FORT LAUDERDALE, Fla. — Florida is scrambling to prepare for the flood of calls expected when the country rolls out a three-digit suicide hotline this summer.
Starting in July, callers will just dial 988 to reach the National Suicide Prevention Lifeline, making it much easier than dialing the current 10-digit number. With mental health now a crisis, some states have created dedicated ways to pay for more staff and upgrade technology to support their 988 call systems. Florida is relying on a patchwork of funding, with some counties more ready than others for the surge in volume projected.
Although the 911 system took decades to build, mental health experts say the country will need to move fast to add staff to man the call lines and update technology for 988 because in the first year alone, call volume is expected to increase by 300%. Florida’s increase could be even greater with suicide the third most frequent cause of death in the state.
“We are a large state, and we got a lot of people who need help,” said Gayle Giese, president of the Florida Mental Health Advocacy Coalition. “We are in a critical window. As national advertising rolls out, it would be horrible if people couldn’t get through.”
In South Florida, the need is great: Figures released by the Medical Examiner’s Office in Palm Beach County show a more than 31% increase in suicides in 2021 from the prior year. In Broward County, about 230 people a year have taken their lives on average over the past few years, according to the Medical Examiner’s Office in Broward County.
In many counties, including Miami-Dade, Broward and Palm Beach, people who call 988 most likely will end up talking to someone at an existing 211 call center, which already answers calls for the National Suicide Prevention Lifeline. There are 12 Lifeline centers in Florida.
Not all have been operating 24/7, but that would have to change when 988 launches.
“The question is will we all have enough staff to answer the increased volume and that is a big worry and that is a big unknown,” said Sharon L’Herrou. President/ CEO at 211 Palm Beach/ Treasure Coast. “So that’s why we’ve been pounding the pavement for additional dollars. We still need to build out our infrastructure.”
Martino, of NAMI Palm Beach County, said some Florida counties have a mental health crisis response system or a part of a system to build on, while others have none. “In Palm Beach we have something. Not particularly adequate but more than some counties. It is a shame that every county has to figure this out for themselves.”
When 988 goes live, someone having a mental health crisis can call or text the three digits and be diverted to a local crisis center, much like 911.
Trained professionals will answer and link the caller to follow-up care with a local resource or set up an in-person visit from a mobile response team that knows how to de-escalate a crisis. The goal is to steer people with mental-health emergencies away from 911 and avoid getting law enforcement involved unless necessary.
“This would keep a number of people out of the emergency room and out of jail,” said Marsha Martino, executive director of NAMI (National Alliance on Mental Illness) Palm Beach County.
Congress approved 988 as the national suicide hotline in 2020 but did not provide full federal funding.
States such as Virginia, Colorado, Nevada and Washington put a tax on cellphones to cover the costs. Florida mostly has left it up to the counties to come up with funding sources. Vibrant Emotional Health, the administrator for the National Suicide Prevention Lifeline, projects it will cost $28 million in Florida in its first year.
The Florida Department of Children and Families, which oversees youth mental health programs has been criticized by mental health advocates for not doing enough to leverage federal dollars for 988. The agency did not respond to requests about progress on funding and whether Florida will be ready in July.
The 988 number will work in July regardless of which states are ready. Callers will have longer wait times in areas that lack enough trained call-takers or mobile responders.
“People are going to call for all kinds of reasons,” says Giese, of the Florida Mental Health Advocacy Coalition. “People with autism, and elderly people who are lonely, and people who are depressed, and people whose friends are contemplating suicide. It’s another number for them to call and it’s the right number because it’s specifically for behavioral health.”
“This could transform our system in a positive way,” she said. “I’m shocked we are not jumping on the bandwagon and making sure it gets funded.”
Attorney Robby Holroyd, who represents the Florida Mental Heath Advocacy Coalition, says during the recent legislative session, some federal funds provided to the state were directed to local call centers and to mobile response teams. But he says the money from the state budget won’t be available until July 1, so Florida likely won’t be fully ready for the initial rollout.
The challenge, he says no one knows exactly what the call volume will be and how quickly Florida needs to ramp up.
Mental health advocates say they are concerned about Floridians losing trust in the system before the system is off the ground.
“It’s going to take some time and it’s going to require some local investment as well,” Holroyd said. “The ultimate goal is to make sure folks in crisis can get the best care possible.”
“When that hotline is activated, I think there’s going to be a giant thud” in Florida,” Marni Stahlman, president and CEO of the Mental Health Association of Central Florida recently told the Orlando Sentinel. “There just isn’t the infrastructure to provide the help people need. We’re really up against it here to get something in place.”
The current hotline number — 800-273-8255 — will remain in operation for people facing a mental-health crisis after 988 begins nationally.
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