music and mental health series: 988, The Suicide and Crisis Hotline

The National Suicide Prevention Hotline rebranded in 2022 and became the Suicide and Crisis Hotline. 988 made the number simple to remember, and the demand for its services has only increased in the past year. Their text line takes away the anxiety that can come with making phone calls. 988 is available for any reason related to suicide, mental health, substance use, emotional distress, or basic needs. The call is confidential and the trained crisis counselors on the line will do their very best to help people work through the crisis or offer additional resources. 

BH Link is the state’s emergency behavioral health facility, operating 24/7 in East Providence since 2018. Karen Jeffreys, director of programs at Horizon Healthcare Partners, took the time to explain the program and the huge benefit it brings to Rhode Islanders and the entire nation.


Bobby Forand (Motif): What changes have you seen since the number changed to 988?

Karen Jeffreys (BH Link): Throughout the course of the last year, we have seen a significant increase in call volume. Some of the increase can be attributed to individuals utilizing 988 instead of the previously established behavioral health emergency line. However, much of the increase can be attributed to an increase in the net volume of calls. Other changes include an expansion to new age groups, including children, and an increased focus on the utilization of the 988 Call Center as a dispatch venue for mobile crisis programs throughout the state. 

BF: Please discuss the texting option. How do texts compare to calls? What are the pros and cons of calling vs texting.

KJ: We have seen an increased demand for texting through the 988 line in the past year. There are many pros to texting from the user’s perspective. They remain anonymous, they have time to process information and formulate their response, it’s fast and easily accessible. For many individuals, It provides an opportunity to reach out to the call center in a manner that they otherwise would not. It may simply feel like a more comfortable option for individuals to reach out for help. There are potential cons, including the lack of a vocal tone and the potential for misinterpretation by either party, as can sometimes occur in text related communication. In some cases, texting may limit the caller’s ability to fully express themselves. That said, we view any new avenue to access care, including texting, as a net positive for people in need. 

BF: 988 is a national program. If someone contacts 988, will they be speaking with someone local? How does that work?

KJ: Generally speaking, if someone calls 988, they will be speaking to a local call center. More specifically, they will be speaking with a call center operating within the call area code of the caller. Most of the calls we receive are coming from Rhode Islanders. However, there are instances where individuals with a 401-area code are not located in RI at the time of the call or live in another part of the country.  In these situations, call centers do their very best to work with the caller to provide access to local resources wherever the caller may be located. 988 call centers rely on callers to let them know where they are located, which is done at the caller’s discretion. 988 Call Centers are not able to geolocate clients in the same way that 911 call centers can. 

BF: How is BH Link affiliated with 988? How did that come about? Are there other centers throughout RI that provide a similar service?

KJ: The BH Link is the state’s emergency behavioral health facility, operating 24/7 in East Providence  since 2018. Horizon Healthcare Partners (HHP) is a conglomerate of seven behavioral health organizations throughout the state, including Community Care Alliance (CCA). HHP has contracted with the state of RI since 2018 to provide services through the BH Link as well the state’s emergency behavioral health call center, inclusive of the National Suicide Hotline. HHP subcontracts the clinical oversight and operations of both services to its partner, CCA. 

Last year, the suicide hotline and 24-hour emergency behavioral health line merged together under the 988 line. HHP and CCA continue to work together to deliver services through the BH Link and 988, which operate within a broader spectrum of available mental health services across the state. This includes Community Mental Health Centers, private practitioners and therapists, hospitals, acute care facilities and many others. The staff at the BH Link and 988 work to ensure that individuals seeking services of any type along this spectrum are assisted in accessing the care that they need.  

BF: When should someone call 988? Is there anything a person calling would need to worry about (police involvement, etc.)?

KJ: The 988 line is designed to assist with any mental health, substance use, suicide or emotional crisis inquiry. These inquiries can range from simple questions about the kind of care that is available to a need for an emergency response vehicle. A call to 988 does not trigger a call to police or first responders of any kind unless the caller indicates that they are in need of a first responder, or the crisis counselor determines that someone is in immediate danger and requires assistance. In order for the crisis counselor to deploy first responders, the caller would need to first provide their location. The vast majority of calls to 988 do not result in the deployment of first responders. Individuals in need of police, fire, or immediate medical care should call 911. 

BF: Why do you think mental health has become such an important issue now? What took so long? How is the stigma changing?

KJ: While mental health has always been an important issue, recent events such as the COVID-19 pandemic, the nationwide opioid crisis, and a greater recognition of racial and economic disparities have raised awareness of mental health issues. Additionally, there is an active effort on the part of mental health and medical professionals, advocates, peers, and even in the media to decrease the stigma that has historically accompanied mental health treatment and conditions. 

Educating individuals on the benefits of seeking help is important. Mental health challenges are extremely common and it’s important for people to know that there is help and it’s ok to seek it out. It’s ok to encourage others to seek help when they need it. We have a long way to go with respect to reducing stigma but we have seen an increase in awareness and acceptance through our efforts to better inform the public.

On October 17, 2020, Congress passed legislation, co-authored by RI’s own Senator Jack Reed, which created the new 988 behavioral health hotline. The legislation, named the National Suicide Hotline Designation Act of 2020, directs the Federal Communications Commission (FCC) to designate 9-8-8 as the universal telephone number for a national suicide prevention and mental health crisis hotline. 

  The need is clear, as stated in the legislation:  “Congress finds the following: 

(1) According to the American Foundation for Suicide Prevention, on average, there are 129 suicides per day in the United States.

(2) To prevent future suicides, it is critical to transition the cumbersome, existing 10-digit National Suicide Hotline to a universal, easy-to-remember, 3-digit phone number and connect people in crisis with life-saving resources. 

(3) It is essential that people in the United States have access to a 3-digit national suicide hotline across all geographic locations. 

(4) The designated suicide hotline number will need to be both familiar and recognizable to all people in the United States.”

Call or text 988 if you are experiencing a mental health crisis or need assistance with substance abuse or emotional distress. BH Link is a 24/7 service located at 975 Waterman Ave in East Providence. Call (401) 414-5465 for more information.

Musicians looking for support can contact Kate Noveau at