Preventing a crisis: Federal 988 director sees NC counseling services up close

More than 112,000 calls came in to 988 or specialized lines for veterans, LGBTQ+ callers, or Spanish speakers over the last 12 months. (Photo: Getty Images)

The federal director of the 988 Suicide & Crisis Lifeline had a look at some of the breadth of mental health emergency response in North Carolina on Thursday, visiting the crisis call center in Greenville and an outpatient clinic in Durham.

The federally mandated 988 number has been available for calls and texts at no charge for about two years.  988 connects North Carolina callers to crisis counselors at the Greenville center who can then connect them to community services if necessary.

It’s important to prevent crises as well as respond to them quickly, said Monica Johnson, director of the 988 and behavioral health crisis coordinating office at the federal Substance Abuse and Mental Health Services Administration. No one expects people with physical health issues to wait until they become emergencies before seeking help, she said.

“There need to be supports around that front end that prevent a crisis. But crisis is a moment in time, so what happens after that,” she said.

According to state Department of Health and Human Services data, more than 112,000 calls came in to 988 or specialized lines for veterans, LGBTQ+ callers, or Spanish speakers between July 2023 and June 2024.  The 988 call center had a 98% answer rate.  The average time for a call to be answered was just over 14 seconds.

“It’s very important that people call when they feel like they need to talk,” said Tracy Kennedy, executive director of Real Crisis Center, which houses the state 988 call center.

“If they just need to discuss something, we can link them before it becomes a crisis. If it’s a crisis, we have different resources, and then if it got to a point where it’s an emergent issue, we have wonderful first responders out there that are saving lives,” she said.

“Chatting and texting and calling – we love the fact that people are just reaching out – sometimes just to find out what it’s all about.”

DHHS launched a statewide “warm line” in February, where people can call 1-855-PEERS NC to talk to a peer support specialist.

988 and the peer support warm line work together to address callers’ needs.

“What they’re calling us for is nonclinical support,” said Cherene Caraco, CEO of Promise Resource Network, the organization running the warm line.

North Carolina’s 9-8-8 Suicide & Crisis Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week.

The statewide Peer Warmline is a phone line staffed by Peer Support Specialists who offer non-clinical support and resources to those in crisis.
North Carolina’s Peer Warmline is available 24 hours a day, 7 days a week.

Call 1-855-PEERS NC (855-733-7762) 24/7

“People call us to be connected for isolation, for loneliness, people call us to celebrate successes, people call us to thank us, people calls us because they’ve lost a loved one, they’ve lost a job, people call us because they’re thinking of suicide,” she said. “Because of the relationship between 988 and our warm line, we know what a more appropriate or effective support is going to be.”

Keeping mental health crises from turning into law enforcement actions where people end up in handcuffs, and creating options beyond hospital emergency rooms are priorities for behavioral health administrators.

The outpatient clinic in Durham that Johnson visited Thursday provides an alternative to hospital emergency rooms for people in crisis.

The clinic sees walk-ins and people brought in by family members or first responders. People  can stay from six hours to five or six days, said Joy Brunson-Nsubuga, Recovery Innovations chief operating officer.

“We will work with them to resolve that immediate crisis and then we connect them back to the community providers,” she said.