Let's say you're an immigrant from Detroit living in Los Angeles and your house just went up in flames.
Like many newer Angelenos, you never bothered to get rid of your old area code. But when you dial 911 from your cell phone, your call will be sent to dispatchers in Los Angeles. Fortunately, he won't be going to Detroit.
The same cannot be said for 988, the national mental health crisis hotline. Callers experiencing suicidal thoughts or a substance use crisis will be directed to a call center based on their area code.
For some callers, this won't matter. A trained counselor sitting in a call room in Detroit might well offer the same words of comfort and assistance as one based in Los Angeles.
Except, in Los Angeles County, professionals do more than talk. They can also help connect the caller with a team of mental health professionals who can meet with them in person.
Crisis Counseling and Suicide Prevention Resources
If you or someone you know is having suicidal thoughts, seek help from a professional and call 9-8-8. The United States' first nationwide three-digit mental health crisis hotline, 988, will connect callers with trained mental health counselors. Text “HOME” to 741741 in the US and Canada to reach the Crisis Text Line.
As long as you're calling from a phone number with a local area code, of course. Otherwise, you're probably out of luck.
For this reason, staff members say the Los Angeles County Department of Mental Health has postponed the full promotion of its 988 line, concerned that a significant number of Angelenos will not be able to access county services. Caller data suggests that about 15% of county residents who would call 988 will be diverted elsewhere due to their area codes.
County officials say it's a complicated problem with an obvious solution: getting the federal government to pass a law that would require the Federal Communications Commission to route calls based on the nearest call center instead of the area code.
On Tuesday, county supervisors voted in favor send a letter supporting legislation introduced last month by Sens. Alex Padilla (D-Calif.) and Thom Tillis (R.N.C.) that would force the FCC to route calls to the nearest call center.
“We did all this work and then we waited a minute,” said Supervisor Janice Hahn, who said she advocated for a legislative solution during meetings in Washington, DC. “They could be in a real mental health crisis.” [or] fails and the call goes to Minneapolis.”
Technically, an out-of-town call center could transfer the caller to Los Angeles County. But local officials believe many call centers wouldn't think to do that because they wouldn't know about the in-person services the county offers. When calls are transferred, advocates say, precious minutes are wasted.
Hahn said the letter was intended to send a signal to the county's legislative team in Washington that it should begin “scouring the halls of Congress” to push for a federal solution, which was particularly urgent in a transplant region.
Padilla said he believed the bill to fix this problem would easily pass with bipartisan support.
“It's a no-brainer,” he said.
Los Angeles County implemented the 988 Suicide and Crisis Lifeline in the summer of 2022. At that time, local politicians He framed the three-digit number as a way to help crisis callers avoid a police response and a potentially deadly confrontation. Instead, callers would be connected to a professional who could explain their mental health crisis and help them get in-person assistance when needed.
The county currently has 47 full-time teams who, as of December, are dispatched 24/7, according to a Department of Mental Health spokesperson. The teams make between 1,200 and 1,500 calls a month, the spokesperson said.
A time investigation in April found that implementation has been fraught with obstacles and that politicians have failed to deliver on many of their initial promises about what 988 could do for voters in crisis. Wait times skyrocketed, with mobile teams typically taking more than an hour to respond. About half the time, it took teams more than five hours to respond.
Nine months later, Traute Winters, executive director of the Los Angeles County chapter of the National Alliance on Mental Illness, said she no longer hears as much about long wait times. Instead, she said, the problem of forwarded calls has become one of the main problems.
“I'm pleased with how it's progressing,” she said of the hotline. “But it's still a work in progress.”
Winters said the problem extends beyond newer Angelenos not being able to reach county hotline workers. Former Los Angeles residents who have since left the region also sometimes find themselves stuck in a call center that cannot fully help them.
Rachel Stankus, a shift supervisor who handles 988 calls headed to Los Angeles County, said she once received a call from out of town that she appeared to be overdosing and was about to swallow more prescription pills. Her Los Angeles area code meant he was her responsibility, although she had no idea where she was calling from.
“We wasted valuable time trying to determine its location,” he said. “Every moment counts when a caller is in crisis.”
Dialing 988 will direct callers to the National Suicide Prevention Lifeline, accessible throughout the US.
