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Thursday / September 28.

Dr. Draper of the Lifeline Believes a Three-digit-number for Mental Health and Suicide Crisis will One Day be as Ubiquitous as 911

Stephanie Hepburn is a writer in New Orleans. She is the editor in chief of #CrisisTalk. You can reach her at​

The murder of Kitty Genovese in Queens, New York, in 1964 sparked outrage and was one of the driving forces behind the 911 emergency call system people know and depend on today. It wasn’t the murder itself that left people incensed but that 38 people witnessed Winston Moseley kill Genovese and did nothing about it. The behavioral reaction was later called The Bystander Effect or Kitty Genovese Syndrome. It turns out that at least one man did call the police to report that Genovese was seriously injured. His call went unanswered.

Most people can’t remember a time before a centralized number for people to call in an emergency; when people dialed 0 for an operator or directly called the nearest police or fire station. John Draper, Ph.D., project director of the SAMHSA-funded National Suicide Prevention Lifeline (800.237.TALK or chat), hopes that a three-digit-number for mental health and suicide crisis will one day be equally ubiquitous. “Right now people have to remember an 800-number, and even though calls go up 15-percent per year and 2.2 million calls were answered in 2018, we know that 13-million people seriously think about suicide each year, which means we are far from the universe of people who could be reached.”

In December, former Senator Orrin Hatch (R-Utah) wrote a letter to Marlene H. Dortch, Secretary of the Federal Communications Commission (FCC), urging the agency to use the three-digit-number 611 for Lifeline. The senator wrote that the designation would connect Americans experiencing mental health crises with life-saving counsel and resources. Currently, 611 links callers to telephone repair and telecom customer service. In 1997, the FCC noted it would continue to do so until needed for another national purpose. Sen. Hatch wrote that making the Lifeline more accessible and user-friendly to Americans is “a pressing, national purpose,” and recommended that 611 be used solely for mental health and suicide crises to eliminate confusion and delay. He further stated that it would be more difficult to market 611 as Lifeline if the number has a dual purpose, which would limit its efficacy.

Dr. Draper says studies show it’s easier to remember three-digits than an entire phone number, making a three-digit-number for mental health and suicide crisis more accessible. The designation would build off the national network infrastructure provided by the Lifeline, and trained mental health and suicide prevention counselors would answer calls. Much like 911 and Poison Control centers, the number would triage to local services and resources, including mobile crisis and respite services. It also, says Dr. Draper, has the potential to decrease stigma. While pondering the long-lasting effects of a three-digit-number for mental health and suicide crisis, Dr. Draper asked his daughter, who has a history of anxiety and depression, what she thought the impact could be. “She responded that people would finally understand mental health crises are real and require a different response than triaging to police or EMS. She said that by creating a cultural shift, ‘It would likely do more than anything else to erase stigma against mental illness, and that’s cool.’”

A three-digit-number, says Dr. Draper, will likely increase the number of callers to the Lifeline and, as a result, has the power to change how people think about mental illness. More callers equate to more data the national hotline can collect and analyze. He says this is precisely what’s happening in the United Kingdom with 111, a three-digit designation for all urgent health needs, including behavioral, that provides advice and triages callers to the appropriate level of care. The number of calls to 111 grew from 12 million to 16 million, with an increase in demand over time. Today, roughly 20,000 people call 111 every day to get advice over the phone from doctors, nurses, and paramedics. Dr. Draper says a similar three-digit-number for mental health and suicide crisis would trigger real parity. “People phoning would give us the data we need in terms of caller expectations from the mental health system, which will increase voice representation and help tailor demands on policymakers to respond to these needs with adequate behavioral health resources in the communities callers live.”

What Dr. Draper and his partners want is to create a culture that fosters autonomy where people’s ability to get help during a mental health or suicide crisis is at their fingertips, quite literally. It’s up to the caller, not his or her provider. “This gives people a sense of agency at a time when they are feeling incredibly helpless, which is powerful.” He also believes that when society places mental health and suicide crisis on the same level as medical crisis, there will be a repositioning, making call centers a visible service similar to EMS. Graduating students will find it a real pathway for learning how to help others. “A cultural shift through a three-digit-number is good for callers and the mental health profession.”

#CrisisTalk is committed to sparking ongoing dialogue on behavioral health crisis and including diverse perspectives and experiences. We’d like to hear what you think about this or any of our articles. Here’s how to send a letter to the editor.