AI can be a first line of defense in answering 988 calls

On July 16, the 988 Suicide and Crisis Lifeline replaced the National Suicide Prevention Lifeline, an important step toward transforming crisis care. The new hotline connects to a nationwide network of more than 200 crisis centers that can help people overcome a suicidal crisis or mental health-related distress.

A call to a mental health helpline run by a trained operator can obviously be lifesaving, but the volume of calls can be overwhelming. Each year in Austin, Texas, for example, the emergency call center diverts more than 80% of its calls to mental health clinicians.

We are facing a 988 staffing crisis just as the service is launching. Reports have revealed that hundreds of positions remain vacant. Tradeoffs, the health policy podcast, reported that the hotline could receive up to 12 million calls in its first year, as 50 million Americans with mental illness seek help.

While 988 is being deployed, most localities are still unprepared and understaffed. In fact, President Joe Biden has requested $700 million to staff 988 people and strengthen the mental crisis system across the country.

In this context, the question is: “Can artificial intelligence help with this personnel crisis?” The answer is both yes and no. AI-enabled bots absolutely cannot listen and advise people on the verge of suicide. Yet we don’t have enough trained clinicians to answer the phone. While people in crisis are waiting for the phone to be answered, it may be too late. Can robots and AI fit into this equation?

AI automation can help process and route incoming calls to eliminate caller wait time with a simple series of questions such as: “Are you in danger of harming yourself or others ? Are you calling about someone in your care who you are concerned about getting hurt? Even screening questions as simple as “Is your call an emergency?” could be handled by a bot with a simple AI that listens for keywords or trauma signals and escalates or routes a call more efficiently.

That said, the need for well-trained, sympathetic humans to respond to people in crisis on 988 is the most important investment.

However, we cannot make the same mistakes that we have made with our frontline workers and 911 responders. In the past, there have been concerns that 911 operators were suffering from the ill effects of the job. 988 workers will handle incredibly delicate situations and the stress will be unimaginable.

We need to ensure that 988 operators have the support and work environment that allows them to respond to every call with attention to detail and a speed that could save lives.

First, let’s start with salary and hours. Call takers cannot be incentivized to work longer hours with higher pay. They need time to recover and learn from their interactions. Family and marriage therapists go to school for more than two years and must practice under supervision for 2,000 hours. An important part of their training focuses on how to personally manage the trauma of their patients so that they can function as healthy and happy members of their family and community.

We need to leverage the technologies we have to support these frontline call-taking heroes. We don’t have to replace the humans on the front lines of 988, but we can use technology to measure their physical and emotional health.

We can use AI to eavesdrop on calls and process unstructured data to help train and assess the effectiveness of approaches after the fact and give us a better sense of the health of our society. However, technology will not replace the real-time human support needed to save lives and help people find the care they or their loved ones need.

It is up to us, as a society, to ensure that the few who bear the burdens on the front lines do not suffer beyond their calling. AI is not empathetic or trained to deal with a crisis and handle that level of critical response, but it does have a place in answering and routing calls.

For now, humans helping humans will make a difference in the 988 Suicide and Crisis Lifeline, but let’s make sure the calls are answered.

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