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Calling 988 Rarely Results in Involuntary Commitment

Last month, South Dakota used Uncle Sam’s money to join the rest of the United States in adopting 988 at the crisis hotline for mental health, substance abuse and suicide. Governor Kristi Noem is staging a suicide prevention conference in Sioux Falls today (also funded by Uncle Sam) to, among other things, encourage people to use 988 to prevent suicide. But we already have folks online saying calling 988 is a bad idea:

Some advocates and people who had experiences with the mental health system took to social media to voice concerns about 988 and warn people not to call it.

One Instagram post said, “988 is not friendly. Don’t call it, don’t post it, don’t share it, without knowing the risks.” The post, which had garnered nearly a quarter of a million likes as of early August, went on to list the risks as police involvement, involuntary treatment at emergency rooms or psychiatric hospitals, and the emotional and financial toll of those experiences.

Other posts on Instagram and Twitter conveyed similar concerns, saying that the hotline sends law enforcement officers to check on people at risk of suicide without their consent and that people, especially from LGBTQ+ communities and communities of color, may be forced into treatment [Aneri Pattani, “Social Media Posts Criticize the 988 Suicide Hotline for Calling Police. Here’s What You Need to Know,” Kaiser Health News, 2022.08.11].

Man—you try to do something nice, and the Twitterazzi fry you.

988 is just a rebrand of the previous national suicide prevention hotline. That hotline does call the police, but only when all of its other efforts to help callers don’t seem to be working:

Officials from 988 say they recognize the risks of having law enforcement officers involved in mental health emergencies. That’s why 988 was created as an alternative to 911, said John Draper, executive director of the hotline and a vice president at Vibrant Emotional Health, the company tasked with administering it.

“We know the best way for a person to remain safe from harm is for them to be empowered and to choose to be safe from harm,” Draper said. Dispatching police is a last resort, he said.

Counselors who answer the phones or respond to texts and online chats for 988 are supposed to be trained to actively listen, discuss the callers’ concerns and wishes, and collaborate with them to find solutions. Most calls about suicide are de-escalated without law enforcement, Draper said. Instead, counselors talk through people’s reasons for dying and reasons for living; have callers connect with supportive family, friends, religious leaders, or others in their community; refer callers to outpatient treatment; or set up follow-up calls with 988.

Only when the caller cannot or will not collaborate on a safety plan and the counselor feels the caller will harm themselves imminently should emergency services be called, according to the hotline’s policy.

At that point, Draper said, “we have the choice of just letting [harm] happen or doing whatever we can to keep them safe.”

In previous years, before the 988 number launched, emergency services were dispatched in 2% of the hotline’s interactions, the service reported. With about 2.4 million calls a year, that means emergency services were initiated for roughly 48,000 calls. Those services can be mobile crisis teams, consisting of people trained in mental health and de-escalation, but in many rural and suburban communities, it is often police [Pattani, 2022.08.11].

If you think you need help with mental illness, substance abuse, or the urge to end your life, call 988. Call your mom, your brother, or someone else you trust. But understand that if the person you contact offers help and you refuse it, and if you continue to make it sound like you are a danger to yourself, then, under South Dakota law [SDCL 27A-10-1], anybody concerned and knowledgeable party can petition for an immediate intervention—i.e., your involuntary commitment for mental health treatment. Don’t blame 988… and for Pete’s sake, don’t discourage people who really do want help from punching three easy numbers that can get them help.

One Comment

  1. larry kurtz 2022-08-11 18:05

    In 2018 the Rapid City Journal blamed the South Dakota Republican Party for spikes in suicides and depression as a Sanford Health executive also cited poor access to medical care as a reason for premature deaths. South Dakota is ranked 6th highest in the nation for suicides reporting more than 22 self-administered terminations per 100,000 people or an increase of 59% since 1999 and the 11th highest increase in any state.

    Matt Walz works for Keystone Treatment Center, the only inpatient gambling addiction treatment center in South Dakota and has been told the best place addicts can buy meth is at the bars with video lootery terminals. “’As for suicide,’ Walz continued, ‘compulsive gamblers have the highest rate of suicide than any other addiction.’” In 2020 the Rapid City Police Department took their complaints to the public because it was overwhelmed with crimes of opportunity driven by meth and gambling. Even the extreme white wing of the South Dakota Republican Party has called video lootery a “scourge.”

    Now, according to WalletHub, gambling has become a leading source of anguish and despair in my home state with few avenues for treatment. The state is tied for first in the number of casinos and machines and second in overall addiction to the poison.

    The reasoning is hardly mysterious. It’s all about the money a too big to jail banking racket, a medical industry triopoly, prostitution, the Sturgis Rally, policing for profit, sex trafficking, hunting and subsidized grazing bring to the SDGOP destroying lives, depleting watersheds and smothering habitat under single-party rule.

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