‘988 Is for Everyone’: Inside the New Mental Health Hotline

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988 is now the 911 of mental health emergencies. The three-digit number will connect you to a crisis call center in your area and a trained counselor to talk, text, or chat with. Andy speaks with Wendy Martinez Farmer and Dr. Linda Henderson-Smith from Beacon Health Options about how 988 reimagines the National Sucicide Prevention Hotline to be more accessible and inclusive, and why you don’t have to be suicidal to call. Suicide attempt survivor and crisis counselor Shelby Rowe opens up about her own mental health journey and explains why resources vary community by community.

Keep up with Andy on Twitter @ASlavitt.

Follow Dr. Linda Henderson-Smith and Beacon Health Options on Twitter @DrLYHSmith and @BeaconHealthOpt.

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Shelby Rowe, Andy Slavitt, Linda Henderson-Smith, Jason Kander, Wendy Martinez Farmer

Andy Slavitt  00:18

Welcome to IN THE BUBBLE. This is your host, Andy Slavitt. Friday, July 15th. Tomorrow represent the potential watershed day in the country, a new set of mental health resources are going to be available to public, we’re going to talk about this on the show, and get a little bit into what it is that America needs. When it comes to mental health. I mean, look, we’re talking more and more about mental health, not just on this show. But as a country, I think people are more and more comfortable talking about mental health in ways that are revealing of vulnerabilities that they’ve had. And that’s a good thing. It also means that with that, solutions can follow. And the release that we’re talking about tomorrow is of the 988 suicide prevention hotline, which is going to be available to all Americans, we’re going to learn about it, learn what it means and what it does. But also, I kind of want to know what part of the solution is this? You know, there’s a lot of aspects to mental health, mental health crises, we hear it in all kinds of conversations, whether we’re talking about someone with severe mental illness, whether we’re talking about kids with anxiety, whether we’re talking about people who are at risk of suicide, we hear it when we talk about other things like guns. So we have three great guests on the show. First, I want to introduce Wendy Martinez Farmer, Wendy ran a Crisis Response Center for a number of years, she’s at Beacon Health Options. She’s very experienced of what people are gonna go through on a day to day basis. Welcome to IN THE BUBBLE, Wendy.

Wendy Martinez Farmer 

Thank you for having me.

Andy Slavitt 

We also have with us today, Shelby Rowe, Shelby is herself, a suicide attempt survivor. She’s also the director of the Suicide Prevention Resource Center. She’s run a number of crisis response centers before in her past, really appreciate you being on the show to help us understand things today, Shelby.

Shelby Rowe  02:03

thanks so much for inviting me.

Andy Slavitt 

It finally I’m delighted to have Dr. Linda Henderson Smith. She’s who’s a psychologist, also at Beacon Health Options, also has dealt with depression and suicide attempts at her own family. So brings a tremendous amount of not just knowledge, but passion to this topic. It’s so great to have you with us, Linda.

Linda Henderson-Smith 

Thank you for having me, Andy.

Andy Slavitt  

You haven’t figured it out already, I should tell you that we are going to be talking about suicide on the show, we have to, we’re going to talk about how we’re going to respond to suicide and how we’re going to respond to crises. And we’re going to solve the problem, we got to talk about the problem itself. But it really is a solution oriented show. But I know for some listeners, that’s a topic that you may want to take some care in listening to. And you should do that. And I should also finally say, what I think you’re gonna hear throughout this show, probably the most important message you could hear is help is available. And help is going to be starting tomorrow, even more available than it’s ever been in the past. And Wendy, let’s start with what will happen if I pick up the phone and call 988 beginning tomorrow.

Wendy Martinez Farmer 

So essentially, the National Suicide Prevention Lifeline number that’s been in place, since I believe 2005, the one 1-800-273 talk number will be accessible via 988. So nothing really changes with the network, that network has been in place for quite some time. But it will be much easier for anyone in need to remember the number. You know, when you have a medical emergency, we all know what number to call. And it’s just not been as clear when it comes to a mental health emergency. So this should make it a lot easier for anyone experiencing a mental health crisis to know what number to call.

