health supports, and instead, what has happened is an increase in involuntary hospitalizations and an increase of police calls, because there’s not infrastructure, and that’s actually, if you know, I’m back, you know, I’ve got the the old episode up, and our first concern was a lack of infrastructure and a lack of local resources to handle crisis response. So this has just blown that open, where police are called more often, crisis response teams are not as available, although they can be called, and that that is a positive, if it’s more going to these crisis response teams that are mental health providers, but people are being coerced into voluntarily hospitalizing themselves or being picked up and involuntarily hospitalized. And so hospitalizations have gone up as had have calls to the police. And so there’s been kind of a combination of yes, people aren’t calling 911, but 988 hotline workers at sometimes are, and it is increasing the things that we were worried about, increasing.
Curt Widhalm 14:14
One of the other problems that we came across while researching through this is kind of an unintended consequence of the 988 system. And this is the point that I said that we would come back to earlier, is that people who call into 988 are not routed into the nearest 988 center. They are routed to the 988 center that is in the closest proximity to where their phone’s area code belongs to. And in trying to deal with the various mental health systems across the country, this creates problems for places that, if somebody is traveling from Los Angeles to Arkansas and ends up calling 988, in Arkansas, whoever is staffing the call center in Los Angeles may not know what the resources are or the interventions are available in the geolocation where the person actually may need services. Which with the amount of training by the callers, would probably often results in routing those calls to a local 911 area which does have the geolocation available.
Katie Vernoy 15:23
Yeah.
Curt Widhalm 15:23
One of the unintended consequences is that by routing phone calls to the area code call centers, is that, particularly in high population areas, this has led to an under advertising about the 988 system in general, because call centers with high populations are going to now have to be responsible for large populations of people who travel all over the place. Now, in the brilliance of fixing one problem and compounding another, there’s currently a bill going through the US Senate in order to address this very specific problem. And this bill would address the 988 problems by moving it over to the same system that the 911 system uses, which is further geolocation of callers, and being able to have it specifically identify the place where the caller is calling in, and routing them to a local call center, rather than to the call center where the person’s area code is from.
Katie Vernoy 16:30
So I could see that being very helpful. You’re you’re concerned about this bill.
Curt Widhalm 16:35
I’m concerned that when we’re talking about the confidentiality and the data leakage that goes along with this, that what is being sold to the public is this is anonymous. You can call in. We’ve got our protocols. Is that this is further data collection, and the ways that places, the call centers, the Vibrant Emotional Health, the VEH, the oversight company, what they’re doing with the data and things like their websites that have trackers that sell information to Facebook, as pointed out in the Mad in America article. If all of this data is not only not being aggregated and anonymized, that we have problems in the way that we’re managing the data. Should we be giving more specific data to these places?
Katie Vernoy 17:27
I hear you, and I think that there is probably some benefit to being able to serve someone in the location where they’re having a crisis. I think that the challenge for me, I agree with the data problems. I think they need to fix that, or at least become more transparent about it. But I think the challenge for me is that if there’s not infrastructure and support to help someone in crisis, this gives more fodder for police or other emergency services that may not have the mental health training to to support a mental health patient or a caller in crisis. And so I think that over time, this probably makes sense, but there’s so many other fixes that need to happen that I I share your worries about data. I share your worries about, you know, police. But I think that in time, wouldn’t it be great if a mental health crisis team could find somebody and support them so they didn’t complete suicide? I mean, I think that would be great. I think that’s the motivation behind it. But if we’re just supporting more police work, I don’t think that’s what this was for, and I don’t think that’s how it’s going to help people.
… 18:44
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Katie Vernoy 18:44
I think the other thing that that I’m not clear on, and this could be a, you know, quote, unquote, branding or messaging issue. Do they have the ability to manage someone who’s calling 988, because of an emotional crisis where they’re not contemplating suicide. Because we’ve talked about some of the reports that that we’ve heard back around how these workers are actually managing these calls. You know, it’s, it’s not a mental health let me get a quick coaching call kind of situation. It’s, I am contemplating suicide, and I need crisis response. At least that’s how I’m understanding it, based on, on what we’ve read. What is, what is your experience? Because I know you’ve, you’ve dug a little bit more deeply with your, you know, kind of interest in suicide and suicide prevention. What is your, what is your understanding of the training and the abilities, the capabilities of these, these, these workers.
