Crisis lines have been operating in Texas for many years. There are currently five Lifeline crisis centers located in several major cities across the state: Austin, Houston, Dallas, Fort Worth, and El Paso.[1] Texas has been diligently working to provide state-wide primary coverage of Lifeline calls. According to Lifeline, call rates in Texas have increased by 87% since 2016.[2] When 988 goes live in July, it is expected that the call rate will rise dramatically. This is concerning because Texas crisis centers are unprepared to meet the demand. Centers are understaffed and often rely on volunteers. There is also no funding to back a long-term plan to grow operations as 988 is implemented nationally and publicized. For instance, there are currently no plans for text or chat options that would help reach young Texans in crisis. 

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Overall, these circumstances have led to a drop in response rates of Texas call centers. In 2020, Texans made 189,494 calls to Lifeline. 6 After veterans and Spanish speakers were rerouted, only 56,442 (40%) of calls were answered by state crisis centers—the second lowest response rate in the nation. When a call is not answered in Texas, it is routed to a national Lifeline center. Callers from Texas will wait 2 or 3 times longer when their call is not answered locally and are more likely to hang up.[3] Additionally, professionals out of state have no idea what crisis services exist in Texas, so cases requiring a response are sent to 911. This creates a cycle of inefficiencies that forestall any meaningful improvement in crisis response. 

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In addition to call centers, mobile crisis units are another crucial element to 988. While most crisis calls can be resolved over the phone, some individuals will need additional help and possibly transportation to treatment. In 2018, Dallas began piloting Rapid Integrated Group Healthcare Teams (RIGHT Care) to reduce the number of crisis calls addressed by law enforcement. This approach has had great success but is limited to certain districts in Dallas. Similarly, in Houston, the Harris Center runs a Mobile Crisis Outreach Team (MCOT). Other cities in Texas should be encouraged to adopt these models as part of their crisis response plan. 

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Although the implementation deadline fast approaches, advocacy groups cannot spread the word about 988 until Texas has the infrastructure to handle increased call rates. In the past, centers have operated independently. With a national push to create a continuum of care, crisis services including call centers, mobile response teams, law enforcement, and public safety answering points (PSAPs) will need to coordinate their efforts to transition to 988 effectively. Without an adequate response, Texans will quickly lose faith in the promising new system.

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“The general public relies on 911 systems because people know that when they dial 911 they will get an emergency response. For 988 systems to achieve a similar level of acceptance, they will have to provide the same reliability.”[4] –TAC 

 

SOURCES

[1] Semi-annual Call Volume and Center Status Report January - June 2020 

[2] Texas Annual State Report 2020

[3] Texas Annual State Report 2019

[4] Implementation of the 988 Hotline: A Framework for State and Local Systems Planning