Andy Slavitt 

So what happens? What happens when someone calls the hotline? If I pick up the phone tomorrow? What does that experience gonna be like?

Wendy Martinez Farmer  04:05

Typically, when you call the number, it routes your call based on your area code. So you will get a center that’s closest to where you are. And you will get a trained crisis counselor. They take a little bit of demographic information. But really they’re just there to listen and to find out what your immediate need is and, and work with you collaboratively to get the best resolution to your call.

Andy Slavitt 

So Shelby, what’s the training like? Who am I talking to? What do they know? And what are they what have they been trained on?

Shelby Rowe 

So it varies a little bit across the country. But I can tell you that every call center that is part of the network, which I think at last count was around 180 centers across the country that currently answer calls for the National Suicide Prevention Lifeline and they will be the call centers of 4988 and each of these centers have to be accredited. And part of that accreditation includes about 40 hours of training, specific to crisis intervention. Now, for some of the call centers, this is 40 hours of crisis intervention on top of being a master’s level mental health professional. For others, this is 40 hours of crisis, intervention training for a college student, a volunteer a peer recovery support specialists. So that is going to vary across the country, but the standard of training is going to be the same. And it includes anything from active listening, de-escalation, and how to really connect with that caller. I was sure we’re going to talk a little bit later about some other steps that are getting added with 988 to more closely connect with a mobile response team or connect with somewhere to go when needed. But for most of those callers for 85% to 90%, that phone call taking a moment to catch your breath, and really connect with another human being and talk through what’s happening is all that is needed to help them get through that moment, help relieve that moment of overwhelm, so that they can get back to what they do best, whatever that is.

Andy Slavitt  06:25

So Linda, I’m wondering, like, how do I know if I should call? I mean, do I have to be feeling having suicidal thoughts? What if I’m feeling incredibly anxious? Like I think a lot of people are in a situation where they don’t think these resources necessarily for them, they kind of underplay or stigmatize themselves in some ways. How do you recommend to people to think about whether or not they should be picking up the phone and using the service.

Linda Henderson-Smith 

So the way that I like to actually talk to clients about it is any moment where you feel like you’re in crisis, however you define that, whether that mean that you are overwhelmed and overstressed out whether that mean that you just broke up with somebody, and you’re just really sad, I need to talk to somebody, right? Like, whatever you deem as a crisis, that’s when you call, you don’t have to be homicidal, you don’t have to be suicidal, you don’t have to be at a point where you’re thinking about going to an ER, right, the difference between 988 and 911, is that this is also around prevention, and having someone to call to text to chat with, right so that you don’t go to that level of meeting to potentially be hospitalized, or where you’re calling 911, because you’re having some type of huge anxiety or panic attack, right? So for me, the way that I define it is or have people kind of define it as self-defined, right? A crisis is self-defined for you, by you. And in that moment, that’s when you make the phone call, or the text or the chat. And I think that’s the other part is people don’t realize that this is not just about a phone call. This is also you can text on your phone to 988, you can chat on a 988 website, right? Like you have the ability to actually do it in whatever way feels best for you.

Andy Slavitt  08:20

So you could just text, presumably, you could just text any like, hey, I’m not feeling great. I mean, something very, the buyers not super high, is what you’re saying. You’re like, you know what, I’m not feeling great. You throw that in a text, which is the safest kind of thing you could do, because we do it all day long. And you’re gonna have someone who’s trying to figure it out to help you on the other end. Okay, I want to play something for you. Because I think you brought up a really good point, Linda about whether or not people should make the call. And that’s the VA has a suicide hotline. And we had last week, in fact, a wonderful, wonderful episode with Jason Kander, who has talked very publicly about his PTSD. And the decision that he was making, trying to make when he was deciding if he should call the VA suicide hotline. Let’s play that and get some of your responses to it.