Curt Widhalm 19:43
So what I’m finding in my research is that the requirements that people who staff these call center lines varies from place to place. The one that I was able to find the most familiarity with is the one that is located close to me, which is run by Dee Dee Hirsch, which is a Behavioral Health Center here in the Los Angeles area that does a lot of DMH type work and respectable place kind of overall, their requirements for a call center worker are that it must be someone who is at least 18 years of age, that they go through about 60 hours of training, and that they have reliable computer phone systems at home. People take these calls from home, kind of things. With a strong preference for people who have had a direct experience with suicide, either loss of a loved one or something like that. So the requirements are not to be mental health professionals, and they even explicitly state on their website that they don’t provide supervision for people earning hours towards like our board licensure sorts of things. These are volunteers in the truest sense of the word, as and people who go through about 60 hours of training. Now.
Katie Vernoy 21:09
And on the on the national website, they said that typically, like the average, is 90 hours of training. So so it’s interesting, so we, the closest one to us is only 60, and that’s being advertised. So it’s, it’s a broad array, I’m assuming, of how many hours of training and what that looks like. And some are volunteers. Some are paid, right? Like there are some paid hotline workers. Or we don’t know that?
Curt Widhalm 21:35
I think that there has to be staff who are kind of overseeing volunteers at some of these places, and this is just kind of where, I think it varies so much from place to place that it’s hard to say that there’s blanket policies and procedures in place. And I think that, I mean, that’s even stated in the Mad in America article, is that there are plenty of differences from one place to the next, that there’s some loosely unifying things across the more than 200 call centers across the US, but nothing that’s here are the specific standards and protocols in every single place. The responses that people are getting from call center staff are varied across what their experiences are. Some people have reported, and there’s some journal articles that we’ll put in our references here, but some of these are also some of the experiences that clients have told me and some of the experiences that people have are these are some of the most comparing compassionate calls at the times that I needed. At other times there have been, from some of these research articles, reports that staff are rude or dismissive. That some staff will end up spending a lot of time talking about what suicidality is, and then say we have a time limit that is available for each call, and we have run out of time, not giving the person who’s calling in much time to actually talk about things. One report looked at a sampling of about 230 transcripts and found that in four cases, the volunteer call worker encouraged the person to go ahead and complete the suicide
Katie Vernoy 23:32
Wow. Yeah, I mean, we were really concerned about the volunteer structure that volunteers. There’s, you know, if you’re trying to get somebody to volunteer to do something like this, like there’s less folks who have the ability to do it. I think there’s also training, you know, when you’re forcing a volunteer to be trained, sometimes the the engagement is lower. Sometimes the capacity is lower. If they’re not providing supervision to pre licensees, I’m suspecting they’re also not providing a lot of supervision to these volunteers. And so the ability for compassion, the ability, you know, the and compassion fatigue, I think there’s, there’s just so many problems with this that I really get concerned. I mean, on the, I don’t know if it was a SAMSA website or the vibrant health or the 988 website, but there were, like, some testimonials, like, you know, you saved my life literally, and, you know, that kind of stuff. So I’m sure that there are some really great hotlines and hotline workers, but to have even, I mean, I don’t know what percent of that is, four out of 280 that’s not a huge percentage, but it’s not low, and it’s not acceptable. But to have them suggesting, why don’t you just complete suicide, like that is that is ridiculous. That is so so far out of best practice that I’m just very concerned, because it doesn’t seem like there’s, there’s enough infrastructure and the ability to actually create some, some solid, solid work here. I mean, I think if they’re going to use the 911 electronic system, they probably should also use a 911 training system. But I don’t know, you know, we’ve not looked at a 911 maybe they go rogue too. But I just this is so cobbled together.
Curt Widhalm 25:22
So a couple of other things I found on the subreddit r/mental health, the post says I called the 988 hotline. So this post says I called the 988 hotline they hung up twice. I finally talked to a lady, and she was really condescending. I tried telling her how they hung up on me, and she said, Well, that’s not me. I didn’t hang up. So why are you complaining to me? So I just let it go. I tried to talk out what was going on with me, and she said, I’m a 37 year old black woman. You’re a 22 year old white girl. Don’t you think I have it hard? Do you think it makes us feel good to listen to you complain? It could be worse.
Katie Vernoy 26:01
Wow. Okay.
Curt Widhalm 26:03
One of my clients, and I have permission to share this, reported that she had called 988, at a point, and after about 40 minutes of very unsuccessful help in a moment where she was contemplating ending her life, that she ended up not only hanging up on the call, but there was no follow up to her. And she stated that her reason for living after such a terrible experience was merely to survive long enough to tell me just how ridiculous the whole system was.
Katie Vernoy 26:40
Clearly a client of yours, I survived to tell Curt so he could complain on the podcast about it. I’m assuming that you did appropriate, you know, emergency response and crisis planning after that. But it is kind of funny that your client would say I survived in order to tell you about this.
