LA County supervisors want Congress to fix broken suicide and crisis hotline
Individuals who are contemplating suicide or suffering other kinds of emotional distress who call the 988 national hotline number may not be getting the help they need.
That’s because a technical snafu often routes their calls to health technicians out of their county, or even out of state, instead of sending their call to the nearest clinic where they can receive hands-on treatment. The flawed system cripples any kind of emergency response for a person experiencing a mental health crisis, even putting the life of the caller at risk, experts say.
The call-routing problems, which have plagued the 988 system since it began operating in July 2022, would be fixed if a bill by U.S. Sen. Alex Padilla, D-Calif., using a new technology called geo-routing, is passed by Congress and signed into law.
The Los Angeles County Board of Supervisors endorsed U.S. Senate Bill 3444 on Tuesday, Jan. 9, and will send a letter of support to the Senate, while pledging to fight for the bill’s passage. On Aug. 8, the board endorsed a companion bill in the House of Representatives by Rep. Tony Cardenas, D-Panorama City.
Padilla’s bipartisan bill, introduced on Dec. 7 and co-authored by Sen. Thom Tillis, R-North Carolina, may have a better chance of being adopted by the Senate, but would still need approval by the House and a signature from President Joe Biden.
“This legislation will have real on the ground impacts. I’m confident the White House will weigh in on this. It needs to be fixed,” said Fifth District Supervisor Kathryn Barger.
Under the federal 988 hotline system, cell phone calls are routed to about 200 call centers using the cell phone caller’s area code — which is often not the area code where the person lives. It can send local callers to far off centers in the East Coast, South or Midwest, instead of here in Southern California. Often, call centers can’t help the caller, or the call gets disconnected, according to testimony given on Tuesday to the L.A. County Board of Supervisors.
“That means if you live in Los Angeles County and are calling from a cell phone with a different area code, you won’t be able to access L.A. County’s call centers,” said Fourth District Supervisor Janice Hahn. Hahn said the county has 47 mobile health access teams ready to help callers but they can’t be connected to a caller dialing 988 using a cell phone with an out-of-area number.
“These teams can only be accessed through the L.A. County call center,” Hahn explained. Often, calls get re-routed back from an out of state call center to the center nearest the caller, but that can waste precious time. “When someone is having a mental health crisis, minutes matter,” Hahn added.
Over 80% of all calls made to the hotline are from wireless phones, the FCC reported in September. Many callers keep their cell phone numbers after they move. Hence, the federal system reads the area code and misdirects the call to that region.
The Padilla bill will direct the Federal Communications Commission (FCC) to require all cell phone carriers to direct 988 calls, and messages left on 988 call lines, to the call center geographically closest to the caller — instead of using the caller’s area code.
“Mental health response on the lifeline must be efficient and safe, but the current system risks connecting callers to response teams thousands of miles away,” said Padilla in a prepared statement.
The bill would use geo-routing to ping a cell tower near the caller. Then the call would be routed to the local mental health crisis center. A mental health professional on the line would be familiar with county resources and could send a mobile treatment team if needed. The caller’s address or identity would not be revealed because geo-routing is different than geo-location, which identifies a person’s whereabouts.
Another communication breakdown occurs if the call is routed by using the person’s ZIP code. If that person has moved, the crisis counselor can be from the city of an old address, putting help far away.
“There is a flaw in the 988 system that needs to be fixed,” said Victor Manalo, a social worker and professor at Cal State Los Angeles, in comments to the board. “This can have devastating consequences for someone experiencing a mental health crisis.”
In fact, operators from the Didi Hirsch Mental Health Services group, which handles calls for L.A. County, testified that their staff and volunteers get many callers from out of state, adding even more confusion to the system. Often calls are delayed in the hand-off.
“I’ve personally answered 988 calls, and sometimes lives are literally on the line,” said Gabriela Torres, program coordinator at Didi Hirsch who manages call center staff. “Expecting them to be experts on resources nationwide is impossible.”
One woman, who did not give her name, told the board she tried to get help for her daughter but the 988 system routed her to services on the East Coast. “The system failed me,” she said.
“Many of our clients are transients and the area code doesn’t match where they are located,” testified Mayra Salazar, director of advocacy for Hillsides, a nonprofit group that contracts with the county for mental health services and often helps those living on the street.
“As a result, many wireless callers to 988 are unable to access local resources that they may need in a time of crisis,” the FCC reported. FCC Chairwoman Jessica Rosenworcel came out in support of changing the routing system through geo-routing on Sept. 28, 2023.
The suicide and emotional crisis hotline’s three-digit number is easy to remember and gaining in use. The FCC reported receiving 20 million calls on the hotline since mid 2022, said Third District Supervisor and board chair Lindsey Horvath.
“In Los Angeles County, often people keep their home area codes on their cell phones,” she said. “There are unintended consequences,” she said. Her friend called for help for someone else and was referred to a call center in Northern California, Horvath said.
“We need this action now,” she added.