Calls to the Warm Line could be sent to voicemail come June should the mental health support hotline serving some 130 people daily fail to secure the necessary funding to remain running.
Established in 2014 by the San Francisco Health Department and operated by the Mental Health Association San Francisco, the San Francisco-based Warm Line was hailed by The City as a major step toward “filling a gap” in the mental health system by serving people struggling with mental illness “before they reach a crisis point.”
Four years later, the Warm Line has turned into a point of first contact for many people in San Francisco and beyond who are in distress but not actively contemplating suicide, serving upwards of 30,000 callers each year.
The Warm Line operated on a three-year state grant that provided it with some $1.4 million annually. But that grant was time-limited, and roll-over funds that were set aside after it expired will run out by June 30.
Without continued state and local support, the Warm Line is also expected to close at that time.
Rachel Kagan, a spokesperson for the Department of Public Health, called the program “very successful,” with about 85 percent of calls made to the Warm Line coming from repeat callers.
Still, Kagan said that the Warm Line is not something the department could “fully fund.” Just 14 percent of the Warm Lines callers are San Francisco residents and Kagan said that the department is currently exploring “ways to continue to support it,” including urging other counties served by it to “pay their fair share.”
“We don’t believe that San Francisco should pay the full weight of the Warm Line,” MHASF Director Rachel Del Rossi said. “We do take calls from the outside.”
The Warm Line has already seen some reductions — no new counselors are being hired despite growing demand, and the Warm Line is no longer taking calls from out-of-state in an effort to stretch its resources.
“Everyone agrees that it’s an important and valuable life saving service, but isn’t sure about where the support will come from,” said Del Rossi.
While many similar support hotlines across the country are volunteer-run, San Francisco’s 40 Warm Line counselors are paid. The Warm Line is a peer-run program that serves as an entry point into the workforce for people living with mental illness.
“This provides a targeted employment opportunity with decent pay,” she said, adding that some 100 peer counselors have moved on from the Warm Line to “first level employment.”
San Francisco’s Warm Line is also the only such service in the state that is staffed with overnight counselors who provide a patient ear to callers on three nights out of the week.
Del Rossi said that the Warm Line is a crucial asset not only for the community it serves, but also for The City. According to Del Rossi, the service saved The City some $3.4 million in emergency services in 2016-17.
A survey of its San Francisco callers showed that 77 percent would “have had to use emergency city services” if the Warm Line had not been in place, according to Del Rossi.
Warm Line callers who are contemplating suicide are referred to the Suicide Prevention Hotline. That organization’s executive director, Eve Meyer, said that the Warm Line complements suicide prevention services by giving people who have “been grappling with mental illness for a long time” a resource to explore “new ideas about how they can best function.”
Mental health services are rarely prioritized over other health services for funding because mental health is still highly stigmatized and often “invisible,” said Meyer.
“People don’t bleed, there are no bandages,” said Meyer. “Nobody asks ‘who is responsible for you’ when you are dying in a car crash on a highway.”
Del Rossi said that the Warm Line has started a public outreach campaign that will run through March, and plans to appeal directly to “state and local” bodies for funding.
“We are also really looking to our community to support us,” she said.
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