988 suicide crisis helpline launches across Canada
Amina Zafar | CBC News | Posted: November 30, 2023 9:00 AM | Last Updated: November 30, 2023
Similar to 911, 3 digits will connect people to suicide prevention services quickly
WARNING: This story contains mentions of suicide.
Canada's 988 hotline, which gives people access to suicide prevention services via call or text, went live on Thursday.
People in every province and territory who are experiencing a mental health crisis and need immediate, real-time support can use the three-digit number.
Similar to 911 for accessing fire, police and medical emergencies, 988: Suicide Crisis Helpline is a short, easy-to-remember number to get a quick response from coast to coast to coast, 24/7 and free of charge.
Dr. Allison Crawford, chief medical officer for the line, is co-ordinating the service. She is also a psychiatrist at the Centre for Addiction and Mental Health (CAMH), the country's largest teaching hospital for mental health based in Toronto.
Crawford said the goal of 988 is to prevent suicide.
"Suicide is a tragic outcome of many factors that differ from person to person," she said. "We know that feeling a sense of burden or a lack of belonging are common feelings that increase risk. Other factors that can play a role in suicide are mental illness, including depression, anxiety, psychosis and substance use."
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What is 988?
Calls and texts to 988 are directed to a network of partners in communities across the country offering suicide prevention services such as counselling.
The 988 service is federally funded and available in English and French to all.
Why is it needed?
According to Statistics Canada, 4,500 people in this country die by suicide every year — equivalent to 12 people taking their own lives every day. For every death by suicide, at least seven to 10 people either attempted suicide or grieved the loss of someone who took their own life.
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Tanya Joy suffered both. Joy of Paradise, N.L., started advocating for suicide prevention services in 2019 after her brother, Jody, died by suicide. Joy, 48, attempted to take her own life in 2007.
"I'm here, I lived," she said. "I was fortunate enough to feel safe to call somebody, and I know that that's why I'm here, because this person intervened."
When someone is in crisis with thoughts of suicide, time is of the essence, Crawford said.
While suicide rates did not increase during the COVID-19 pandemic, crisis lines across the country saw an increase in calls from people who reported feeling high levels of stress.
Joy now hosts Joy Run, a 50-kilometre trail run to raise awareness about suicide prevention. She said nature helped with her grief and that running with others prevents her from feeling isolated.
Who is 988 for?
It's for everyone.
There are multiple ways to get in touch. When someone calls 988, they're first presented with a menu. Children, teens and Indigenous people are among those who can choose to access services specifically geared to them.
Children and young adults can also contact Kids Help Phone for mental health support by texting CONNECT to 686 868 from anywhere in Canada.
In addition to calling 988, First Nations, Inuit and Métis will also be able to reach the Hope for Wellness Helpline. Its responders were specifically trained in cultural humility and are available by calling 1-855-242-3310. Services in Cree, Ojibway (Anishinaabemowin) and Inuktitut are provided upon request.
Like Kids Help Phone, the Hope for Wellness service is also a menu option through 988.
The previous suicide prevention line, Talk Suicide Canada, was about a quarter the size of 988 in terms of coverage across the country.
One of the reasons 988 were adopted as the digits for the hotline is because the same numbers are used in the United States for a similar crisis line that launched in July 2022.
People who are deaf or hard of hearing can access ASL/LSQ interpretation through 988.
Who answers?
So far, a network of 39 partners across Canada will offer support close to home through 988.
There's also a hub of trained responders who can be called on when more capacity is needed and a local responder is not available.
South Asian Canadian Health and Social Services in Brampton, Ont., a not-for-profit organization, is one of the partners in 988. It offers individual and group counselling to people of all ages, along with a separate crisis line that includes cultural and linguistic services.
Nausheen Ali co-ordinates 988 training for the Brampton group. When someone calls, the responders will ask if the person is having thoughts of ending their life or harming themself.
"Once that elephant in the room has been addressed, it makes it easier to kind of listen to someone's story and see how they got to where they are and how they're feeling," Ali said.
The responders then take a non-judgmental approach to discussing whether there's a plan, associated mental health issues, use of substances, protective factors and strengths, supports and coping strategies.
As the person's stress lessens and any immediate risk is addressed, the conversation shifts to collaborate on a safety plan.
It is up to the person calling or texting to decide how much or how little personal information they share with responders, who are both paid and volunteers.
What happens when you call or text?
A caller will first hear a greeting notifying them they've reached the 988 suicide prevention line and be asked which official language they wish to use.
Those under age 18 will be offered specialized support.
Then there's a privacy message with a link to find out more.
A responder then listens or reads texts, responds with empathy and compassion and stays engaged as long as needed to offer support.
Crawford said in the vast majority of cases, emergency services won't be contacted.
But 911 will be activated if someone is at immediate or imminent risk of harming themselves or someone else. The 988 responder will stay connected on the call to support the person while they wait for help to arrive.
What isn't included in 988?
Everyone who reaches out will be served, but 988 is meant to keep someone safe at the moment. It's not meant to help navigate the mental health system.
Instead, 211 provides information for government and community-based, non-clinical health and social services. People looking for help with financial, housing and legal issues should call this number instead of 988.
What needed to happen to get to the launch date?
Before 988 could launch, all communities across Canada needed to switch successfully to 10-digit dialling with area codes, a process that took months.
The Canadian Radio-television and Telecommunications Commission said telecommunication providers have made 988 available to everyone in the country by phone call or text.
What's next?
CAMH will report to the Public Health Agency of Canada on how many calls were received, the time taken to answer them and abandonment rates from someone hanging up or ending the call before reaching a responder. Eventually, it will provide information about user satisfaction, without handing over any personally identifiable information.
Based on experience in the U.S., demand could be high immediately after the launch, causing some callers to experience a longer wait time. If so, people will hear a message encouraging them to stay on the line.