Jason Kander 

Finally, one night, I had sort of this, like just glimmer of an idea that maybe I should try something else, you know. And so I got up from the couch sitting there with my wife and I went the other room, and I called the Veterans Crisis Line. And I thought, because again, I had this impostor syndrome, this sense that it was Stolen Valor, the idea of me claiming the mantle of PTSD. I was real sheepish about it. And I was, I thought they might tell me, look, this is an important line. We got to keep this open. You know, this wasn’t your service, like you need to? You need to not call this number or, you know, I was embarrassed about it. And one of the very first questions the woman on the other end of the line asked was have you had suicidal thoughts? And the only person I had ever admitted that out loud to was Diana, my wife, but I said yes. And like it was just a spigot like, tears came out of me. And the most important thing that happened was the way she responded to me. She asked me about my service, that kind of thing. And her entire tone of voice was that of somebody who was talking to someone who didn’t sound any different than anybody, they talked to that shift or ever in that job. And that clicked for me. And I realized, I’m not any different than any of these other people.

Andy Slavitt  10:29

How do you guys think about that, about Jason’s experience?

Wendy Martinez Farmer 

What a tremendous example of what it should be like, you know, it’s about normalizing the pain that people go through on a day to day basis, and letting them know that they’re not alone, you know, that other people have experienced that very same pain, and that counselor is there for them. That’s exactly the kind of experience that we would want people to have.

Shelby Rowe 

Yeah, I was listening to him speak and realizing that, you know, one of the tragic side effects of kind of being in a suicidal crisis is being self-dismissive of feeling like, hey, I’m a burden on other people. Like, this isn’t for me, this help isn’t for me, which really gets in the way. And so listening and glad, you know, that he really articulated well, that we’re wrestling with that. So yes, we want anyone inside of that go well, I wonder if I should call to call. And now the VA crisis line is going to also be part of 988, they will be able to dial 988 and then press one for veterans.

Andy Slavitt 

Linda, what thoughts came to you?

Linda Henderson-Smith 

So, […] a veteran, right? It hit me a little different. And so for me, it was comforting to know that a veteran, right gets the same active engagement, empathy, compassion, and kind of trauma informed response, especially considering the levels of PTSD amongst our veterans, right, so. And the crisis that we’re having in terms of suicide, death by suicide within our veteran population. For me, it was very comforting to recognize that, even though it’s a different line, right, it’s the same level of training and crisis counseling that happens, no matter which line people call.

Andy Slavitt  12:36

One of the things that Jason tries to explain, particularly to non-veterans, is that people who aren’t veterans have the same exact exposure potential to PTSD as people who are veterans. And that just because the bullet didn’t whiz past your head, you know, Jason’s point, and he’s made this to me several times, is that you can be walking down the street and experience something, see something, see a child get hurt, your brain doesn’t know the difference. But he’s your brains never been to Afghanistan. And so your brain can have the same kind of reaction. And the point he really tries to make is twofold. One is, let yourself, experience it, admit what you’re experiencing, and don’t evaluate it, don’t rate it, your pain is your pain. And then the second thing he talks about is that PTSD is, amazingly highly treatable, as are a lot of mental health issues. And I think, Shelby, you’re making the point, I think that, like, when you go through a mental health crisis, not only do you not think you rate highly, but oftentimes you feel like there is no end, because you’re in this pit. And you don’t realize that there’s evidence based standards, they can actually help you just the same way. If you break your leg, bruise your knee, you get diabetes. So we talked about that a little bit as you think about the resources available. Because once you make that call, a lot of other things have to happen presuming that you’re gauging, right?

