988 Mental Health Crisis Hotline is Now Live

Is 988 different than 911?

There is now an alternative to dialing 911 for mental health needs.  How is 988 Different than 911? Calling or texting these three numbers, “988,” will connect individuals to a local mental health crisis counselor for support. Federal Trade Commission set up the 988 Mental Health Crisis Hotline service to replace the National Suicide Prevention Lifeline with localized resources. 

Whether the person is experiencing a suicidal crisis, mental health-related distress, or substance abuse situation, they will be connected to a mental health professional who is familiar with services in the respective local area to find the right people to assist. 

“The switch to 988 improves access to care especially during urgent or emergency situations, such as during a suicide crisis.  The PsychANP encourages naturopathic physicians to consider including 988 as one of the important resources in developing safety plans for our patients who are at risk for suicide or mental health crises,”

Alex Tan, ND, president of the Psychiatric Association of Naturopathic Physicians. 

Prior to the 988 Hotline, the National Suicide Prevention Lifeline was just that—national. Federal, state, and local organizers of 988 recognized the limitations of a national service because mental health issues are best addressed in the community where one lives. 

Veterans can press “1” after dialing 988 to connect directly to the Veterans Crisis Lifeline. For texts, Veterans should continue to text the Veterans Crisis Lifeline shortcode: 838255.

The National 1.800.273.TALK (8255) number for the National Suicide Prevention Lifeline will continue to operate indefinitely. The only time someone might be connected to the National Suicide Prevention Lifeline from 988 is if there is a backlog in a local area. 

Is 988 Different from 911? 

How is 988 Different than 911?

The 988 Suicide and Crisis Lifeline does not connect the user to the local police. Instead, there is a network of more than 200 crisis centers with experienced mental-health experts available to help individuals overcome crises. These centers are supported by local, regional and state counselors. They have the backing of the Substance and Mental Health Services Administration (SAMHSA)—an agency of the Department of Health and Human Services. the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA). Calls and texts can be made  24/7 for confidential support in suicidal crises, mental health-related distress, or substance abuse situations. 

PsychANP believes that primary care providers, including naturopathic physicians, should have basic competency in suicide risk screening, assessment and appropriate interventions. 988 is one of the important and accessible resources in developing safety plans for our clients when appropriate. For example, low to moderate suicide risk patients may be recommended to reach out to 988 as a resource when needed as part of a comprehensive suicide safety plan, while high risk suicide risk patients should be referred to a mobile crisis unit, 911, 988, or the ER depending on the specific infrastructure of care in a city or state.  Naturopathic physicians, who are trained as primary care providers, can help provide mental health care to the level of their training and scope of practice,”

Alex Tan, ND, president of the Psychiatric Association of Naturopathic Physicians. 

Additional facts about 988 Mental Health Crisis Hotline

  1. Though the mental health support comes from local individuals, 988 does not geolocate like an emergency 911 call. It will not find a person to send emergency help. 
  2. The planners behind 988 considered that law enforcement may not always be the appropriate response team for mental health crises. History shows a disproportionate amount of trauma for individuals who entered the criminal justice system or psychiatric holdings in hospitals and emergency rooms for mental health issues. The unintended consequences created a great deal of mistrust and stigma around mental health. The 988 hotlines are designed to overcome some of this systemic dysfunction through warm communication from crisis counselors who are trained to determine the type of care needed. 
  3. Though there is a high death by suicide rate in this country (see below), about 2% are acute situations, explained Brooke Briggance, with the Cypress Resilience Project (on a web forum Aug. 2022 about the new 988 service). The remaining 98% are thoughts of suicide with no intent to take action. The 988 mental health experts are trained to de-escalate the crisis, help the caller establish a mental health safety plan process, direct them to the right people for care and provide follow-up, said Briggance. 

Limitations of 988

The 988 system was designed to provide alternatives to 911. However, if the 988 counselor establishes that a 911 call is necessary, they will facilitate that action. The Substance Abuse and Mental Health Services Administration (SAMHSA) is encouraging all fire and law enforcement to continue training in cross-system collaboration with 988 and other community mental health providers so people can get the appropriate type of help that is needed. (here is an example of what police are being told about 988). 

Overdoses are probably the most visible example of a limitation of 988. Since the system does not geolocate, if someone overdoses from heroin, morphine, fentanyl, or oxycodone and the reverse-drug naloxone is onsite, the 988 counselors can guide the person or witness through the process. But needless to say, they cannot administer it by phone or text, nor can they geolocate to find the person. 

The situation may require an in-person mental wellness check depending on the regional or local system that may be law enforcement, or it could be an EMT or other local mental health crisis expert. Briggance said there is a need for more mobile mental health units that can facilitate an in-person mental health wellness check and determine the type of care that is needed. 

It’s not perfect, but the 988 Suicide and Crisis Lifeline is an improvement over the previous system of engaging with law enforcement for something they are not always adequately trained to address. This easy-to-remember 988 number will allow individuals in crisis to get the help they need and decrease the stigma surrounding mental health and substance abuse issues. 

Suicide Facts from the American Foundation for Suicide Prevention 

Facts About Suicide 

  • Suicide is the 12th leading cause of death in this country, with 130 per day. 
  • In 2020, 45,979 people died from suicide with 1.20 million attempts.
  • The rate of suicide is highest in middle-aged white men.
  • Firearms account for 52.83% of all suicide deaths.
Is 988 Different than 911? Suicide Rates in the US

In 2020, the suicide rates were higher among adults ages 25 to 34 years (18.35 per 100,000) and 75 to 84 years (18.43 per 100,000), with the rate highest among adults ages 85 years or older (20.86 per 100,000). Younger groups have had consistently lower suicide rates than middle-aged and older adults. In 2020, adolescents and young adults aged 15 to 24 had a suicide rate of 14.24.

This article is provided by the Institute for Natural Medicine, a non-profit 501(c)(3) organization, partnered with the American Association of Naturopathic Physicians. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing health care systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following  initiatives:

  • Education – Reveal the unique benefits and outcomes of naturopathic medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

Get Involved!

Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.