Curt Widhalm 27:00
Exactly.
Katie Vernoy 27:03
I think it’s so hard, because I understand that crisis response can be really hard, and especially if you’re not getting paid, or if you’re getting paid very little, you’re poorly trained, you don’t have supervision. I could understand how it would be very challenging, to keep yourself out of it, to not say like, Hey, stop complaining you don’t have it as hard as I do. Or to not be able to do the interventions that truly it sounds like are more along the lines of therapy or crisis coaching versus a hotline worker just providing resources. And so it feels like there’s some sort of, some sort of improvement or revamping of how this is working. I know I looked back at our episode from a couple years ago, and your idea was like, you know, like, use this for helping the mental health workforce, like, give people double hours, pay them well, and have these, these folks just out of grad school, staffing these, these hotlines. That would be awesome, right? But it costs money and it costs time, and that’s one of the other things that we reported, and we’re getting close to time, so I think this is where we’re going to have to finish up, but, that was one of the things that we worried about, is that there was a lack of ongoing funding to develop these resources. There’s some folks that have put in place, you know, kind of charging for calls. Some people are trying to see if there’s some Medicaid or other things, but they’re gonna have a hard time not being HIPAA compliant if they’re actually taking Medicaid dollars. But they’re trying to cobble together this resource, you know, these this funding for this resource that is literally about saving people’s lives. And there’s not a federal element to it, that that that goes beyond, I think it was a few years. And so to me, we’ve got this system. I guess the question I have for you, Curt is, do you feel like this is better than nothing?
Curt Widhalm 29:06
98% success is 98% success. I don’t want, I don’t want to minimize that most cases seem to be resolved without in person intervention needed. Whether that be crisis team, whether that be law enforcement that sent out. It seems to be working 98% of the time. It’s just that the 2% of the time seems to be something where those are not going any better than they have in the past. According to SAMHSA and VEH that the 2% has been consistent with the number of in person interventions since the the 10 digit hotline was out before the 988 system, and so there’s more calls coming in. So 2% is going to mean more more people, and 2% is going to mean more interventions just on raw, raw numbers.
Katie Vernoy 30:06
Sure.
Curt Widhalm 30:08
The intervention concerns, it is better than nothing, and I don’t want to focus on, you know, in their statistics, my clients, who chose survival, just to tell me how terrible it was, probably gets marked as a 98% like that was a successful call on their end. I don’t know that 98% is exactly 98%. To answer your question simply, yes, it is better than nothing, but I don’t think that that means that we have to stop aiming to improve it. Now, the concerns brought up in the Mad in America article about data and that kind of stuff is alarming in ways that I don’t think that most people are going to grasp. It goes against our ideas around like informed consent, as far as what is happening with this information, it’s another byproduct of businesses managing mental health and mental health care that is run by these businesses, run by business people, rather than health care people. So I do have a lot of concerns as far as what happens with this data, what happens when it gets sent out to the Facebooks and the Googles and the Amazons. And I don’t know that that is necessarily something that most people are going to realize until some years down the road. It is seemingly really good to keep people out of the emergency rooms, which we’ve had suicide episodes around, you know, that could potentially be worse. It does seem to be working in a lot of ways. There’s still a lot of room for improvement.
Katie Vernoy 31:52
And it sounds like there may be some room for advocacy from mental health providers that this is, you know, if you have the capacity and an interest and some knowledge, being able to talk to legislators about some reforms that need to happen. You know, maybe that’s another episode where we can talk about that. But to me, I feel like, as a mental health provider, my my goal will be to have resources in place, and my clients don’t feel the need to call 988. But it sounds like 988 is a is a good last resort. I just I hope that in building it out and having improvements, that we do get a stronger, a stronger workforce that are staffing these, these hotline numbers. I think it it would be really good to have that. I think if, if I think for the the 988, data, all of the data that potentially is being used for research, or those types of things, I think whether it’s an increase in transparency or actually coming through and trying to kind of adjudicate, are they breaking the law here? Are they skirting the law, are they doing something that is is not appropriate, and then have that that fixed? I guess. I’m not, I’m not able to say it well. But I feel like the data thing, to me is worrisome and may hurt people. But my my bigger concern right now that feels a little bit more fixable within the system versus, you know, kind of a let’s take this all down, is making sure that when people call in, they actually get the help that they’re seeking.
Curt Widhalm 33:32
You can find our show notes over at mtsgpodcast.com. Follow us on our social media. Join our Facebook group, the Modern Therapist Group, to continue on this conversation, and until next time I’m Curt Widhalm with Katie Vernoy.
… 33:44
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