Shelby Rowe  14:15

Right. And I think, you know, of listening to that, and especially hearing you talk about that, you know, I’ve lived with PTSD since I was 19, you know, and went through my own crisis. And remember, at the time in 2010, I was running through a crisis center in another state, and sitting and looking at my phone and I knew how well trained the staff was I recruited and trained them and they were wonderful. But I think on that of my fear that internal, I’m a burden to others. They’re gonna recognize my voice. And I remember looking at my phone going, Wow, I wish I could call a hotline and didn’t reach out but yes, that place of despair you know when you’re in hopelessness center to spare, and then our brain and Linda, you know, our resident psychologists on the panel may be able to more articulate this, but your brain doesn’t know the difference between physical pain and psychological pain. So whatever liberties you would give yourself in an excruciating physical pain moment, give yourself that same grace. And a hotline is a great place to call it is probably the most supportive, empathetic, you’re going to have a moment to really sit and process what is going on. And again, for most callers, that is all that they need. And then for that smaller percentage, that need additional care within the next 24 hours, that is the best way to get that care, it is the best warm handoff, if there is additional services, accessing those services through 988 is going to be the best, because sometimes just getting help itself is traumatic. And so having that having someone else that’s already kind of smoothing it and doing that warm handoff, so you don’t have to tell your story to three people that same day you share it once on that call, and they’ll help you with the next steps.

Andy Slavitt  16:21

When we come back, we’re going to talk about what leads to crisis and how this first step can be transformational. So Shelby made me very curious about this kind of notion about how the brain works. Because I think to some extent, when we’re experiencing mental health issues, we either think that this is coming from something we’ve done wrong, or it’s something we should be able to control. And we don’t really think about it, the way Shelby talked about it that much like our body sometimes fails us and needs repair. The same is true with our mind, give us an understanding that like how a layperson should think about how a crisis occurs to somebody?

Linda Henderson-Smith 

So I think because crisis is self-defined, it’s really hard to talk about how it kind of happens for everybody, right? But ultimately, what happens is, if and when a situation happens, that is traumatic to us, and or there’s an event or a series of events or a set of circumstances, right? That is actually overwhelming to us and overwhelming to our systems, when we don’t have the coping mechanisms or the resources to handle them. It can put us in a state of crisis, right? And so what generally happens biologically, when we have traumatic events happen, right? When trauma occurs, or crisis occurs, is we go into our survival mode, we go into fight, flight or freeze, right. And when we’re in fight, flight, or freeze, our brains are 100%, unable to process anything, learn anything, or respond in a way that’s cognitively, you know, collected. So we tend to react from a place of survival, and we do what we have to do to survive. That’s not necessarily always the best thing, right? Some people fight. Some people flee. And some people freeze and oftentimes that freeze looks like not seeking help, not making phone calls, not accessing the services or the resources that they need. And so the great thing about 988 is it is a small enough number, where our brain even in that space of being in our survival mode can remember that, we can remember three numbers 988, similar to 911. It’s much harder to remember 1-800-273-TALK.

Shelby Rowe 

Yes. And you know, working in suicide prevention and public health my whole career, I can’t tell you the number of times that someone would come into my office or text me or something, and I go, What was that number again? What was that number? Because in that moment of crisis, so not only is it handy for the people that are experiencing a crisis, but for their best friend or loved ones, because when your family member is in this life threatening crisis, trying to remember a 10 digit number is difficult.

Andy Slavitt 

I want to make sure I understand how much this is for everybody versus just for some people. If you’re 13, if English is isn’t your first language? If you’re trans? Have disabilities? Like what, what is there to say this is for you.

Wendy Martinez Farmer  20:11

Nine it aids for everyone. And I, you know, I’ve run crisis call centers for many, many years and have fielded calls from 7 year olds, 8 year olds, young people reaching out for help. So the network is really working very diligently to make sure that the individuals answering those phones are culturally humble, but have the training in place to make sure that they can connect people to resources, no matter what they need, if you need a different language, the lifeline has a relationship with the language line to get immediate interpretation for over 200 languages. So there are ways that the lifeline can help you know, all people who call, certainly that’s something that needs continuous training, and then the lifeline staff will continue to need more and more training as we go forward. But it is meant to be a safe place for anyone to call.

Andy Slavitt 

Wendy, what is a seven or eight year old? How do they express what they’re going through?

