What's Next for the 988 Lifeline?
Part II
So now that the 988 Lifeline has been up and running for a little over a year, what’s working, and what needs improved? What’s next?
In a July 2023 interview with Iowa Public Radio, Emily Blomme, CEO of Foundation 2 in Iowa, said one of the biggest challenges the 988 call centers face right now is finding and retaining staff. My sister confirmed this from her own firsthand experience working as a chat/text crisis counselor for Foundation 2. She began her training with a half dozen individuals, and within six months, only two of the original six were left. A few had quit before training even ended.
As a chat/text counselor, she worked 4/8-hour overnight weekend shifts and was paid $17/hour with benefits, which averaged to around $28,000/year. And while she earned a $1000 sign on bonus and was provided a headset, she had to provide her own computer system for the chat platform. Between the low salary, tech requirements, and stressful nature of the job, burnout is unfortunately common.
Above all, though, she said, the job required constant empathy, patience, understanding, and being “quick on their feet” because intense, life-threatening situations unfold rapidly. Two of her most serious situations:
A teenage male in active suicide, and a father threatening homicide after discovering a high school coach was engaging in a sexual relationship with his daughter. In both cases she had to immediately dispatch law enforcement and medical services. Curiously, counselors generally don’t know what happens to callers or chatters after disconnecting unless the person shows up again later on a call or in a new chat/text message, or if law enforcement calls back, but that’s rare.
If a chatter won’t give their location but needs intervention, counselors must look up their IP address to try and get a physical address for where to send help. Additionally, not every Iowa county has a mobile crisis unit, further complicating responses. My sister once had to connect a chatter in crisis with a law enforcement officer through a Zoom call on the chatter’s iPad.
Counselors are also unable to block callers and chatters clearly under the influence, who use expletives and name calling, make threatening statements to the counselor, or are individuals with intellectual disabilities who don’t actually need mental health crisis counseling (and in that case have to be limited to one call per shift).
Technical Issues
Calls/chats/texts are based on the user’s area code, and most people dial from their mobile phone. However, if a person has moved to another state but kept their existing number, their call will be routed to a center based on their area code, which means Iowa counselors often scramble to find and send assistance for a person living in and calling from an entirely different state.
Spam calls and messages are also a problem, and, surprisingly, messages from users in other countries who have figured out how to work around and access the 988 Lifeline call centers from their international location. My sister said she received repeated texts from a woman in Germany, as well as messages from individuals in Greece and the Netherlands, all seeking mental health support.
Getting the Word Out
Despite the massive increase in call volume, a recent Pew Charitable Trusts poll found only 13% of adults know about 988 services. Iowa officials have delayed launching any major marketing and advertising campaigns while the call centers continue to work out some of the kinks mentioned above.
Counselors have even had instances where they’ve contacted Iowa law enforcement agencies to request a welfare check on a caller or chatter in crisis only to discover the agency has never even heard of the 988 Lifeline, Foundation 2, or Your Life Iowa, Counselors then spend precious time explaining who they are, what their organization is, what they’re doing, and what they need.
Funding
Arguably the biggest issue 988 faces is funding. Currently only 8 U.S. state legislatures have passed designated funding for 988 services, and Iowa is not one of them. This past May the Biden administration announced an additional $200 million available to states to help with 988 services. An official with the Iowa Department of Health and Human Services said they’re planning to use temporary federal funds until they come up with a long-term plan, though it’s unclear what that plan will be.
Mental healthcare professionals and advocates unilaterally agree figuring out long term funding and increasing awareness for 988 services are top priorities. With long term funding for 988 still undetermined in Iowa, I’ll be watching this topic closely during the 2024 state legislative session. ~
I love to hear from readers. Any thoughts about or experiences with the 988 Lifeline?
Thank you for reading 988: Mental Healthcare in Iowa!
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Thank you for educating all of this about this service, its importance, and the struggles they are having without proper funding. We all need to be much more watchful.