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EDITOR’S NOTE: Physicians, providers, and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in "Healthwise Maui," which appears in The Maui News. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana'i Community Hospital and accepts all patients. To submit a question, go to mauihealth.org/healthwise.
Q: What actually happens when you call the 988 Crisis Lifeline? How do you know when it's time to call?
Giulietta Swenson, PsyD, Maui Memorial Medical Center Inpatient Behavioral Health, Pacific Permanente Group: Many people hesitate to call a crisis hotline because they're unsure what will happen on the other end. The truth is that calling or texting 988, the Suicide & Crisis Lifeline, is a simple, confidential way to connect with support when you're struggling.
When you call or text 988, you'll be connected with a trained crisis counselor. The conversation typically begins with a few questions to help determine your immediate safety and understand what kind of support you need. If there is no immediate danger, the counselor will invite you to share what's been going on.
Their role is not to judge you, lecture you, or tell you what to do. Instead, they will listen with compassion, help you process what you're experiencing, and work with you to identify helpful next steps. They may also connect you with local resources or services that fit your specific situation.
A common concern is privacy. Calls and texts to 988 are free and confidential. You do not have to provide personal information about who you are or where you are in order to receive support. The primary goal is to help you stay safe and feel supported. In situations where there is an immediate threat to someone’s safety, emergency services may need to be contacted. Otherwise, you remain in control of the conversation and can end it when you feel ready.
It's important to know that you do not have to wait until a situation becomes unbearable before reaching out. Consider calling or texting 988 if you or someone you know is:
• Thinking about suicide, self-harm, or wishing they were dead
• Experiencing overwhelming emotional distress
• Feeling trapped, hopeless, or in unbearable emotional pain
• Struggling with alcohol or substance use
• Withdrawing from family, friends, or daily activities
• Feeling lost and unsure where to turn for help
You can contact 988 on behalf of yourself or someone else who may be struggling.
While the 988 Lifeline provides crisis support, some situations require immediate emergency assistance. If you believe you or another person is in immediate danger, or if you feel unable to prevent yourself from harming yourself or someone else, call 911 right away.
Remember: reaching out for help is a sign of strength, not weakness. No problem is too small to discuss, and support is available 24 hours a day, seven days a week.
Q: How much time do you really have to get to the hospital after stroke symptoms start?
Casi Saranillio, RN, Stroke Program Manager, Maui Health: Every minute that passes after a stroke begins, nearly 1.9 million brain cells are lost. That's why we say "Time is Brain." Stroke is a medical emergency, and every minute saved can preserve brain function and improve recovery.
Although some stroke treatments can be provided several hours after symptoms begin, the goal is not to arrive within hours, the goal is to arrive immediately. The sooner treatment is started, the more brain tissue can be saved and the better the chance for a positive outcome.
Stroke symptoms are typically sudden and cannot be explained by another known medical condition. We encourage everyone to remember the acronym BE FAST:
Balance - Sudden loss of balance or coordination
Eyes - Sudden vision loss or double vision
Face - One side of the face droops or appears uneven
Arms - Sudden weakness or numbness, usually affecting one side of the body
Speech - Slurred speech, difficulty speaking, or difficulty understanding speech
Time - Time to call 9-1-1 immediately
Many stroke symptoms affect only one side of the body because a stroke often impacts one side of the brain. Sudden weakness, numbness, facial droop, vision changes, difficulty speaking, severe dizziness, or a sudden severe headache should never be ignored.
Today's stroke treatments can be remarkably effective. In some cases, when patients arrive quickly enough, hospitals can administer treatments that restore blood flow to the brain and may dramatically improve, or even completely eliminate, stroke symptoms. However, these treatments are highly time-sensitive and are only available to eligible patients who seek emergency care at once.
If you or someone around you experiences sudden stroke symptoms, do not drive yourself to the hospital and do not wait to see if the symptoms improve. Call 9-1-1 immediately. Fast recognition, rapid EMS activation, and prompt treatment save brain cells, reduce disability, and save lives.