Wendy Martinez Farmer 

Interestingly, very, in a very similar way that that, you know, an older person would, you know, I remember a time where we had a seven year old call, and they were very, very clear that they were thinking of taking their own life, that they were overwhelmed, much like Linda said, they had been completely overwhelmed by everything around them. They were fearful, and did not feel like they had the support that they needed. And it’s tremendously sad to know that that someone that young can have those feelings. But what an amazing thing that someone that young had the courage to reach out, she reached out for care and was able to get care that day.

Andy Slavitt  22:04

I’m curious about one thing here, and maybe we can answer this. But Linda, maybe I’ll start with you. What does he have to show in terms of if someone is feeling suicidal? If they’re able to get through the crisis of the moment? Is that many times, is that oftentimes enough? Where circumstances improve where people get a different perspective? And that indeed, helps them? In other words, is it are these feelings of hopelessness and despair sometimes fleeting, to the point where if you could just help someone through the crisis, you really can get them on the road?

Linda Henderson-Smith 

So I would say it really, truly depends, right? Again, it’s person by person, but what we really kind of look at is their desire, their plan, their capabilities, right? Like whether or not they’re just having kind of thoughts, like, I would just be better off if I wasn’t here, but they have no plan to do so, they have no desire to really do it. If they have resources and resilience skills, right, they may not actually follow through with that, right, like, so I think the phone call or text or chat is a huge piece of the intervention. But for individuals who are frequently in that place, right? Ongoing services and supports are going to be needed, so that they can process through kind of what’s going on and learn those coping skills. So they are no longer overwhelmed.

Andy Slavitt 

That’s the part I’m curious about. Is those other people, the people that are, it’s more than a crisis of the moment, say they’re, they’re living in an abusive situation. And they’re feeling despair, because their circumstances are very much leading them to feel like there’s no hope, or they’ve got deeper issues that require pharmacological answers, which there are many these days, or they require ongoing therapy. So what happens in that situation? Is the person who answers the phone able to bring those resources to bear and how?

Wendy Martinez Farmer  24:18

You know, right now, it will really vary based on where someone lives, you know, what kinds of resources are available to them after that phone call. But the hope is, is that as we identify more, through what happens with 988, what people’s needs are, that those other community resources will be built out in the community. mobile crisis is a great example. You know, in some communities today, there are mobile crisis teams available 24/7. But if that phone call isn’t enough, that a mobile crisis team can go right to that individual and intervene at the time, but not all communities have that right now. So that’s something that we’re all building towards. But the goal For all of the lifeline centers is to make sure that they really understand the local resources so that they can connect that individual to the most appropriate resource that will meet their needs at the time.

Andy Slavitt

Are the people that answered the phone today have a set of resources in front of them for different types of domestic abuse, for getting people into different forms of therapy relationships for all those other sorts of things? And is it funded? I mean, is it funded? Or are people going to be faced with? Sure you can have this but you know, you’re gonna have to find a way to pay for it.

Shelby Rowe 

So yes, and no. Yes, there are those resources there, and they can link and that is going to vary community by community, on what is covered in that area. You know, I in Oklahoma, you know, where I live, we have some of our tribal nations, that they have good resources to cover, substance abuse treatment, that to have someone called in their crisis, where if they’re related around that, if they were ready to get sober, there are different resources that would cover that for those tribal citizens, so that they could get their loved one into treatment as soon as possible. Whereas there are other areas where, unfortunately, in that community, if you are in crisis, you are very well aware of the lack of resources. But sometimes just having someone to talk to, to listen, and validate, you know, sometimes it is an ongoing or chemical. Sometimes, it is situational, you know, the grocery store where I shop at in a predominantly Black neighborhood. And thinking of other times when I was on a crisis center, there may be a mom or a dad or a teenage boy, after the shooting of buffalo that needs to go to the grocery store. And you just need to sit and do some breathing exercises with a stranger in the car. So you can get inside and do your task of buying groceries for your family, where that would be situational. You know, that is not a clinical anxiety that is a normal response to trauma. And the hotline gives you a moment to catch your breath at this anonymous vote for someone to listen and help you get through that moment. And so yes, they can help link you up to what is available, and depending on what it is. But that crisis line person is going to help explore those resources with you to know like what’s going to be something what you’re going to have to pay for and things like that and keep that caller in the driver’s seat as much as possible. They are trained crisis line workers to respect that autonomy and dignity of that caller, because it’s that caller that reached out and it is the privilege of that line. To get to offer help.

