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“All across our country, people are hurting. They need help. The good news is that getting that help just got a lot easier… This cross-government effort has been years in the making and comes at a crucial point to help address the mental health crisis in our country, especially for our young people.”
—FCC Chairwoman Jessica Rosenworcel
The Saturday, July 15 launch of the three-digit 988 line—which will provide Americans experiencing mental health crises with access to trained counselors—could be a significant step forward for public health in the US. The product of a three-year joint effort by the U.S. Department of Health and Human Services (HHS), the Federal Communications Commission (FCC), and the U.S. Department of Veterans Affairs (VA), the 988 Suicide & Crisis Lifeline will eventually supersede the 10-digit National Suicide Prevention Lifeline (1-800-273-8255).
Federal backing for the 10-digit Lifeline, which launched in 2005, had been somewhat anemic until four years ago. In 2018, Congress finally agreed to kick in some serious funding to revamp the system for a culture in which the telephone has become a tertiary communication option for many citizens under the age of 40. In July 2020, while the country was agitatedly debating the merits of protective facial masks and the danger of fomites, President Trump signed the National Suicide Hotline Designation Act into law. It is hoped that the new 988 system will provide a resource to reduce instances of drug overdoses (which increased by 31% between 2019 and 2020) as well as suicide (the 12th ranked cause of death in 2020) and other mental health crises.
For anyone who feels so overwhelmed “that it impairs their ability to get through the day”… if they are willing to wait on hold (in most states)
Unlike 911 systems, which lack resources for training dispatchers in the handling of behavioral health crises, the 988 Suicide & Crisis Lifeline encompasses a network of some 200 state and local call centers supported by HHS through the Substance Abuse and Mental Health Services Administration (SAMHSA).
The new line offers a more direct, robust, and flexible path for people seeking assistance with mental health issues. John Draper, executive director for the National Suicide Prevention Lifeline, told Yahoo Life this week that 988 is for anyone who is grappling with a debilitating emotional storm (or is worried about a loved one in such a situation) and has much broader applications than the 911 “what is your emergency?” line. As Draper describes it, 988 is a resource anyone can text or call when they feel “so overwhelmed by their experience [and] their feelings that it impairs their ability to get through the day.” It covers virtually any mental health crisis and people are urged to call well before they reach a gun/pills on the table situation.
Health and Human Services Secretary Xavier Becerra sees the new line as an important step in addressing the mental health crisis gripping the country in the wake of the two most stressful years in most Americans’ living memory: “988 is more than a number, it is a message: we’re there for you. Through this and other actions, we are treating mental health as a priority and putting crisis care in reach for more Americans. There is still much work to do. But what matters is that we’re launching, 988 will be live. We are looking to every governor and every state in the nation to do their part to make this a long-term success.”
However, it will take time to recover from 13 years of not-very-enthusiastic government support. Many states have not yet allocated funds for the 988 program and only 20 have even partial legislation in the works to implement the line. Draper says they are prepared for this: “In the event that [a local call center] is unable to answer the call because they lack the resources, we are providing at the national level backup services… So in the event that the local centers are unable to take those calls or those chats or texts, somebody will be there to take them. It’s a matter of holding on, maybe for just a little bit longer, and we’ll answer.”
“Recent investments made in the Lifeline have already resulted in more calls, chats, and texts answered even as volume has increased, but we know that too many people are still experiencing a suicidal crisis or mental health-related distress without the support they need,” said Miriam E. Delphin-Rittmon, Ph.D., the HHS Assistant Secretary for Mental Health and Substance Use and leader of SAMHSA. “Over time, the vision for 988 is to have additional crisis services available in communities across the country, much the way emergency medical services work. The success of 988 depends on our continued partnership with states, as the federal government cannot do this alone. We urge states and territories to join us and invest further in answering the call to transform our crisis care response nationwide.”
Vets’ fingers have a shorter walk
VA administers the Veterans Crisis Line through the Lifeline’s national network. Because of VA’s partnership with the Lifeline, the Veterans Crisis Line is affected by this transition to a new number. Veterans and their loved ones can now Dial 988 then Press 1 to reach the Veterans Crisis Line.
“988 has been a long time coming and will serve as a critical resource during a crisis when every second counts. The new, shorter number will help ensure Veterans have easier access to the Veterans Crisis Line,” said VA Secretary Denis McDonough. “This launch is a whole-of-government approach in line with the President’s call to prioritize mental health by strengthening access to crisis services, and preventing Veteran suicide, our top clinical priority.”
A bull market for a mental health crisis line
In 2021, the Lifeline received 3.6 million calls, chats, and texts. That number is expected to at least double within the first full year after the 988 transition.
[Click here to open a view with a full-page version of this chart.]
The United States had one death by suicide every 11 minutes in 2020, according to the Centers for Disease Control and Prevention. Suicide was the second leading cause of death for young people aged 10-14 and 25-34. From April 2020 to 2021, more than 100,000 people died from drug overdoses. Studies have shown that after speaking with a trained crisis counselor, most Lifeline callers are significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful.
The 10-digit Lifeline number 1-800-273-TALK (8255) will continue to be operational after July 16 and will route calls to 988 indefinitely. Veterans, service members, and their families can also still reach the Veterans Crisis Line with the current phone number 1-800-273-8255 and Press 1, or by chat or text to 838255.
More information on 988 is available at www.samhsa.gov/988 and https://www.samhsa.gov/find-help/988/faqs.