BIPOC and LGBTQ+ Communities Share Reservations on 988 Hotline

by Lauryn Bray

988 has been touted as a way to help reduce harmful police interventions in mental health emergencies, but emergency medical services and law enforcement will be called if someone indicates that they are a danger to themselves and/or others. While some people argue that this is necessary to prevent a potential crime from occurring, others argue that it adds fuel to the fire, as EMS and police are not trained in properly addressing mental health crises. Instead, mental health advocates are encouraging the use of task forces and peer support models for suicide prevention and intervention as alternatives to the hotline.

The National Suicide Prevention Lifeline, 1-800-273-TALK, has been shortened to 988 in the hopes that the number will be easier to remember, allowing more people to connect to suicide prevention services. Now called the Suicide and Crisis Line, 988 is available to anyone with access to a phone; however, due to fear of response from law enforcement, QTBIPOC folks do not always feel comfortable utilizing the hotline during times of crisis.

"Even though Black and Brown folks are the minority throughout the state, we still have to understand that police scare us. We are not comfortable with them," said Kurt Ragin, the program manager for the medical case management program at People of Color Against AIDS Network (POCAAN). "So, if someone's coming in to aid me in my anxiety episode or my depression that may lead to suicidal attempts or thoughts, and there's a police officer there, it could possibly heighten it and make me not even want to receive the services or even use the number again."

During the daytime, Ragin works as a program manager at POCAAN, but after six o'clock he is known as Julian Lanvin. Ragin, who is active in the ballroom scene, is a dance instructor at The Playground Kiki, a nonprofit organization for QTBIPOC created by Christopher "Chi-Chi" Davis in response to the appropriation of ballroom culture.

Suicide is the second and third leading cause of death for Black and Hispanic populations, while Native American and Alaskan Indians have the highest rates of suicide amongst People of Color. Behind them are Black men. According to the Trevor Project's 2021 national survey on LGBTQ+ youth mental health, 42% of the 35,000 surveyed LGBTQ+ youth reported that they contemplated suicide in the past year (2020) with more than half being transgender and nonbinary youth. With the impact of the pandemic, the climate change crisis, and a new catastrophe every day, suicide rates have only increased, and mental health prevention and intervention are needed now more than ever. The survey also indicated that over 80% of LGBTQ+ youth stated that COVID-19 made their living situation more stressful and 70% of LGBTQ+ youth reported that their mental health was poor most of the time or always during the COVID-19 pandemic.

While it is true that mental health collectively declined for almost everyone during the uncertainty of the pandemic, LGBTQ+ youth — especially those living in non-affirming households — were especially affected. As lockdown prevented them from seeing those who they consider their real families, many queer and trans youth were confined to environments where they could not express themselves freely, which added another layer of confinement. At the same time, Black and Brown folks were bombarded with imagery of anti-Black violence as the aftermath of the deaths of Breonna Taylor and George Floyd were broadcast across all media platforms. Two years later, as the country dives into an economic recession, suicide rates continue to rise for every demographic.

The establishment of 988 is an attempt to address the rising suicide rates; however, with the historically deadly police response to Black and Brown people in mental health crisis and the possibility of law enforcement being dispatched, the likelihood that 988 will be utilized by QTBIPOC is low.

"You don't know if you're going to get a cop who's just pissed off that they have to deal with your panic attack. There's no idea on what you're going to be receiving, and I think we see that a lot in some of the very unfortunate fatal events that have happened to majority Black folks who call for mental health crises. You don't know if there's racism on the other side," explained A, a Masters in Social Work (MSW) student and employee at a mental health organization who wishes to remain unnamed for privacy reasons.

Months after the deaths of Breonna Taylor and George Floyd, Philadelphia Police officers Sean Matarazzo and Thomas Munz murdered Walter Wallace, a 27-year-old Black man who was experiencing a mental health emergency, in front of his parents' home after relatives called 911. Wallace, father of seven, was diagnosed with bipolar disorder and was on medication. Instead of tasing Wallace, who was armed with a knife, law enforcement officers shot him 14 times.

The dispatching of police to individuals in crisis has been criticized before. Officers are not trained in providing trauma-informed care, and they lack the experience needed to properly aid and assist someone who is experiencing a mental health emergency.

Unfortunately, the problems with 988 extend beyond the possibility of intervention from law enforcement. The United States health care system has a carceral model for treating mental health emergencies — if you demonstrate that you are a danger to yourself and/or others, police will come and take you to a psychiatric unit where you will be confined and monitored. Even if individuals make it past the police alive, they must then circumvent the dangers of in-patient treatment.

"Not only just contacts with law enforcement, but if they go to the hospital, if they go into in-patient psychiatric units, that's a further traumatizing environment and also usually an environment that is full of racism, transphobia, homophobia, and sexism. I have met folks who have been sexually assaulted. I have met folks who have been physically assaulted. So even if the contact doesn't end at law enforcement, they are still going to go on to experience a great deal of trauma," said B, another MSW student and employee from the same mental health organization who wishes to remain anonymous.

Additionally, because there is a stigma around mental health, many individuals do not have experience with the behavioral health system, either because they were never encouraged to get help, or they fear that seeking mental health treatment will somehow penalize them in the future. This means that many people's first experience with mental health care is calling 988, and if utilizing that resource results in police brutality or involuntary confinement for an individual, it is highly unlikely that they will use that number again the next time they are in crisis or recommend it to others in need.

There is another way we can provide emergency mental health services without law enforcement. By establishing peer support programs and task forces with people who have trauma-informed training and lived experience on how to navigate the mental and behavioral health system, we can better assist individuals in crisis so that if law enforcement absolutely has to be there, they won't be expected to provide emotional support services.

"Peer response models and peer support models kind of get at the fact that you know what you're going to get on the other side, because it's probably someone that's been in the same boat as you or has been experiencing a similar mental health issue. Most police officers maybe aren't experiencing that same mental health crisis so they might not even understand what you're going through. But when you look at peer support, you have someone who maybe didn't experience it in full but who knows that system — knows what going to the hospital might look like, knows what involuntary commitment might look like — and has an idea of what's on the other side," explained A. "There's something about someone who just gets it, and this has been a factor in all of our lives — you want someone who just understands."

The Trevor Project provides 24/7 crisis services to LGBTQ+ youth from trained counselors who understand the challenges LGBTQ+ youth face. Support is free and confidential. To get started, text START to 678-678 or call 1-866-488-7386 to speak with a counselor over the phone. You can also visit TheTrevorProject.org/Get-Help to chat online with a counselor. If you have to wait to speak with someone, the Trevor Project recommends trying a calming exercise until you're connected.

For queer and trans communities and Communities of Color, someone who understands makes all the difference. Building community and finding space for QTBIPOC to gather outside of the racism, homophobia, and transphobia they encounter in majority white institutions and spaces is preventative care.

"Step one is [to] find each other. Step two: Let's create spaces for us. Step three: Let's support existing businesses and nonprofits that are for us and by us … because people automatically [assume] that there is nothing for Black and Brown LGBT folks," said Ragin. "And there is."

Editors' Note: This article has been updated to further anonymize sources who did not wish to be identified for safety reasons.

Featured Image: Photo by Benjavisa Ruangvaree Art/Shutterstock.com