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FCC advances plans for 988, a national suicide-prevention hotline

The U.S. is grappling with a spike in suicides, even as rates are falling in other parts of the world.

(Jenny Kane/AP)

The Federal Communications Commission is moving forward with plans to make 988 the nation’s suicide prevention hotline in the face of a mental health pandemic that claims more than 130 Americans each day.

The agency says three digits will be simpler to remember in times of crisis, as 988 echoes the national 911 emergency hotline. “We believe that this three-digit number dedicated for this purpose will help ease access to crisis services, it will reduce the stigma surrounding suicide and mental health conditions, and ultimately it will save lives,” FCC Chairman Ajit Pai said Thursday during the commission’s open December meeting.

The proposal is now open for public comment before the agency begins the rulemaking process. Currently, the proposal calls for carriers to implement 988 within 18 months. The decision comes as the United States grapples with a spike in suicides, even as rates are on the decline in other parts of the world. The suicide rate hasn’t been this high since World War II, according to the National Center for Health Statistics.

From 1999 to 2017, the U.S. suicide rate rose 33 percent, and the jump has sharpened since 2006. It is the fourth leading cause of death for people ages 35 to 54, according to the American Psychological Association, and the 10th leading cause of death overall. In 2018, the national suicide rate was 13.9 per 100,000 people, according to the United Health Foundation. And 2019 is on track to surpass it.

The trend line is even more dire among certain populations: Among Native Americans, rates have skyrocketed 139 percent for women and 71 percent for men since 1999, the federal Centers for Disease Control and Prevention reported in June. Experts think this is tied to Native Americans’ higher rates of poverty, substance abuse, unemployment and post-traumatic stress disorder, as well as geographical challenges that keep them sequestered from mental health resources.

Other at-risk groups include veterans and LGBTQ youth, who experience far higher suicide rates than the rest of the population, commissioners noted at Thursday’s meeting. More than 20 veterans commit suicide each day, and more than 500,000 LGBTQ youth attempt to kill themselves annually. In 2018, more first responders died by suicide than in the line of duty.

“Those facts are not easy to hear,” Commissioner Jessica Rosenworcel said Thursday. “Because for those of us who have lost family or friends they loved — myself included — they are cruel reminders of birthdays missed, holidays gone and words of encouragement that were never received.”

Suicides also have swelled in farming communities, which have been rocked by disastrous weather that is ruining crops, a protracted trade war that’s erasing profits, and towering farm bankruptcies and loan delinquencies. One 2017 study found that farm owners and workers were three to five times as likely to kill themselves on the job compared with other occupations.

The data speaks to the correlation between declining economic and social well-being and high suicide rates among America’s white working class. Research from Princeton University economists Anne Case and Angus Deaton found that overall deaths from suicide, drugs and alcohol, or “deaths of despair,” have risen steeply since 2000, especially for middle-aged white Americans without college or high school educations. The rise in these deaths has contributed to a drop-off in American life expectancy, which has fallen each of the past three years.

“Feelings of isolation and crisis — those are not experiences that happen to 'them’ or ‘others.’ What we’re talking about is what our parents feel, our kids feel, what we feel,” Commissioner Brendan Carr said at the meeting. “Anything we can do to break down barriers, to make it easier for conversations about mental health and counseling to feel within reach, is something we should do.”

The push for a 988 line began in August 2018, when Congress and President Trump signed the National Suicide Hotline Improvement Act, which ordered a study of the efficacy of a three-digit hotline and a review of the existing National Suicide Prevention Lifeline (1-800-273-TALK). According to the FCC’s report, the lifeline responded to more than 2.2 million calls in 2018, with an average of 183,790 calls per month. The lifeline’s crisis chat function responded to more than 102,500 chats in the same period.

The FCC’s report found that it would be easier to put a new, three-digit number in place than to mount a campaign to repurpose an existing N11 code (such as 211 or 911). The new three-digit hotline will cost about $570 million the first year, the FCC estimated in its report to Congress, and about $175 million the second year, but the agency believes that the benefit would quickly outweigh the initial costs: Suicides and suicide attempts cost the nation nearly $70 billion annually in lifetime medical and work-loss costs alone, according to the CDC.