The Suicide & Crisis Lifeline\u2019s 988 hotline marked its one-year milestone this month. Mental health experts say the three-digit number made help more accessible than before.<\/p>\n

The hotline was designed with the idea that people experiencing emotional distress are more comfortable reaching out for help from trained counselors than from police and other first responders through 911.<\/p>\n

Since the federally mandated crisis hotline\u2019s new number launched in July 2022, 988 has received about 4 million<\/a> calls, chats, and texts, according to a KFF report<\/a> \u2014 up 33% from the previous year. (The hotline previously used a 10-digit number, 800-273-8255, which remains active but is not promoted.)<\/p>\n

At a July press event<\/a>, policymakers and mental health experts celebrated the hotline\u2019s first-year successes as well as its additional $1 billion in funding from the Biden administration. Health and Human Services Secretary Xavier Becerra described 988 as a \u201cgodsend\u201d during taped remarks. \u201cIt may not be the solution,\u201d he said, \u201cbut it lets you touch someone who can send you on a path to where you will get the help you need.\u201d<\/p>\n

Those same advocates recognized the dark reality represented by 988\u2019s high call volume: The nation faces a mental health crisis, and there is still much work to be done.<\/p>\n

One year in, it\u2019s also clear that the 988 hotline, a network of more than 200 state and local call centers, faces challenges ahead, including public mistrust and confusion. It\u2019s also clear the hotline needs federal and state funding intervention to be sustainable.<\/p>\n

Here\u2019s a status check on where things stand:<\/p>\n

\n\t\t
\n\t\t\tEmail Sign-Up\t\t<\/a>
\n\t<\/h4>\n
\n\t\tSubscribe to KFF Health News’ free Morning Briefing.\t<\/p>\n<\/div>\n
What Worked?<\/strong><\/p>\n
The original 1-800 national mental health crisis hotline has operated since 2005. The huge increase in calls to 988 compared with those to the 1-800 number in just a year is likely linked to the simplicity of the three-digit code, said Adrienne Breidenstine<\/a>, vice president of policy and communications at Behavioral Health System in Baltimore. \u201cPeople are remembering it easily,\u201d she told KFF Health News.<\/p>\n
According to a survey by NAMI and IPSOS<\/a> conducted in June, 63% of Americans had heard of 988, and those ages 18 to 29 were most aware. Additionally, the survey found that LGBTQ+ people were twice as likely to be familiar with 988 as people who don\u2019t identify as LGBTQ+.<\/p>\n
The 988 hotline provides 24\/7 support for people in suicidal crisis or other kinds of emotional distress, Breidenstine said. \u201cThey can be calling if they really just had a bad day,\u201d she said. \u201cWe also get some calls from people experiencing postpartum depression.\u201d Callers are directed to a menu of options to choose which kind of service would best help them, including a veterans\u2019 line.<\/p>\n
As it launched, mental health experts worried about the hotline\u2019s ability to keep up with demand. But it appears to be growing into its position. \u201cDespite a huge increase of demand on the system, it\u2019s been holding up, and it\u2019s been holding up exceptionally well,\u201d Hannah Wesolowski<\/a>, chief advocacy officer at the National Alliance on Mental Illness<\/a>, told KFF Health News. It now takes an average of 35 seconds<\/a> for someone reaching out to 988 \u2014 by calling or texting \u2014 to reach a counselor, according to data from the Substance Abuse and Mental Health Services Administration. A year ago, that average was one minute and 20 seconds.<\/p>\n
Wesolowski said one of the biggest surprises with the launch was the frequency of text-message traffic. In November 2022, the Federal Communications Commission voted to require 988 to be texting-friendly.<\/p>\n
In May, according to SAMHSA, 988 received about 71,000 texts nationwide with a 99% response rate, compared with 8,300 texts in May 2022 with an 82% response rate.<\/p>\n
This month, HHS announced the addition of Spanish<\/a> text and chat services to 988.<\/p>\n
Challenges Ahead<\/strong><\/p>\n
More than half of Americans have heard of 988, but only a small fraction understand how the hotline operates. According to NAMI\u2019s survey, only 17% of people who responded said they were \u201cvery\/somewhat familiar\u201d with the hotline.<\/p>\n
Most people think that by calling 988, like 911, emergency services will automatically head their way, the survey found. Currently, 988 does not use geolocation, meaning call centers don\u2019t automatically receive information about callers\u2019 locations. Vibrant Emotional Health<\/a>, which operates the hotline, is working to incorporate geo-routing into the system, which would help identify callers\u2019 regions \u2014 but not exact locations \u2014 making it possible to connect them to local counseling groups and other mental health services.<\/p>\n
But incorporating geo-routing into the hotline isn\u2019t without controversy. When it launched, people responded on social media<\/a> with warnings that calling 988 brought a heightened risk for police involvement and involuntary treatment at psychiatric hospitals. \u201cBased on the trauma that so many people in the mental health community have long experienced when they\u2019ve been in crisis, those assumptions are very understandable,\u201d Wesolowski said.<\/p>\n
Fewer than 2% of calls end up involving law enforcement, she said, and most are de-escalated over the phone.<\/p>\n
\u201cThe vast majority of people think that an in-person response is going to happen whenever you call \u2014 and that\u2019s just simply not true,\u201d Wesolowski said.<\/p>\n
Another challenge mental health advocates face is informing older adults about 988, especially veterans, who are at higher risk of having suicidal ideations. Americans ages 50 to 64 had the lowest awareness rate of 988 \u2014 at 11% \u2014 among all age groups, according to NAMI\u2019s survey.<\/p>\n
This is a telling sign of how older generations are less willing to discuss and admit to mental health struggles, Wesolowski said. \u201cYoung people are just more willing to be open about that, so I think that breaking down that stigma across all age groups is absolutely vital, and we have a lot of work to do in that space.\u201d<\/p>\n
Is 988 Sustainable?<\/strong><\/p>\n
Since the hotline launched, it has been dependent on federal grants and annual appropriations. A gush of funding flowed when 988 launched, \u201cbut those annual appropriations are something you have to keep going back for year after year, so the sustainability aspect is a little more fraught,\u201d Wesolowski said.<\/p>\n
This is where Congress and state legislatures come in.<\/p>\n
Mental health leaders hope to push legislation that allows 988 to be funded the same way 911 is nationwide. The Wireless Communications and Public Safety Act of 1999<\/a> mandated 911 to be the country\u2019s universal emergency number, and ever since, users have automatically been charged \u2014 an average of about a dollar a month<\/a> \u2014 on their monthly phone bills to fund it. Six states have imposed a similar tax for 988, and two states \u2014 Delaware<\/a> and Oregon<\/a> \u2014 have bills for this tax on their governor\u2019s desks.<\/p>\n
It\u2019s under the FCC\u2019s power to levy a nationwide tax, but the federal agency hasn\u2019t done so yet.<\/p>\n
\n
\n\t\t\t\t\t\t\t\t\t\t\tColleen DeGuzman: <\/span>
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t cdeguzman@kff.org<\/a>,\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t@acolleendg<\/a>\n\t\t\t\t\t\t\t\t\t<\/p>\n<\/aside>\n
\n
\n
\n\t\t\t\tRelated Topics\t\t\t<\/h3>\n
\t\t\t\t
\n\t\t\tContact Us\t\t<\/a>
\n\t\t
\n\t\t\tSubmit a Story Tip\t\t<\/a>\n\t<\/div>\n<\/section><\/div>\n