Andy Slavitt  28:06

When we we’re going to talk about what part of the current crisis that we’re facing as a country and some of the big issues we’re facing this is going to solve and what other solutions might be necessary. So look, one of the things that you can’t help but talk about in the news is some of the late adolescent early 20s shootings that we’ve experienced recently, as a country. And I think people sometimes inappropriately assume that mental health is behind what’s going on. Sometimes it is. Sometimes it’s anger, sometimes it’s a violent tendency. Sometimes it’s a broken heart, or there’s a lot of different things. But, you know, oftentimes, I think we’d like to think that crashes are something that can be done, you know, we’ve passed a red flag bill, but identifying kind of these situations, de-escalating situations like this. I guess I want to know, how much of answer do we think this hotline is, versus what else we need? So to get it up to 20,000 feet here, given all of the needs we have as a society? What part of this do you think this helps? And probably more importantly, what else do we need? This feels like a small down payment against a bigger problem, doesn’t it?

Linda Henderson-Smith 

It’s a huge problem. And you’re right 988 As Wendy said earlier, right is the first step to solving the problem. The issue is what we need are trauma informed crisis systems of care. That good Have people the prevention, the intervention and the maintenance that it takes to really be mentally well and mentally healthy, right. And that gives the support and the resources that that people need in the time of crisis, to really get their needs met on an ongoing basis. As Shelby said, right, each community has different resources available currently. And so not every, not every place has what everyone needs in order to really maintain their mental wellness. But yeah, I think I think 988 is really truly kind of that first step in building towards that, that really true system of care that we need here in the United States to really start to address the issues that we’re seeing around mental well-being.

Shelby Rowe  30:52

And this gives us a chance for the first time to think about and thoughtfully build an equitable system. With last time crisis care was looked at in this country, you know, we think about when 911 came about and other things, you know, we’re in a different world in 2022. And when we say we want, you know, a crisis system for all, that includes a lot of people that pass systems were never built for. And so there is a lot of work to be done. There’s a lot of opportunity. Because, you know, sadly, in our country, you know, we say that this is for all Americans. There’s a lot of people want to tribal communities, I’ll only speak for my community that when we see all Americans, we automatically assume that does not include us, because systems historically did not include us. So it will take time, but I have been encouraged, leadership change is hard. But leaders at every level and the federal government and the private sector, they want to get it right. So first skeptical listeners. Yeah, so if you’re noticing inequity in your community, you are not wrong. But please know that people are working and hard conversations are happening every day, to build this so that we can have a system that all of us without any disclaimers can say 988 crisis care is for all Americans.

Andy Slavitt  32:33

Linda, sometimes, I want to understand the interplay between 988 and 911. Sometimes people are reluctant to want to call 911 When someone’s having a mental health crisis, but it’s the only number they know. And then their fear is that course you make that phone call. cops show up with guns. And they have kind of one way of dealing with the situation. Could this help change that equation?

Linda Henderson-Smith 

That’s one of the main goals, right? Unfortunately, or actually fortunately, law enforcement is not trained, they are not trained mental health professionals. They are not individuals that are trained in how to deal with mental health crises. What we are hoping with 988 is that by giving by getting people to people that are trained in crisis, de-escalation, trained in crisis intervention, trained in crisis engagement, and getting them to mental health professionals, that it will reduce the number of times that law enforcement will need to be involved in mental health crises, which will then reduce the fear of having a police officer show up at your door with a gun when you just needed some assistance or someone to talk to you in that moment.

