The American Association of Suicidology (AAS) appreciates the opportunity to submit comments and express our support for the Federal Communications Commission’s (FCC) proposed rule, Implementation of the National Suicide Hotline Improvement Act of 2018. AAS is the nation’s oldest and largest membership-based suicide prevention organization. Founded in 1968, our mission is to promote the understanding and prevention of suicide and to support those who have been affected by it.

Suicide is a massive public health issue in this country. Equitable access to appropriate care, is critical and necessary to ensure people receive the services they require in their time of need or crisis. Additionally, by providing access to rapid care, as in telephonic or texting resources, other services are less likely to be overwhelmed or strained. For instance, the ability for more suicidal crises to be diverted away from emergency services has the potential to alleviate costs to hospital systems and municipalities.

AAS fully supports the FCC’s proposed rule plan to identify a three-digit number – 9-8-8 – to be designated for suicide and other mental health crises. It is also absolutely necessary that these changes are made in ways that limit the amount of potential confusion regarding the transition from the previous number. AAS supports the use of a media campaign to highlight the change with a “launch” date to better distinguish the turn-on of the service, followed by sustained messaging after the fact. Messaging and service provision should include distinct programs for different high-risk populations, such as LGBTQA+, Native American/Alaskan Native, Military Service Members, and others.

AAS also fully supports the use of contemporary technologies as part of these suicide and mental health crises responses, not only telephonic services. In the last 6 years, Crisis Text Line has handled 129 million messages, accomplished over 50,000 crisis de-escalations, and initiated over 30,000 active rescues (interactions where emergency services were required). The ubiquitous use of text messaging, especially among our youth, will require this modality to be included in the processes outlined by the FCC.

Furthermore, the critical nature of these services requires that crisis centers answering calls and texts from those in crisis be adequately resourced to handle the inevitable increase in volumes of contacts. Many crisis centers are underfunded and understaffed. To ensure that crisis calls are answered locally and in a timely fashion, these centers need the appropriate resources to operate at levels that meet the scale of the demand. The legislation implementing the FCC’s plan must include a funding mechanism that ensures crisis center sustainability and enhanced capacity. It is vital that participating centers meet nationally recognized crisis standards by accrediting bodies and implement the evidence-supported practices championed by the National Suicide Prevention Lifeline.

As an organizational leader in the field, AAS believes that establishing a unique, 3-digit number for mental health and suicide prevention offers a unique opportunity increase the effectiveness of crisis services in this country. Thank you for your leadership as we work to improve the lives of Americans.

Colleen Creighton
Chief Executive Officer