Federal initiatives to modernize public communications networks for mental health support and emergency services are using modernized infrastructure to accommodate the quickly changing technological landscape and better provide emergency services support.
When Congress first funded the National Suicide Hotline in 2001, the state of communication technology looked very different. The hotline — now called the 988 Suicide & Crisis Lifeline — has since received over 20 million calls from those needing support for suicidal crises or mental health-related distress and has evolved to a data-rich engine that accommodates phone calls, chat messages and texts routed through a national network of 200 crisis centers.
From a simplification standpoint, the hotline itself shortened to just three digits — 988 — in 2022 after an FCC order required all telecommunications providers to activate the number for all subscribers. This includes the Department of Veterans Affairs' Veterans Crisis Line.
Longer term, the Substance Abuse and Mental Health Services Administration (SAMHSA), which oversees the effort, envisions a system that seamlessly links those in need to community providers delivering a full range of crisis care and prevention.
The agency said the demand for this support will only continue to grow amid broader federal priorities in mental health and suicide prevention. But transformation, as the agency said, can't happen overnight. It'll take tackling some of the major challenges like staffing and funding to get there.
The Future of 911 is Underway
Similar challenges plague other public safety communications modernization initiatives, such as NextGen911 — the nationwide decades-long effort to replace analog 911 infrastructure with a digital system to accommodate modern communication methods.
Federal leaders working to overhaul the 911 service infrastructure are amid conducting the technical and data work that will be key to closing the gap between those in need and first responders. This includes Defense Department installations around the globe so that those on a military base can make a 911 call from any device and that call can be interoperable with civilian counterparts.
“The end goal is to decrease the response time to save lives,” John Holloway told GovCIO Media and Research. Holloway is deputy director of the Global Public Safety Communications Ecosystem Modernization at DOD. The office is overseeing the agency's Public Safety Communications (PSC) IT architecture implementation, which includes upgrading from time-division multiplexing (TDM) systems to internet protocol (IP) solutions.
The entire premise of modernizing 911 infrastructure is to move from legacy, outdated technology that takes much longer to route calls to the right place. The old way put more burden on call center dispatchers to get accurate information to emergency responders.
Modernizing this system essentially comprises three levels, Holloway explained.
First, “you have your basic 911 dialing where you pick up the phone, dial 911. It goes to an operator, and the operator will start asking you questions,” Holloway said. He added that the next level is “enhanced 911” in which an operator picks up the phone and the caller’s address is initiated into the call.
The third generation of 911 provides the caller’s latitude, longitude, elevation, name and phone number.
“The whole idea is to reduce the response time to get to somebody because within a minute, somebody could bleed out,” Holloway said.
The Next Generation Challenge
Despite the dire need to bring these systems and infrastructure up to date, Holloway said that NG911 still faces a lack of funding.
“Just because you hear that next gen is coming, or people are using it a lot, depends upon the state and a lot depends upon the county,” Holloway said. “The technology exists, but the equipment has not been fully deployed yet.”
Lawmakers in March introduced bipartisan legislation that would provide $15 billion toward implementing NG911, though it has yet to see a vote.
Billy Bob Brown Jr., executive assistant director for emergency communications at Cybersecurity and Infrastructure Security Agency (CISA), said public safety is a nationwide approach and next gen is essential for everyone.
“Every citizen in the United States deserves to be safe and have the ability to request assistance, no matter where they are in the country,” Brown told GovCIO Media and Research. “As Next Generation 911 rolls out across the state and local communities, the federal communities also need Next Generation 911 capabilities to roll out simultaneously so that we don't create a gap where citizens on federal property would be unsafe.”
At CISA, the Emergency Communications Preparedness Center (ECPC) is working to ensure agencies develop a cohesive approach toward modernization efforts.
“One of the challenges that we've always faced and will continue to face is resources. Trying to get enough to ensure an effective and efficient rollout of that capability nationwide is something that's going to take a concerted effort by decision-makers at every level of government across all of the public and private sector,” Brown said.
Funding is not the only concern. There also is a shortage of emergency telecommunicators.
One in four jobs at public communication centers were vacant between 2019 and 2022, according to a recent report from the International Academies of Emergency Dispatch.
“It's not the technology. It’s the person,” Holloway said. “99% of the time, they're over busy and then we throw this new technology at them and they don't have time to do the training to learn how to use it.”
Since the next generation of 911 provides an environment for phone calls, text messages, images and videos to public safety answering points, Holloway said the technological advances increase the need for better trained 911 communicators.
“Sometimes when they get a call, and a person is explaining what the situation is depending upon the person taking the call, they can visualize the event. And sometimes as you might imagine, it could be very horrific,” Holloway said. "If you start throwing video in of, say, a horrific vehicle crash, what is that going to do to the mental state of the 911 operator? I mean, a lot of them are suffering from PTSD now.”
The current roadmap for NG911 might not be near completion, but critical work is underway across the government to develop ongoing strategies around things like policy, metrics, implementation pathways and funding channels. The technology work behind efforts like NG911 and the 988 Suicide & Crisis Lifeline mean more people get the services they need, where and when they need them.
“The 988 Lifeline is responding to thousands of people in crisis every day. The data continues to show increased calls, texts and chats and at the same time, speed to answer rates are significantly improved,” said Miriam E. Delphin-Rittmon, HHS assistant secretary for mental health and substance use and the leader of SAMHSA, in a press release about the hotline. “This means that more people are getting help and they are getting help more quickly, which is crucial for a person in crisis.”