Deachman: Emergency 988 suicide prevention hotline will also expose funding problems

The sheer simplicity of a three-digit number will de-escalate more crises. But what about services for the next day?

Published Aug 09, 2023 • Last updated 25 minutes ago • 4 minute read

The Distress Centre of Ottawa and Region’s Kathyrn Leroux says the three-digit 988 suicide-prevention hotline will help de-escalate more crises more quickly. But many mental health experts say it will also create a bottleneck, with inadequate funding for necessary services. Photo by Julie Oliver /Postmedia

Residents here and elsewhere should welcome the federal government’s recent announcement that it will invest $156 million over three years towards the 988 suicide-prevention hotline, as well as an additional $21 million to support the capacity of distress centres handling those calls.

It’s difficult to see how the service won’t save and improve lives, including many of those who make up the 60,000 calls that the Distress Centre of Ottawa and Region receives annually — approximately 1,700 of which are classified as “active suicide” calls of varying severity — as well as the lives of families, colleagues and friends affected.

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In 2021, the most recent year for which Ottawa Public Health has published data, there were 76 suicides in Ottawa, about one every five days. That’s the lowest number in years — by comparison, there were 97 in 2020 and 100 in 2019. Countering that decline, however, is the rate of self-harm-related emergency department visits by Ottawans, which, at 161 per 100,000 population in 2021, is the highest ever reported by OPH, going back to 2010 when the figure was 103.

Mental health providers are understandably lauding the 988 service, but caution that one outcome of its anticipated success will be to further highlight and exacerbate the inadequate availability of services. If governments are pushed to meaningful action — a.k.a. more services funding — that will ultimately prove an added benefit of the new call system. If, instead, they continue to pay lip service to the problem, as Joanne Bezzubetz, former president and CEO president of Ottawa’s Royal Mental Health Centre, last year accused them of doing, the problem can only worsen.

First things first, though. The benefits of the service, which is scheduled to begin at the end of November, are numerous, starting with the sheer simplicity of a three-digit number, similar to the 911 emergency service on which Ottawans have depended for 35 years. Imagine having to remember a 10- or 11-digit number to call when your house is on fire. Difficult, right? Now imagine the same thing when your brain is on fire.

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Another considerable advantage of the 24-hour-a-day, bilingual service is that it will be available to all Canadians, including those living in rural areas where such crisis hotlines often currently don’t exist.

At its core, the service, according to a 2021 Mental Health Commission of Canada report on its implementation, will save lives.

“While significant upfront costs are involved,” the report concluded, “the benefit to human life far outweighs them.”

Kathyrn Leroux of the Distress Centre of Ottawa and Region describes the service and funding for it as “spectacular.”

“The whole concept is wonderful,” she says, “because at the base of it, you hope that the person who is calling is calling as kind of a last handout for somebody to help them, and in the vast majority of cases we are able to de-escalate, which is great.”

While the centre hasn’t signed a service agreement yet, it’s expected that it will handle calls in the 613 and 343 area codes. The extra funding will boost the centre’s call capacity by adding both human resources and training, while the centralized nature of the system will reduce the number of dropped calls by redirecting them to the closest geographical location if responders at the Ottawa centre are all occupied. Additionally, the increase in capacity, Leroux says, will lessen the burden on police and paramedic services.

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The fact that mental health is increasingly being acknowledged and more openly discussed is a positive step. In its 2021 election campaign, the federal Liberals promised a Canada Mental Health Transfer to provinces and territories of $4.5 billion over five years, and Carolyn Bennett was appointed to the inaugural position of minister of Mental Health and Addictions soon after the Liberals won re-election. (York Centre MP Ya’ara Saks, former director of Trauma Practice for Healthy Communities, currently holds the post).

But the dedicated transfer hasn’t yet happened, and the 988 service is only four months from its launch, which, according to the Canadian Mental Health Association, is expected to generate a four- to six-fold increase in calls, creating a massive bottleneck.

Meanwhile, there are already long wait lists for treatment, and ongoing issues surrounding making those treatments more accessible and affordable.

Obviously, we want people who need help to reach out, and 988 is going to make that easier, and de-escalate more crises more quickly than before. But what about the next day? Will the services that people need be there then?