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Lauren Mucke, a licensed triage clinician, takes a call to the Telecare Mobile Crisis Response Team office at 2121.

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Since 2005, people in crisis and feeling suicidal can call the National Suicide Prevention Lifeline at 1-800-273-8255.

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Starting Saturday, that Lifeline number has a three-digit number — 988 — and aims to become the 911 number for psychiatric emergencies, giving people with any mental illness the ability to call or text to reach trained clinicians to offer support

In San Diego County, when someone with an area code calls 988, they are automatically routed to the local emergency and access line, which was part of the Lifeline network and operated by the county's contracted agency, Optum.

The 988 effort was launched by federal legislation in October 2020 as a step toward transforming the nation's crisis behavioral health system "in the same way that 911 has fueled the growth of emergency medical services in the United States over time," according to a Substance Abuse and Mental Health Services Administration report. health. The long-term goals, it said, are to reduce reliance on law enforcement by connecting 988 callers to mobile crisis teams when needed, lighting up emergency rooms and encouraging people to seek help early.

States and their provinces are tasked with making this vision a reality. The federal government has earmarked $282 million for states to expand existing infrastructure used by more than 200 Lifeline call centers and increase staffing as the number of calls is likely to increase.

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A June survey released by the RAND Corporation found that fewer than half of 180 behavioral health program directors surveyed were confident their jurisdictions were ready to deploy 988 with the funding, manpower and infrastructure. "Our findings confirmed what many advocates and experts feared," said Ryan McBain, a RAND policy researcher. Concerns center around the expected increase in calls, as well as insufficient staffing and long-term funding.

San Diego Access and Crisis Line expects "a really big increase in total call volume," but the county is "in good shape" as 988 debuts thanks to "significant investment" in the call center and new services like mobile crisis response . team," said Luke Bergmann, director of the county's Behavioral Health Services.

First, California is investing $28 million in 13 public and private call centers that take Lifeline calls, including the San Diego Access and Crisis Line. But in a state the size of California, Bergmann said, that's not enough. The county has allocated $1.5 million in its fiscal 2022-2023 budget to upgrade its phone infrastructure and double its phone staff, with plans to hire 20 counselors.

The access and crisis line, which handles about 7,000 calls each month, expects a 125 percent increase in calls during the first year of 988 implementation, according to the county.

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In the first three months of this year, California's 13 call centers answered 85 percent of Lifeline's calls, with 58,000 answered in the state and nearly 250 forwarded to other states. According to Bergmann, the rate of missed calls on the access line and crisis calls was between 0.7 percent and 1.1 percent from January to May.

It's too early to tell how many calls will increase and how many calls will go unanswered, so more long-term funding is needed, said Kathryn Nacario, CEO of mental health provider NAMI San Diego.

"Federal, state and local governments need to highlight and recognize that we are in a behavioral health workforce crisis, and as we ask people to use more mental health or early intervention services like 988, we hope that they will invest more dollars,” she said. said said

Provincial mobile crisis response teams, service providers Telecare Corp. and Exodus Recovery, Inc. also be prepared for them to expect an increase in the number of 988 calls requiring their assistance.

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"We are making progress in staffing and continue to hire each week as our call volume continues to increase," said Mary Woods, Director of Telecare. To date, the agency has responded to more than 1,700 calls and receives an average of up to 25 calls per day, she added.

Funding for mobile crisis response teams and increased call center staffing could come through a proposed state bill that would impose a monthly telephone surcharge of up to 30 cents per line, which could raise more than $190 million a year. The measure, which was introduced in February 2021, remains pending in committee.

In the near term, the county will "prioritize this service as much as possible within our budget latitudes and push for additional funds from our local spending," Bergman said, adding that Saturday's launch is more of a "first wave of being able to make a cultural transition. how we think about behavioral health."

Get top headlines from the Union-Tribune delivered to your inbox weekday mornings, including top news, local news, sports, business, entertainment and opinion. SAN DIEGO COUNTY, Calif. — Starting this week, San Diego residents are facing a mental health crisis. self or substance use, including suicidal thoughts, can call or text 988 to get help for themselves or a loved one.

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On Saturday, the 988 number will connect with a qualified counselor who can help and connect them with services in the area where they live. This new service is in addition to the San Diego County Access and Crisis Line at (888) 724-7240.

"Anyone struggling with substance use or mental health issues such as depression, anxiety, suicidality, loss or anger can call the Access and Crisis Line to speak with a representative," says Dr. Luke Bergmann, director of behavioral health at the County Health and Human Services Agency.

"ACL clinicians are trained to respond to behavioral health questions and crisis situations and can provide compassionate and knowledgeable support to callers," said Dr. Bergmann added.

"You just don't see it because it's unimaginable," said Margaret Strahm, whose 19-year-old son Aaron was a student at Mesa College in Linda Vista when he took his own life in 2000.

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In the 22 years since Aaron's death, Strahm has dedicated her life to spreading awareness about suicide prevention by volunteering with the Yellow Ribbon Suicide Prevention Program.

"Anything we can do to try to prevent [suicide] and try to save lives," she added.

With its launch, 988 will become the new nationwide phone number to connect people to the National Suicide Prevention Lifeline, a national network of local crisis centers that provide free, confidential emotional support to people experiencing suicidal, mental health and/or substance use issues. crisis, 24 hours a day, seven days a week in the United States. People can still call or text the National Suicide Prevention Lifeline at 1-800-273-8255.

The Access and Crisis Line provides confidential and free support and resources nationwide in more than 200 languages ​​from experienced counselors on all behavioral health, mental health and substance use issues, including substance use support services, crisis intervention, mobile crisis response services, suicide prevention and psychiatric areas.

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During the initial rollout, calls and texts made to 988 will be connected to a local crisis call center based on the phone number from which the call is made and the call center's capabilities.

According to national data, more than 44,000 Americans died by suicide in 2020, and data suggest that the COVID-19 pandemic has exacerbated suicidal thoughts and actions. In the same year, 419 suicides were registered at the local level.

SEE ALSO: Minority Mental Health Awareness Month and how mental health is linked to gut health (July 8, 2022)

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