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Anniversaries can be wonderful – or emotionally difficult. I just celebrated a milestone wedding anniversary – a joyous occasion. Yet, the first anniversary of my brother’s passing as a result of suicide is looming and brings back feelings of shock, disbelief and the lingering question, “Is there anything I could have done?” My brother and I were, sadly, neither geographically nor emotionally close as adults (his choice on both.) Yet the raw feelings remain, the helplessness, the abiding sense of loss.

In my head, I know there truly was nothing I could have done. But I choose to do something now. And that is to be open about death by suicide in this platform and any others I may have in order to spread a message of prevention; to advocate for mental health check-ups and encourage primary care physicians and Advanced Practice Providers to include mental health wellness checks in patient visits; and to share three easy digits that can save a life: 988.

988 was established to improve access to crisis services in a way that meets our country’s growing suicide and mental health-related crisis care needs. 988 will provide easier access to the Lifeline Network and related crisis resources, which are distinct from the public safety purposes of 911 (where the focus is on dispatching Emergency Medical Services, fire and police as needed) These three numbers, effective July 16, 2022, are the new National “Lifeline Network” for anyone who needs support for a suicidal, mental health and/or substance use crisis. Through a call or text to 988, individuals and loved ones in crisis can reach a real person who is a trained crisis counselor.

As you read this blog you might be asking yourself how is 988 different than 211. In most states, including Michigan, the 211 system provides health and social service assistance information and referrals. At the same time, 988 crisis counselors will provide support for people in suicidal crisis or mental health-related distress in the very moments they need it most. While generally being different in scope, these systems need to be aligned (interoperability), and in many cases, local Lifeline centers will also respond to 211 contacts. The reality is that 988 crisis centers will need to continue to coordinate with 211 and other community service agencies. This will help ensure an all-inclusive approach regardless of which number a person in crisis may use first.

Suicide statistics are alarming. According to a recent Wall Street Journal article on the new hotline, “The suicide rate in the U.S. increased by 30% from 2000 to 2020….and while overall rates have declined from a 2018 peak, suicides among groups including children have risen in recent years.” If you can share the 988 – I think of them as numbers to live by – please do so.

Separately, July again took me to Mackinac Island for the Michigan Academy of Family Practice Physicians (MAFP) annual conference. What really struck me this year was the breadth and depth of topics ranging from Diversity, Equity, and Inclusion to palliative

care and the “No Veteran Dies Alone” program. Breakout sessions, at least the ones I attended, were at capacity and comprised of a very engaged group of learners. Yes, I am referring to the physician as a learner. The interaction between presenter and physician provided an opportunity for sharing of ideas, including workflows in place to improve efficiency and outcomes. I commend the MAFP Annual Conference Planning Committee for curating a conference that truly was a “prescription for change.”