With No Clear Path on 3-Digit Suicide Prevention Hotline, Government May Need to Intervene
With advocates pushing different N11 options for a nationwide, three-digit number for suicide prevention and mental health crises calls (see 1812110033), there may not be consensus or compromise. Some told us that the FCC may ultimately have to choose. Some may lobby Congress, where legislators are monitoring the situation.
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"We are confident that the FCC will come to the conclusion that a dedicated three-digit dialing code will be identified and designated without delay," emailed a spokesperson for Rep. Chris Stewart, who along with fellow Utah Republican Sen. Orrin Hatch, has been pushing 611. Hatch's last day in Congress was Thursday. The FCC can designate a number without congressional OK, "but Congressman Stewart will introduce legislation if necessary," she said. Congress expects to see a recommended number from the agency when it reports findings in February, she said.
Although different groups back different national numbers, they said agreement is possible. They also said all stakeholders agree there needs to be such a hotline. But experts aren't backing off pushing their preferred digits.
"It's not going to be a fight" over the numbers per se, said Steve Taylor, counsel-public policy, United Way Worldwide. He said 211 -- which United Way nationally pushed -- "by far makes the most sense" and United Way plans to continue advocating it.
Carolee Hall, a member of the FCC-advising North American Numbering Council, said NANC is looking at the comments submitted to the agency and considering issues that range from repurposing an existing N11 number to using a non-N11 three-digit code. The Idado Public Utilities Commission staffer said the group expects to get industry data soon about usage of the various N11 codes, which should help in narrowing down the most sensible options. She said NANC expects to make a recommendation to the FCC. That recommendation was to have come now, but the agency shutdown likely pushes that deadline off.
There's unanimity on the need for a three-digit hotline for suicide prevention and mental health crises, and that the current 162 lifeline crisis centers handling such calls are grossly underfunded, said John Madigan, American Federation for Suicide Prevention senior vice president-public policy. Whether the number is 611 -- as AFSP backed -- or something else "is a technical issue [and] we can deal with that," he said. Madigan said AFSP will contact 211 advocates to discuss number issues. He said AFSP will spend coming months talking to lawmakers about 611 being "the only logical number." "We certainly don't believe it's our way or the highway,” but 211 already serves a purpose for community information and referral services and isn't the right home for crisis services, he said.
Divided stakeholders could severely hurt the national suicide hotline initiative by causing delays, Taylor said. But the decision might end up coming from Congress and interested agencies, including the departments of Health and Human Services and of Veterans Affairs, deciding on the most efficient and cost-effective route, he said. Since it took close to 40 years for 911 to go nationwide after its conception and about 20 years for 211 to get to the point where 211 call centers cover the bulk of the U.S., starting from scratch for a new number "is not the way to go," Taylor said. He said whatever number is chosen will likely be an N11 number repurposed and the chance of designating a new three-digit number "seems kind of slim."
The hope is the FCC's next step is to take the valid options it has been presented and then consult with stakeholder organizations, said a spokesman for the American Association of Suicidology. It backs 611, typically used to contact carriers. That could lead to conversations about finding agreement, he said.
A number fight didn't seem to be looming in late November at a Substance Abuse and Mental Health Services Administration-organized meeting about the National Suicide Hotline, said Jeffrey Davis, American College of Emergency Physicians (ACEP) director-regulatory affairs. No discussion then was on an exact number, but "it didn't seem to be a sticking point for people," he said. The bigger focus of the meeting was on issues like delineation of when to call the number vs. 911, and hotline funding issues, he said. Davis said ACEP will likely remain agnostic on the number issue and it's more concerned with adequate education and support services so people know when to call.