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Crisis Hotlines: A Vital Response Resource

  • April 30, 2020
  • Anxiety, Depression

Crisis hotlines provide support and assistance easily available to anyone 24 hours a day, a vital resource at any time, but especially critical during our current national crisis. Many hotlines are seeing significant increases in calls. A national crisis hotline run by the Substance Abuse and Mental Health Services Administration (SAMHSA), the Disaster Distress Helpline, saw an increase in calls of more than 300% in March compared to February this year.

“Crisis hotlines serve as core part of the nation's mental health safety net, ensuring that care is available during a crisis, noted Kimberly Williams, President and CEO of Vibrant Emotional Health (formerly the Mental Health Association of New York City) at a recent APA online meeting. Williams and colleagues presented on the role of crisis hotlines in mental health care delivery at APA’s online Spring Highlights meeting held April 25 and 26.

Through trained counselors, crisis hotlines provide rapid crisis intervention, actively engage in problem solving, and assess risk for suicide. Research supports the effectiveness of crisis hotlines.

An example of a local crisis line operating at the epicenter of the U.S. COVID-19 pandemic, is NYC Well, operated by Vibrant. It provides free and confidential support with counselors and peer support specialists 24 hours a day in multiple languages. It provides referrals, has a services finder on its website, conducts follow up services, and offers both text and chat access, in addition to phone access. While most contact is still by phone, they have seen growth in text and even greater growth in chat contacts in recent years.

The top four issues among callers to NYC Well have consistently been mood concerns, a stressful life event, interpersonal concerns, and anxiety concerns. Most of their calls are from individuals (about 80%) but they also get calls from service providers (about 10%) and from friends/relatives (about 10%).

NYC Well has been highly promoted during COVID-19 crisis and serves as a source for updates on service delivery changes across the city. They started seeing significant increase in contacts in March with a focus on health for the callers or loved ones. Then as more information and guidance became available the hotline saw calls focusing more on managing emotional health.

The Suicide Prevention Lifeline is a national network of local centers – 172 centers in 49 states – providing crisis response since 2005. Studies have shown the Lifeline is effective in reducing imminent risk through collaborative de-escalation; follow-up calls to persons at risk are effective (80% of individuals say calls helped keep them safe); and training programs for counselors are effective.

The current national crisis also brings added challenges for the crisis counselors answering the phone calls and text messages. Many of them are struggling with challenges of trying to work from home—balancing work and home life, challenging work environment, isolation—while also handling a more difficult workload with less available support from their colleagues.

Nationwide Hotline to Come

While not expected to available for some time, progress is being made toward establishing a nationwide three-digit number for a suicide prevention and mental health crisis hotline. A single nation-wide three-digit number for crisis centers will be easier to remember in times of crisis and lead to greater access, could help reduce reliance on 911 and local emergency services, and it could help save lives.

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