Michele Roberts is the Assistant Secretary for Prevention & Health at the Washington State Department of Health. She is also co-chair of the Washington State Health Care Authority’s Crisis Response Improvement Strategy (CRIS) Committee.
The CRIS Committee has been working on initiatives to prepare for Washington’s implementation of the 988 suicide prevention line. Residents will be able to call or text 988 to connect to trained counselors in times of crisis beginning July 16th. Roberts discusses 988’s impact on residents’ care in this Q&A.
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State of Reform: On July 16th, Washingtonians will have access to the 988 suicide prevention line. Other suicide prevention lines have been available, like the National Suicide Prevention Line, but 988 offers a simpler dialing process. What are some other benefits unique to 988?
Michele Roberts: You’re correct that 988 is a simpler number for people to dial if they’re having thoughts of suicide, mental health or substance use crises, and any other kind of emotional distress. Someone can also dial 988 if they’re worried about a loved one who may need crisis support.
While 988 will be easier for people to remember, the 10-digit National Suicide Prevention Lifeline (NSPL) number will remain active after 988 goes live on July 16th. If somebody calls that number instead of 988, they’ll reach the same trained crisis counselors who are answering 988 calls.
[Some] other benefits of 988 include opportunities to strengthen and expand the NSPL network and build a robust crisis response system that links callers to community-based providers who can deliver a full range of crisis services.
Starting July 16th, someone can text 988 and connect with a crisis counselor. Not all crisis centers are accredited to provide text and chat services. One of the 3 crisis centers in our state, Volunteers of America of Western Washington, is accredited to provide text and chat services. We’re fortunate to have them on board and able to offer these services to people in Washington.
Washington will also launch the Native and Strong Lifeline, which is dedicated to serving American Indian and Alaska Native individuals who call 988. The lifeline will work in partnership with the Indian Behavioral Health Hub, a resource line for tribes, urban Indian organizations, families, and non-tribal providers who support tribal and urban Indian communities to identify resources and follow up with people who access 988.
Callers [will also be able to] press 2 to access the Spanish Language Line. Language Line Solutions also provides translation services in over 250 additional languages for people who call 988.”
SOR: The CRIS Committee has been collaborating with crisis service providers on the initiative to help reduce the use of emergency room and police departments with the 988 service. Can you discuss some ways it will be effective in doing that?
MR: The 988 line will provide easier access to the NSPL network and related crisis resources, which are distinct from the public safety purposes of 911, where the focus is on dispatching EMS, fire, and police as needed. [The 988 and 911 lines] will be closely coordinated.
We know that the vast majority of people seeking help from the NSPL do not require additional interventions. Fewer than 2% of NSPL calls require connection to emergency services like 911. Some safety and health issues may warrant a response from law enforcement or EMS like when a suicide attempt is in progress. The 988 coordinated response is intended to promote stabilization and care in the least restrictive manner.”
SOR: What types of moves have crisis response providers had to make in order to prepare for the initiative?
MR: There are 3 crisis centers in our state: Crisis Connections, Frontier Behavioral Health, and Volunteers of America of Western Washington. To prepare for 988, all 3 crisis centers have been accredited by the NSPL administrator, Vibrant Emotional Health, and are ready to take calls starting July 16th. Volunteers of America of Western Washington is also accredited to provide NSPL text and chat services.
The crisis centers have also worked hard to increase staffing levels in anticipation of a higher volume of calls once 988 goes live and ensure new staff receive training, supervision, and call monitoring to adhere to the NSPL requirements.”
SOR: Have there been any notable challenges in trying to implement the 988 initiative? If so, how were those overcome?
MR: Like many states across the country, Washington is experiencing a workforce shortage, which is a major barrier in meeting the projected increase in 988 utilization over the coming years. The crisis centers have worked hard to recruit and hire qualified workers and this effort is moving in the right direction.”
SOR: What will the CRIS Committee’s role be in relation to the 988 service after the line goes live on July 16th?
MR: The CRIS Committee will continue to develop recommendations to support the statewide improvement of behavioral health crisis response and suicide prevention services and advise the Steering Committee in developing recommendations for an integrated behavioral health crisis response and suicide prevention system with elements described in House Bill 1477.”
This interview was edited for clarity and length.