California tribes and mental health professionals look to improve crisis hotline experience for Native Americans

Updated March 30, 9:58 a.m.

The 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) has seen an increase in contacts since it was rebranded as the easy-to-remember 988 number in July 2022. According to the state’s largest crisis care provider, Didi Hirsch Mental Health Services, total calls answered in California increased by 22% in the six months following the change, compared to the six months before. 

However, Didi Hirsch Services estimates that less than 1% of the 264,000 calls state crisis centers received last year were from Native American people.

Data from the California Department of Public Health shows that Native people have the highest rates of substance involved deaths, and serious mental illness, and the second highest rates of suicide in the state. Native American people account for 1-2% of California’s population. 

The trend is nationwide, where suicide rates for American Indian and Alaska Native people are 1.6 times higher than the U.S. all-races rate.

Some tribal leaders in California say they believe there are cultural barriers that are standing in the way of people reaching out to 988 when they’re in crisis, and came together with mental health professionals during a summit in Sacramento to explore solutions. 

Virginia Hedrick is an enrolled member of the Yurok Tribe of California and the executive director of the California Consortium for Urban Indian Health, which does advocacy on behalf of seven health clinics and two residential treatment facilities in the state. She said many tribes have beliefs that affect the way they talk about feelings of distress, including suicide ideation.

“Many of us have a cultural belief that once you speak about something, you're speaking life into it, you speak power into it,” she said. “So if [asked] sometimes specifically direct questions, it can be really challenging and offensive because you don't want to say it in that way. You have a different way of saying it.”

Hedrick added that some tribes don’t speak about someone who has died for a year, and in other cultures, you talk about pain through stories that may be hard for a non-Native person to understand. 

One 988 model in Washington state, which directly links Native callers with a team of Native volunteers, has gained attention and could be a blueprint for California to follow. 

Assembly member James Ramos, a Democrat representing the greater San Bernardino area and the first Native American elected to the California legislature, said he’d like to see California follow the Washington model. Ramos is a member of the Serrano/Cahuilla tribe, and says his experience growing up on the San Manuel Indian Reservation showed him how much stigma there was in reaching out for outside help, and how Native people are often met with stereotypical ideas by non-Native people.

“Having the infrastructure is important because we need to know when someone calls that they're reaching out and talking to somebody that they can relate to,” he said.

Ramos says he thinks Native people in California experience higher rates of substance use and suicide in part because of decades of historical trauma, a trauma that has not been reckoned with in the state or the nation. He’s sponsoring a bill that would have school districts work with local tribes in their area to teach the factual history and culture of the American Indian people in their area.

Correction: A previous version of this story incorrectly spelled Virginia Hedrick's name. It has since been updated.