Wendy Martinez Farmer 

And the lifeline is extraordinarily successful already. You know, only about 2% of the calls that go into the lifeline centers result in as in a 911 call happening. So the lifeline centers are extraordinarily successful at helping to de-escalate. The other thing I wanted to mention relations to kind of like violence prevention and making sure that people have access to care is just a reminder that 988 is not just for the individual who’s in crisis. It can also be a mother, a teacher, a neighbor, if they do take third party calls. So if you’re concerned about a loved one, you know, when I ran the crisis line that was kind of our number one caller, but beyond the self-caller was mom, who was concerned about a young person and wanting to know what to look for, and how to help their loved one. So it’s important to know that it’s not just for the person in crisis themselves. It’s also for other people who are trying to seek help.

Andy Slavitt  34:57

I’m curious how to deal with confidentiality the situation like that.

Wendy Martinez Farmer 

It’s delicate, certainly. But the goal is, you know, hopefully to get that other person to call. But you know, the lifeline and through accreditation policies has a policy that if somebody a third party calls and they are very concerned about someone, that lifeline center, we’ll make an attempt to reach out to that individual and try to get them help. And it’s uncomfortable. It’s, you know, a difficult situation always, but very often has very positive result.

Andy Slavitt 

So as a close, I want to, I want to ask you all in the unevenness to just tell me what your greatest aspiration is, for this, if we’re sitting here having this conversation a year from now, what do we hope happens, whether it’s outcomes we’re looking for, or other specifics in your mind? As we sit here at the front? What’s the great goal you have in mind? Would you like to see happen, and maybe we’ll start with you Shelby.

Shelby Rowe  36:03

So what I would like to see happen is that if there was, say, a Black neuro divergent trans 15 year old girl that calls the lifeline, that she gets the same positive, caring, compassionate experience, as the mayor of her local town, if they called and asked for help, I want the system to be equitable. And so yes, I am working on the back end to get as many trainings developed for call centers, so that their staff is ready to compassionately serve anyone, no matter what their situation is. So that’s my hope and dream.

Andy Slavitt 

Got it, Wendy, questions same to you. And also, you work in an or mental health organization be can help options. You know, as you reflect on that answer, how do you think about it in terms of what role you will play in that process as well over the next year?

Wendy Martinez Farmer 

Yeah, we are very, very dedicated in our work to making sure that we help fill the gaps in the crisis system. You know, we’re taking national backup texts and chats to try to help this system go well, on July 16. My hope is that individuals who are having a mental health crisis have the same experience that someone who’s having a medical emergency has, I survived a heart attack driving in my car when I was 40. And I survived because everyone rallied around me, and there was a smooth system in place to make sure I got immediate care. I’m here today because of it. And I think every day how that could have been different if my emergency had been mental health related. So I am dedicated to making sure that anyone who’s having a mental health emergency has the same smooth, coordinated lifesaving care that I had. And you know, that all comes with making sure and that’s as a mental health organization, we can make sure that care for mental health emergencies is on par with that of medical emergencies.

Andy Slavitt  38:12

Exciting. And finally, Linda, I’ll give you the last last last word.

Linda Henderson-Smith 

So my hope is that as we build this system, similar to what Shelby said, we build it with equity in mind and foundationally. Really looking at building a system that’s not just equitable, but it’s also based on parity, right, so that we actually truly do have access to services, resources, skill building, and really relationship because I feel like it’s the relationships that really kind of keep us mentally well, right. But that 988 is the first step to us creating relationships across this country to support each other in our weakest times, in our hardest times.

