New National Mental Health Crisis Line Can Save Black Lives
Our "Race to Health" columnist shares how new 988 number can save Black people with mental illness from police violence.
A few weeks ago, Congress passed—and the president signed—the National Suicide Hotline Designation Act. Introduced by Representative Seth Moulton (D-Mass.), it establishes 988 as “the universal telephone number for the purpose of the national suicide prevention and mental health crisis hotline system.” The creation of the number, which is slated to be live by July 2022, is a move that could help millions of people with chronic mental illnesses, including schizophrenia and bipolar disorder.
“When your house is on fire, you can get help by calling 911. A year-and-a-half ago, we set a goal to make it just as easy to get help in a mental health emergency. Today we finished the job and made 988 the national number for mental health emergencies,” Moulton said in a statement. “This is a win for every American who has been affected by a mental illness. It is a national step forward out of the shadows of stigma that prevent too many people from getting help and into a new era when mental health care is easy to get and normal to talk about. This will save tens of thousands of lives every year.”
And the number of people who need help is rising as the COVID-19 pandemic puts people under enormous strain. The National Alliance on Mental Illness (NAMI) reported a 65% increase in emails and calls to its HelpLine, which provides support and resources for people with mental health conditions and the people who care for them.
The fact that securing qualified help will be just as easy as securing a firefighter to run to your home, sirens blaring, is a major step. Another one: The law’s summary page on Congress.gov says that the U.S. Department of Health and Human Services “must develop a strategy to provide access to competent, specialized services for high-risk populations such as lesbian, gay, bisexual, transgender and queer (LGBTQ) youth; minorities; and rural individuals.”
But even before I read that passage, I was excited about what this could mean for protecting Black people from police violence. Walk with me: A study from The Treatment Advocacy Center found that up to 50% of people killed by police are in the middle of a mental health crisis. In the same report, researchers found that people who have mental illness that has gone untreated are a whopping 16 times more likely to be killed during encounters with law enforcement.
We also know that Black people are three times more likely to be killed by police than our White counterparts. Add in mental illness, and you have a deadly cocktail. The stats make it clear—a 2020 analysis conducted by researchers at University of California Berkley and University of California San Francisco found that unarmed Black men aged 55+ with mental health challenges who live in the South walk around carrying an astronomical risk of being fatally shot by law enforcement officers.
I talked to Marilyn Thomas, Ph.D.—a postdoctoral fellow in the departments of epidemiology and biostatistics and psychiatry at the University of California San Francisco and one of the authors of the report—about the big picture that these numbers paint. “People with mental illness and Black people are more likely to interact with police in general. Compared to White people, Black people also have higher risk of developing chronic mental illness, including psychotic disorders and dementia,” she says. “However, officers are more likely to place a White person showing signs of mental illness on a psychiatric hold than a Black person exhibiting the same signs. Officer use of force is also greater against non-White people and those perceived as mentally ill. This not only makes Black people that are having a mental health crisis more vulnerable to police violence and deadly use of force, but it increases the likelihood of being arrested as opposed to receiving medical treatment.”
Indeed, the news is full of stories of families calling the police for help or a “wellness check,” only to have their beloved killed by officers who are not trained to care for them. Most police officers are not required to learn how to safely interact with people experiencing mental health crises; those who are typically only receive eight hours of de-escalation training, according to APM Reports.
The avoidable deaths that they cause don’t just hurt the victims and their families. Experts say that seeing Black people die on video negatively impacts all Black people’s mental health. A study published in The Lancet found that:
Police killings of unarmed Black Americans might compromise mental health among other Black Americans through various mechanisms, including heightened perceptions of systemic racism and lack of fairness, loss of social status and self-regard, increased fear of victimization and greater mortality expectations, increased vigilance, diminished trust in social institutions, reactions of anger, activation of prior traumas and communal bereavement.
If handled correctly, 988 could save Black lives. The new federal law not only creates an easy to remember number, but it increases federal funding to help local crisis centers better handle calls. It also lets states charge cell phone users a fee that can be used to fund the program, just as many states currently do for 911.
That money should be used to support mobile crisis teams run by trained mental health professionals—not police. It works—programs that shift this work to medical teams have been hugely successful in Eugene, OR, and Stockholm, Sweden. And cities including Oakland, CA; Indianapolis; and Olympia, WA, are currently working to put in place similar models.
“Mitigating police violence against those struggling with a mental health crisis will require a structural level approach informed by public health evaluation of the efficacy of current policies and practices at every police agency, as well the integration of mental health experts to help inform the development and implementation of effective interventions,” says Thomas.
The Federal Communications Commission aims to have the number live by July 2022. In the meantime, people who need help dealing with anxiety, depression and suicidal thoughts can text “HOME” to 741741 or call 1-800-950-NAMI (6264) to connect with a crisis counselor.
- The National Suicide Hotline Designation Act: The National Suicide Hotline Designation Act of 2020. (2020). congress.gov/bill/116th-congress/senate-bill/2661
- Prevalence of Deadly Police Violence in Mentally Ill: Treatment Advocacy Center. (2015). "Overlooked in the Undercounted: The Role of Mental Illness in Fatal Law Enforcement Encounters." treatmentadvocacycenter.org/overlooked-in-the-undercounted
- Statistics on Police Killing Black People: Mapping Police Violence. (2020). mappingpoliceviolence.org/
- Police Killings, Mental Health and Older Black Men (1): Annals of Epidemiology. (2020). "Black And Unarmed: Statistical Interaction Between Age, Perceived Mental Illness, And Geographic Region Among Males Fatally Shot By Police Using Case-Only Design." sciencedirect.com/science/article/abs/pii/S1047279720302957?via%3Dihub
- Police Killings, Mental Health and Older Black Men (2): Berkley News. (2020). "Stark Racial Bias Revealed In Police Killings Of Older, Mentally Ill, Unarmed Black Men." news.berkeley.edu/2020/10/05/stark-racial-bias-revealed-in-police-killings-of-older-mentally-ill-unarmed-black-men/
- Impact Police Killings on Black Mental Health (1): Penn Today. (2020). "Police Killings and Black Mental Health." penntoday.upenn.edu/news/police-killings-and-black-mental-health
- Impact Police Killings on Black Mental Health (2): The Lancet. (2018). "Police Killings And Their Spillover Effects On The Mental Health Of Black Americans: A Population-Based, Quasi-Experimental Study." thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)31130-9.pdf
- Text For Help: Crisis Text Line. (2020). crisistextline.org/text-us/
- Call For Help: National Alliance on Mental Illness. (2020). nami.org/help