As the 988 Suicide and Crisis Lifeline is being rolled out, most localities are still unprepared and understaffed.
On July 16, the 988 Suicide and Crisis Lifeline replaced the National Suicide Prevention Lifeline, an important step toward transforming crisis care. The new hotline connects to a national network of more than 200 crisis centers that can help people overcome a suicidal crisis or mental health-related distress.
A call to a mental health hotline manned by a trained operator can obviously be a lifesaver, but the volume of calls may be overwhelming. Each year in Austin, Texas, for example, the emergency call center diverts more than 80% of its calls to mental health clinicians.
We are facing a 988 staffing crisis just as the service is launching. Reporting has revealed that hundreds of positions remain unfilled. Tradeoffs, the health policy podcast, reported the hotline could get up to 12 million calls in its first year, as 50 million Americans with a mental illness seek help.
As 988 is being rolled out, most localities are still unprepared and understaffed. In fact, President Joe Biden called for $700 million to staff 988 and strengthen the mental crisis system across the country.
Against that backdrop, the question is: “Can artificial intelligence help this staffing crisis?” The answer is both yes and no. AI-enabled bots absolutely cannot listen to and advise people on the brink of suicide. Yet, we do not have enough trained clinicians to pick up the phone. While people in crisis wait for the phone to be answered, it can become too late. Can bots and AI fit into this equation?
AI automation can help field and route incoming calls to eliminate callers’ wait time with simple set of questions like: “Are you in danger of hurting yourself or others? Are you calling about someone in your care you fear might hurt themselves?” Even screening questions as simple as, “Is your call an emergency?” could be managed by a bot with simple AI that listens for keywords or signals of trauma and that escalates or routes a call with more efficiency.
That said, the need for well-trained and sympathetic humans to respond to people in crisis on 988 is the most important investment.
However, we cannot make the same mistakes we made with our frontline workers and 911 responders. In the past, there have been concerns about 911 call-takers suffering ill-effects from the work. 988 workers will handle incredibly sensitive situations, and the stress will be unimaginable.
We need to ensure 988 operators have the support and work environment that affords them the ability to respond to every call with the attention to detail and speed that could save lives.
First, let’s start with pay and hours. Call takers cannot be incentivized to work more hours with more pay. They need time to recover and learn from their interactions. Family and marriage therapists go to school for two-plus years and must practice under supervision for 2,000 hours. A significant portion of their training is on how to personally deal with their patients’ trauma so they can function as healthy and happy members of their families and community.
We must leverage the technologies we have to support these frontline call-taking heroes. We should not replace humans at the front line of 988, but we can use technology to measure their physical and emotional health.
We can use AI to listen to the calls and process the unstructured data to help train and gauge the effectiveness of approaches after the fact and give us a better idea about the health of our society. Technology will not, however, replace the real-time human support needed to save lives and help people find the care they or their loved ones need.
It’s on us as a society to ensure the few who take on the frontline burdens do not suffer beyond their calling. AI is not empathetic or trained to deal with a crisis and handle this level of critical response, but it does have a place in answering and routing calls.
For now, humans helping humans will make the difference in the 988 Suicide and Crisis Lifeline, but let’s make sure that the calls are answered.