The National Suicide Lifeline Is Now 988. How Well Does It Serve the LGBTQ+ Community?

Until recently, individuals in crisis who wanted to seek help by phone or text had two main options: They could call 911, which might involve the police or result in a trip by ambulance to the emergency room. Or they could call the 10-digit National Suicide Lifeline, which requires having the presence of mind to find it. Now, a new mental health hotline, known as the 988 Suicide and Crisis Lifeline, replaces the 10-digit number and broadens its scope. But it remains to be seen how well it will serve the LGBTQ+ community.

Dr. Antonia Caretto is one therapist who has full confidence in the new system. She explained that calls from a particular area code are routed to the crisis center nearest to them. For area code 248, which covers Oakland County and portions of Livonia and Northville in Wayne County, that’s Common Ground.

“That means they know the local resources, which is nice,” said Caretto, a psychologist whose areas of specialty include LGBTQ+ issues. “And especially with Common Ground, we know that they are very LGBTQ-sensitive. It was mandated that part of the switch to 988 include strategies to provide specialized services, especially to LGBTQ youth, because of the higher rates of mental health issues and suicidality.”

“So I think it's probably fine for an LGBTQ person to utilize the service,” she continued. “Trevor Project has been very involved in helping with this rollout. And they endorse it. So I trust them immensely.”

Callers to 988 are connected through the existing Michigan Crisis and Access Line (MiCAL) to call-takers throughout most of the state. Calls from Macomb County are routed to Macomb County Community Mental Health and in Kent County, Network 180. A possible glitch in the system presents itself when someone calls using the area code from their former residence, because they are then routed to services in that area. However, it’s possible to connect a caller to local services from that point.

Dr. Debra Pinals is medical director for Behavioral Health and Forensic Programs at the Michigan Department of Health and Human Services. The new hotline isn’t just for people who feel suicidal, she said.

“It's not just a suicide prevention lifeline,” Pinals said. “It's also a general crisis line, which means that a caller defines the crisis. And so the idea is that we can help connect people to care and help support their needs prior to when they might be in more of a suicide crisis, so we can do more preventive work upfront.”

The lifeline provides access to a network of supports and referrals. That includes peer “warm lines” for connecting with another individual who’s experienced mental health or substance abuse issues. Calls to 988 can be taken in either English or Spanish. Over 250 languages are available through a translation service. Text is English only.

Pinals said 911 remains a critical part of the infrastructure, but 988 presents a specialized service for behavioral health, emotional crises, substance use crisis and suicide prevention.

While 988 is not a federal program, it was made possible by the Biden Administration with more than $400 million earmarked to strengthen mental health services and other supports offered via states’ own crisis centers. In Michigan, at least $3 million is budgeted for more staffing and infrastructure, placing the state in a solid position to build out the network.

As the system becomes more established, Pinals said they would be looking into the best ways to support the LGBTQ+ community, one population at greater risk for suicide. She assured Pride Source that call-takers are equipped to respond to crises related to one’s sexual orientation and gender identity.

“The idea is that the line and the call takers will be able to have the training and skills to support those types of crises, as well as refer people to other resources, if that's what's needed,” Pinals said. “But we want to do that with the voice of people in the LGBTQ+ community. And so one of those strategies will be to reach out to certain vulnerable populations and to have focus group-type conversations to help inform how we work with the crisis responders.”

Jeff Kapuscinski, chief external relations officer for Common Ground, explained that part of their 96-hour crisis intervention training involves an LGBTQ+ component. “Topics within that section focus on understanding the possible complexities this population is faced with,” said Kapuscinski by email, on behalf of Common Ground staff.

Kapuscinski said it’s been the experience of Common Ground that most calls from self-identified LGBTQ+ people aren’t generally calling about LGBTQ+ issues, but “crisis workers treat every caller with dignity and respect, meeting them where they are in that moment, focusing on utilizing trauma-informed care. If a caller is in need of specific LGBTQ+ support and resources, our training covers multiple referrals we are able to offer to the caller.” He added that LGBTQ+ callers can expect to receive support in a confidential and non-judgmental space.

That could go a long way toward responding to the 45 percent of LGBTQ+ youth ages 13 to 24 who seriously considered attempting suicide in the past year. That’s according to the Trevor Project’s 2022 National Survey on LGBTQ Youth Mental Health. The survey also revealed that 73 percent reported experiencing anxiety, while 58 percent said they experienced depression. Sixty percent of LGBTQ+ youth who wanted mental health care were not able to access it.

Caretto said she can relate to the kind of extensive training involved in working on a hotline because she answered a crisis line when she was in high school and college. And she said she hasn’t heard about negative experiences from clients who, in the past, have called hotlines like Common Ground.

Pride Source asked Caretto what she advises clients to do in a mental health emergency if she is not available.

“Well, on my voicemail, it says, ‘If this is a life-threatening clinical emergency, hang up and dial 911, or go to the nearest hospital emergency room,’” Caretto said. “I will now change that so that it says ‘Dial 988’ instead of 911.”

Help Is a Call (or Text) Away In addition to 988 , these agencies and organizations can help people struggling with mental health issues, domestic violence or suicidal thoughts: The Trevor Project Help Resources : Call 1-866-488-7386 , text START to 678-678, or start an online chat at Crisis Text Line:  Text HOME to 741-741 National Domestic Violence Hotline:  Call 1-800-799-SAFE First Step Domestic Violence (Southeast Michigan):  Call 1-734-722-6800 Wayne County SAFE:  Call 1-313-430-8000 LGBT Detroit Healing & Support Services:  Call 1-313-397-2127, Ext. 101 (not an emergency services line)