Andy Slavitt 

Can I probe that a little bit to equity questions? You know, I know that if I’m going through something, it really helps me to talk to somebody who can relate to what I’m going through someone who maybe they look like me, maybe they have the same background as me. Maybe they have experienced its crisis. And I think we’ve learned in the little we’ve been learning over the last few years about health equity, that the same is true in all forms of health equity, that people need to see people and it helps to talk to people, whether it’s a physical health or mental health crisis, who can relate to them who have common experience. If someone who is a person of color, or trans person or a rural person for that matter, could cause a mental health crisis. Is there a system in place is there likelihood that people are going to be able to find someone that they connect with and connect with their background?

Linda Henderson-Smith 

So I know the goal for many of the centers across the country is to really, truly hire, right? Based on the population was that they serve and baked in from the populations that they serve, so that people can have access to individuals who look like the sound like them have been through some things like that have lived in their community. And so I know that is a huge push, not just from the Centers, but from the federal government to really think about doing this foundationally as an equitable system, to kind of alleviate any potential for systemic prejudices and issues that we know have come up in other systems in the past. So, I mean, I think that that’s one of the hugest pushes I know, Shelby and I were recently on a, on a panel talking about this, right? Like, this is important for us to really be thinking about, and it’s, it’s being discussed, as Shelby said, every day in one way or another as we build the system.

Andy Slavitt  40:52

Well, I have no problem with the last word, but I can’t help but say, first of all, thank you all. This is an exciting day. Secondly, I do hope this leads to a reduction in suicides. And I hope it really leads to a reduction in suicides, particularly in hard hit communities, communities that were feeling pains, not just for years, but for generations. And among kids who deal with the same things we do but had but don’t have the decades of coping mechanisms that some of us have built up. And if we could sit here a year from now, and say those things have happened, they’ve started to happen, will have done something really good here. And I thank you for all the work you’ve done over the years and decades to get us to this point.

Andy Slavitt

Let me give you a brief update on what’s coming up on IN THE BUBBLE. So you listen next week, we have three great shows. Senator Chris Murphy, it’s great to come on the show, Chris, you may know has been leading the charge on gun reform legislation, gun safety legislation. He knows more about it than anybody I know. And guess what, he got a success. And he got a bipartisan bill done. We’re going to talk about that bill, exclusively with Chris. And we’re going to see what’s going to be different and also what it says about the NRA and what it says about what’s changing, and the power dynamics of actually getting this kind of legislation through. Then on Wednesday, kind of related topic, we’re going to talk about what role governments playing and can play and help us through some of these problems, which are very, very challenging with a kind of a different type of guests, Adam Conover, who is really smart guy. And he has a Netflix special, which is sort of a it’s about the government. It’s called the G word. It’s got a kind of a comedy bent to it. But it’s a really interesting kind of social commentary about some of the things that are lying. What’s really happening in government, I think it’s a fascinating conversation. And then Friday, we’re going to on the heels of the Dobbs Jackson ruling, which was the ruling that overturned Roe v. Wade, we’re going to take on an interesting topic, which is different ways that we are now going to have to deal with topics for example, unwanted pregnancies. There are millions of them every year, many of them end up responsibility of women. But is that the right way to think about it? Is there things we should be doing differently? We’re gonna have an interesting show on that with a couple of scientists doing some work around male contraceptives. So those are three shows for next week. I think you’ll love them all. Enjoy your weekend, everybody. And I look forward to talking to you on Monday.


Thanks for listening to IN THE BUBBLE. We’re a production of Lemonada Media. Kathryn Barnes, Jackie Harris and Kyle Shiely produced our show, and they’re great. Our mix is by Noah Smith and James Barber, and they’re great, too. Steve Nelson is the vice president of the weekly content, and he’s okay, too. And of course, the ultimate bosses, Jessica Cordova Kramer and Stephanie Wittels Wachs, they executive produced the show, we love them dearly. Our theme was composed by Dan Molad and Oliver Hill, with additional music by Ivan Kuraev. You can find out more about our show on social media at @LemonadaMedia where you’ll also get the transcript of the show. And you can find me at @ASlavitt on Twitter. If you like what you heard today, why don’t you tell your friends to listen as well, and get them to write a review. Thanks so much, talk to you next time.

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