988 Suicide and Crisis Lifeline with Joe Ash (October, 2023)

Thanks to the National Suicide Hotline Designation Act of 2020, 9-8-8 is now the new dialing code for the Suicide and Crisis Lifeline in RI, as well as nationwide. In this interview, Joe Ash—Administrative Director of the BH Link and 988 Call Center in RI—discusses how the 988-crisis line was established, what this resource offers, what its impact has been thus far within RI, and opportunities for collaboration moving forward.

Could you please introduce yourself and tell us about your role at BH Link/Horizon Healthcare Partners and the work that you do around the 988 Suicide and Crisis Lifeline?

My name is Joe Ash and I am the Administrative Director of the BH Link and 988 Call Center in Rhode Island. I work alongside my Assistant Director and the rest of the leadership team here to provide support to program supervisors and staff, engage in program evaluation, develop and strengthen connections with partners, and implement new program elements and initiatives (in a nutshell).

988 is the dialing code for the new Suicide and Crisis Lifeline in RI, as well as nationwide. Could you start by telling us a bit about what the 988 Lifeline offers and how it works?

Our 988 call center answers calls, online chats, and texts from any number in the nation with a 401 area code. Our services include crisis de-escalation, risk assessment and screening for suicidality, safety planning, mobile crisis and outreach referral, resource navigation, and BH Link walk-in coordination.

Why was it so important to create this new 988 dialing code? Could you provide a bit of background around how the 988 Lifeline came to be within RI?

The 988-crisis line is a national initiative, and we are so proud that it was Rhode Island’s own Senator, Jack Reed, who proposed this legislation federally! The legislation, named the National Suicide Hotline Designation Act of 2020, directed the Federal Communications Commission (FCC) to designate 9-8-8 as the universal telephone number for a national suicide prevention and mental health crisis hotline. The idea behind 9-8-8 was that to prevent future suicides, it was critical to transition the cumbersome, existing 10-digit National Suicide Hotline to a universal, easy-to-remember, 3-digit phone number to more easily connect people in crisis with life-saving resources. Prior to this legislation, the BH Link’s 24/7 call center had already been responsible for handling the lifeline calls for all of Rhode Island.

In regard to what went into the development of 9-8-8 at the state level, I can attest to the fact that it was a very collaborative process involving community stakeholders, local partners, and leadership from Horizon Healthcare Partners (HHP), Community Care Alliance (CCA), and the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH, our licensing body).

What is BH Link’s role in terms of operationalizing the 988 Lifeline? How does the Lifeline differ from the behavioral health crisis support/services offered through BH Link and how does the Lifeline intersect with these services?

Great question! The BH Link and its corresponding 24/7 call center were opened toward the end of 2018. The BH Link triage facility is a 24/7 walk-in program that serves as an alternative to the emergency room for mental health and/or substance use assessment and referral needs. We refer folks to a whole range of services including (but not limited to) outpatient counseling, crisis stabilization units, residential settings, etc.

Our 988 call center answers two statewide lines and is really meant to be an alternative to 911 for folks with behavioral health needs ranging from active suicidal thoughts to needing information about local mental health and recovery services.

Both elements of our program are unified under the goal of providing the least restrictive and most person-centered forms of support possible. One thing that makes RI’s 988 call center quite unique as compared to other call centers in the country is that our call center and walk-in center are directly connected.

How were people informed of the new dialing code as the 988 Lifeline was being rolled out? Since its initial implementation, how has the Lifeline been promoted throughout RI?

Most of Year 1 (which just recently came to a close) was geared towards staffing up and enhancing the quality of services offered by the 988-call center. This was all in preparation for the national 9-8-8 marketing campaign, which will soon be underway during the current project year. You can expect to see news segments, articles, billboards, signage, and events around the state geared towards raising awareness of the 988-crisis line.

Additionally, we have 988 outreach staff who travel all over the state spreading the word about the new 988 resource. Our outreach staff attend community events and meetings, staff resource tables at local events, and are available to present when asked. If you need 988 materials or would like to request an informational presentation, just give us a call! For more information, contact Elizabeth O’Dea at 401-699-5318 (eodea@hhpartners.org) or Jo-el Tillinghast at 401-654-0979 (jtillinghast@hhpartners.org).

What has the Lifeline’s impact been thus far in terms of helping to provide crisis support and prevent suicide? Could you tell us a bit about how the state/BH Link monitors and evaluates the efficacy of the 988 Lifeline?

The greatest impact that we’ve seen already has been in the areas of access and utilization. Just the switch to the new three-digit number, along with some limited increases in visibility of the 988 Lifeline, have effectively doubled the number of Lifeline calls that we’ve answered within the past year.

In terms of outcomes related to efficacy, we are able to evaluate performance-based data associated with the crisis triage work taking place here at the 988 call center. These metrics will speak to indicators of access and quality of services. As we move forward, I expect that a great deal of attention will be given at the state and federal levels to outcomes data (i.e., trends in suicidality and suicide prevention).

How can folks involved in substance use prevention and mental health promotion work in RI help to support and promote the 988 Lifeline? Are there any new or evolving opportunities for collaboration that you’d like to share with substance use prevention providers across the state?

Yes, there are many opportunities for collaboration! We’re very interested in collaborating and integrating with other prospective partners to create systems that work for the people of Rhode Island and aim to meet folks where they are in the community. We also appreciate help spreading the word about 988 within the community. Please give us a call if you’d like us to present to your staff or to attend your next community event. For more information, contact Elizabeth O’Dea at 401-699-5318 (eodea@hhpartners.org) or Jo-el Tillinghast at 401-654-0979 (jtillinghast@hhpartners.org).

Is there anything else you’d like to share regarding the 988 Lifeline that you’d like folks to be aware of?

There have been some recent legislative pushes to get some form of geo-routing in place for the 988 national network. Right now for anyone dialing 988, their call will be routed to a call center based on their area code. So if you’re living in Rhode Island but don’t have a 401 area code, getting connected to the appropriate resources may be more challenging. This doesn’t prevent the call center who takes your call from engaging in immediate support and risk assessment, it might just mean a couple of extra steps to get you connected to the most appropriate referral. If you’re in Rhode Island and concerned about not reaching a local line, you can always contact our local statewide line by dialing 414-LINK. Either way, we are dedicated to building a set of pathways for our community that mean there will be no wrong number.

Once again, please call us if you’d like to request 988 materials or coordinate a presentation at a future meeting or a resource table at your next event. And finally, please help us spread the word to your friends, family, co-workers, colleagues, and anyone you think should know about the new resource of 988.

BH Link

In the event of a mental health or substance use crisis, call to connect with a licensed counselor, 24 hours a day, 7 days a week. Bilingual support and medications to assist with recovery are available.

401.414.LINK (5465)