988 launched in August. Are people in Philadelphia calling the new mental health hotline?

Federal officials visited Philadelphia last month to mark the July 16 kickoff of a new national mental health hotline with anxious anticipation of how the new 988 number would be received.

The line is one of the major national developments in mental health in years, and many hope that 988 will be a catalyst for investment in a neglected crisis response system. But along with the excitement, some raised concerns that call centers wouldn’t be ready in some parts of the country if demand was greater than anticipated. More recently, some mental health advocates warned about the line’s potential reliance on police.

So how is 988 faring in Philadelphia? Here’s what we know:

» READ MORE: What to know about 988, a new national mental health hotline

Yes — at first.

The number of calls nationally increased by 45% during the first week of 988.

In the line’s first two days, Philadelphia experienced a 37% call increase, according to data from the Department of Behavioral Health and Intellectual disAbility Services.

Matthew Wintersteen, a clinical psychologist at Thomas Jefferson University and a member of Pennsylvania’s 988 planning team, said in an email that call centers in urban and suburban communities received more calls after the launch.

But, he said, “the initial surge in calls around mid-July seems to have slowed.”

Some of this surge was because people were trying out the new line, to confirm that “somebody’s actually picking up the line that they’ve been starting to hearing about,” said Dale Adair, chief psychiatric officer at the Pennsylvania Department of Human Services.

After the initial spike in Philadelphia, call volume is mostly back to normal.

The city’s crisis call center counselors respond both to calls that come in through the national line — whether the caller dialed 988 or the 10-digit Suicide Prevention Lifeline number that is still active — and through the Philadelphia Crisis Line (215) 685-6440.

According to data from DBHIDS, in the month prior to the July 16 launch of 988, Philadelphia received 5,885 calls — 4,820 of which came through the local Philadelphia number. In the month following the launch, the overall number of calls increased by 5% to 6,176, with a larger share of calls coming through 988.

It’s going to take time to catch on.

Organizers expect that, over time, more people will start calling 988 once they become more familiar with the new line as a resource for broad mental and behavioral health needs — not only suicide.

Call center directors in the area hadn’t expected a dramatic overnight increase.

Many people still don’t know about the line. A poll commissioned by the National Alliance for Mental Illness found that as of May, two months before 988 launched, about 77% of people had never heard of the resource.

There’s also been little effort by the federal government to promote 988, in part because some call centers aren’t ready for an increase in volume. Public awareness campaigns are expected to ramp up in 2023.

» READ MORE: Philly, stop sending police to mental health crises

Sometimes.

The vast majority of calls to crisis hotlines are resolved over the phone. When a hands-on response is required, counselors dispatch a mobile crisis unit.

Between January and July, Philadelphia dispatched such units nearly 5,000 times — in response to roughly 12% of calls.

In some instances, 988 counselors are required to call 911.

According to the hotline guidelines, counselors responding to 988 should call 911 when the caller is at imminent risk or either refuses or is unable to collaborate on a safety plan. These “active rescue” situations do not require the caller to agree to having help sent over.

In July, Philadelphia counselors called 911 in 29 out of 6,142 calls. The crisis line also received 65 calls from 911 dispatchers when the call was suicide related.

The Treatment Not Trauma Coalition, a group of Philadelphia mental health providers that advocate for robust crisis response that does not involve police, have raised concerns over 988 and law enforcement. In an oped in The Inquirer, Julia Lyon and Thomas Clancy, who are affiliated with the group, wrote that police response “is not in line with best practices for people experiencing mental health crises and presents great risk for vulnerable people.”

Not yet.

Currently, 988 calls get triaged through the caller’s area code. That means that people who are traveling or have an area code that doesn’t match where they live reach a call center that might not know about nearby resources, such as providers and mobile units.

» READ MORE: Biden administration officials visit Philadelphia to kick off a new national mental health hotline

In a July 15 roundtable discussion in Philadelphia, Federal Communication Commission chairman Jessica Rosenworcel said the commission wants 988 to be able to triangulate calls between cell towers like 911 does. “We want to work on understanding who calls, where they are calling from, and how we can make it more precise,” she said.