988: New Suicide Prevention Hotline Launches This July

The 911 For Mental Health Crises

Rolling out this summer, instead of dialing 911 for assistance for a mental health crisis or emergency, individuals can call the hotline number 988. This easy-to-remember dialing code will direct callers to the National Suicide Prevention Lifeline, where trained counselors will aid callers and potentially dispatch specially trained responders if needed. The law that created this new line passed through Congress on Oct. 17, 2020, and reduced the National Suicide Prevention Lifeline’s 10-digit phone number to 3. However, the current Lifeline phone number, 1-800-273-8255, will remain available after 988’s debut. 

Since 2005, the current suicide lifeline has received over 20 million calls from people in distress looking for support, with nearly 2.4 million calls occurring in 2020. Federal health officials suggest that as many as 12 million more calls will come through with the hotline’s debut this summer. Currently, there are 180 crisis call centers scattered across the US. Each center is connected to community resources, hospitals, social services, and first responders. 

If the 988 crisis line is effectively resourced and promoted, it will be able to reduce healthcare spending with cost-effective, early intervention. Additionally, it will reduce the use of law enforcement, public health, and other safety resources. This reduction in spending would be accomplished by redirecting calls that would typically go to 911 to 988. The crisis line will also aid in meeting the growing needs for mental health resources and help reduce stigma toward those seeking and receiving mental healthcare. 

Why 988 Is Needed: Mental Health In America

With 1 in 5 people above the age of 12 having a mental health condition and the suicide rate in the US climbing 30% since 1999, having crisis intervention only 3 digits away can help millions access the help they need, even if that is just a listening ear. Research by the National Association of State Mental Health Program Directors even suggests that for 80% of callers, the emotional support provided by the lifeline will be enough. 

While rising suicide rates are troubling, according to research from Harvard University, 9 out of 10 individuals who attempt suicide will go on to live their lives. This long-term survival rate aligns with the observation that suicidal crises are often “short-lived,” even when chronic risk factors are attributed to these crises. This statistic highlights how crucial it is that individuals receive support and treatment for their mental health because the likelihood that they can continue to live fulfilling lives is high. 

When Calling 911 Causes More Harm Than Good

When 911 operators receive a call about someone experiencing a mental health crisis or emergency, the first responders dispatched will likely be police officers. However, a fear that many individuals experiencing a mental health crisis face when contemplating dialing 911 is if they will go to jail or not, so much so that many choose not to make that call. In fact, over 2 million individuals with a mental illness are “booked” into the nation’s prisons and jails, according to Hannah Wesolowski, who directs policy for the National Alliance on Mental Illness. Advocates for 988 hope that the hotline crisis will reduce the number of individuals who end up incarcerated by not dispatching law enforcement. 

Ranging levels of mental health training across police departments can dictate how these delicate and often tumultuous situations will go. Some individuals will be admitted to a hospital, some may end up in handcuffs, and some may end up in a worse situation. For example, the Washington Post reports that police have fatally shot more than 1,500 people with mental illness in just the past 6 years. Some communities are reevaluating who will respond to mental health emergencies to avoid these situations. For example, some cities, like Chicago, are staffing mobile crisis responders with social workers and paramedics, while others team up police officers with mental health workers.  

Mental Health Crisis Versus Mental Health Emergency

A mental health crisis includes any non-life-threatening situation where an individual may display signs of erratic or unusual behavior, emotional instability, or thoughts of suicide or harming others. Additional examples of a mental health crisis include but are not limited to:

• Alcohol or substance abuse
• Talking about threatening behavior
• Self-injury, but not needing immediate medical attention
• Emotionally distraught, very depressed, angry, or anxious

In contrast, a mental health emergency involves a potentially life-threatening situation where an individual may be severely disoriented, actively harming themselves or others, or unable to function or care for themselves. Additional examples of a mental health emergency include:

• Acting on a suicide threat
• Homicidal or threatening behavior
• Severely impaired by drugs or alcohol
• Highly erratic or unusual behavior

Funding For 988

In December, the Department of Health and Human Services committed nearly $300 million to revamp and expand resources for the National Suicide Prevention Lifeline and its local call centers. Additional funding for the crisis call centers and the crisis intervention teams responding to mental health emergencies and crises reported to 988 is to be determined by states and cities. When Congress passed the 988 legislation, states were given the authority to implement a “988 fee,” similar to the current 911 fee, which adds a fee onto people’s cell phone bills to cover these services. This current fee equates to about a dollar every month to support 911 services. In 2018, the fees for 911 generated over $2.5 billion to support the crisis service, so many advocates and health care officials are hopeful that 988 can acquire similar investments for the hotline crisis. However, as it stands, only 4 states have passed similar legislation for 988 funding, so it is still to be determined how the National Suicide Prevention Lifeline will acquire funding to implement its services.