988 - A Step Towards a Transformed Crisis Care System in America
By Mary Jean Weston, LCSW“According to 2021 data from the Centers for Disease Control and Prevention (CDC), New Jersey had next to the lowest suicide mortality in the United States. While this may appear to be good news, New Jersey residents continue to die by suicide, and we believe that every life lost is one too many.”
NOTE: This article talks about suicidal thoughts and feelings. If this is a triggering issue for you, please consider if or when you want to read further.
September is Suicide Prevention and Awareness Month. It’s a month when we, as professional Social Workers, can take some time to consider the importance of life and how fragile it is. Every day we work in some capacity to help people make their lives better. But some individuals are in a very dark place and struggle to find any light or hope for their future. Ending their lives. Dying. Being dead. This is their solution to the crises, the pain, the exhaustion, the anger, the fear, the isolation, the hopelessness, the loneliness… Being dead is their solution to the complete despair they are facing.
For those who have not been down this road, it may be hard to imagine just how deep and dark this place can be. It’s the reason that we learn in our professional training that it’s okay to ask someone if they are thinking of killing themselves. Those who are in this dark corridor often find this a helpful question, as it opens the door to a conversation few people are comfortable having with them. For those who are not contemplating suicide, it seems like
a strange question. It is often answered by, “No!” followed by some additional comment that indicates this is not a path they would be likely to choose.
A Crisis of Mental Health Crises
According to the American Foundation for Suicide Prevention (AFSP), suicide was the 11th leading cause of death in the U.S. in 2021 (the last year for which we have complete data). That same year, 48,183 Americans died by suicide and there were an estimated 1.7 million suicide attempts. Clearly many, many people are in that dark place. And since the end of 2021, stressors including the pandemic, the economy, climate change and political developments, as well as many personal challenges, have continued to bring difficult times to many people.
988 - A Step Towards a Transformed Crisis Care System in America
In 2020, the Federal Communications Commission
(FCC) designated 9-8-8 as the new 3-digit dialing code to connect individuals to the pre-existing National Suicide Prevention Lifeline (NSPL).
Previously, the NSPL offered a 10-digit 800 number for people to call, but the FCC required all U.S. states and territories to transition to this easy-toremember, 3-digit dialing code by July 16, 2022. On this date, in New Jersey and across the country, the 988 Suicide & Crisis Lifeline was established, and 988 became the new number to call, text or chat ( https://988lifeline.org/chat/ ) for suicidal, mental health and substance use crises. When people contact 988, they are connected to trained crisis counselors who provide free, confidential support and resources based on the need(s) presented. New Jersey currently has five 988 Lifeline centers that respond when people in crisis reach out. Anyone in the United States or its territories can contact 988 for themselves or for someone else, and services are available 24 hours a day, every day of the year.
New Jersey
According to 2021 data from the Centers for Disease Control and Prevention (CDC), New Jersey had next to the lowest suicide mortality in the United States. While this may appear to be good news, New Jersey residents continue to die by suicide, and we believe that every life lost is one too many. Nevertheless, these statistics reflect the robust crisis and acute care continuum available in New Jersey. Mental health and substance use resources for New Jersey residents include the 988 Lifeline, ReachNJ (substance use treatment referral), NJ 211 (social and community services referral), behavioral health clinics, community support services, screening, partial care, respite homes, wellness centers, hospitals and other community programs.
To expand the crisis and acute care continuum of services and complete the 988 system, two other programs are being developed by the New Jersey Division of Mental Health and Addiction Services (DMHAS) which is part of the New Jersey Department of Human Services (DHS). One is a statewide system of Mobile Crisis Outreach Response Teams (MCORT) for situations requiring a mental health response in the community. When this program is operational, Teams will be
dispatched without law enforcement whenever it is deemed safe to do so. They will meet with individuals in person, help them de-escalate their crisis and access needed resources. Until the Mobile Crisis Outreach Response system is in place, existing community services are available to help people who contact 988. Once these Teams are activated, they will work with and complement current crisis response services. In addition, Crisis Receiving and Stabilization Centers (CRSC) will be located throughout the state. These Centers will offer community-based services in a facility designed to meet the immediate needs of people experiencing a mental health or substance use crisis, and they will provide referrals to other community programs. Both MCORT and CRSC will be available 24 hours a day, every day of the year.
Social Workers and Suicide Prevention
Social workers have the unique skill set to work at the micro, mezzo or macro levels to support suicide prevention. As a result, social workers play a crucial role in preventing suicide in the United States and in our state. Social workers in New Jersey comprise much of the workforce that provides so many of the crucial services offered throughout the crisis care continuum. And social workers are already involved in the 988 system answering calls, texts and chats, or serving in other capacities at New Jersey’s Lifeline centers. Information about employment opportunities with 988 is available at Careers: Lifeline (988lifeline.org)
We have an opportunity to reflect on where we are as professionals in addressing this critical public health concern. One recommendation would be to learn QPR. QPR (“Question. Persuade. Refer.”) is an evidence-based suicide prevention training, teaching participants to recognize the warning signs of suicide and then to question, persuade, and refer people at risk for suicide to helpful resources. In 2 hours, you can learn to save a life. The New Jersey DMHAS Disaster and Terrorism Branch offers this training for free to the public and privately to organizations. The monthly public training calendar is posted about half-way down the page at Department of Human Services | Division of Mental Health and Addiction Services Home (state. nj.us) . If you are interested in hosting a private training for your organization, please contact
DMHAS.DTBtraining@dhs.nj.gov. These trainings are funded and made possible by a Substance Abuse and Mental Health Services Administration (SAMHSA) Mental Health Awareness Training grant.
Finally, I encourage you to take a few minutes to learn more about suicide prevention and 988. For national information, go to 988 Suicide & Crisis Lifeline | SAMHSA . For information about 988 in New Jersey, go to Department of Human Services | 988 Suicide & Crisis Lifeline (state.nj.us) . And if you have questions about 988, please email 988Questions@dhs.nj.gov
If you or someone you know is experiencing suicidal thoughts, a mental health crisis, substance use crisis or any kind of emotional distress, you can contact 988 via call, text or chat ( https://988lifeline.org/chat/ ) for free, confidential support.
References
A Crisis of Mental Health Crises
American Foundation for Suicide Prevention: Suicide statistics | AFSP
988 - A Step Towards a Transformed Crisis Care System in America
Federal Communications Commission: FCC Designates 988 for the National Suicide Prevention Lifeline | Federal Communications Commission
New Jersey
CDC: Suicide Rates by State | Suicide | CDC
About the Author:
Mary Jean Weston is a Licensed Clinical Social Worker (LCSW) and the New Jersey 988 State Lead for the New Jersey Division of Mental Health and Addiction Services (DMHAS) in the Department of Human Services. In this capacity, she has guided the state’s preparation for and transition to 988. She is now working to expand funding for 988 Lifeline centers and establish a program of Mobile Crisis Outreach Response Teams across the state. Prior to working for DMHAS, Mary Jean served as the Associate Executive Director of NASW-NJ for 10 years. She holds a Bachelor’s degree from Duke University and a Masters of Social Work degree from Smith College School for Social Work.
