New law can fast-track 988 success

Our country is on the verge of transformational change in how we provide care for people dealing with mental health or substance use challenges. 

Beginning Saturday, July 16, people will be able to connect with the National Suicide Prevention Lifeline through an easy-to-remember number: 988.  

This long overdue upgrade in crisis care will occur three weeks after passage of the Bipartisan Safer Communities Act, the largest investment in our nation’s mental health programs since the 1960s.  
Independently, both developments are seismic shifts that will result in better mental health and substance use treatment. Together, they represent the biggest opportunity in a generation to transform access to lifesaving services. 

The National Suicide Prevention Lifeline (soon to be the 988 Suicide & Crisis Lifeline) is a network of more than 200 state and local call centers funded by the U.S. Department of Health and Human Services (HHS) through the Substance Abuse and Mental Health Services Administration (SAMHSA) and administered by Vibrant Emotional Health. The Lifeline offers 24/7 access to trained crisis counselors who can help people experiencing suicidal, substance use and other mental health crises. 

Transitioning to 988 as the universal entry point will expand awareness of the Lifeline, which will likely increase demand for crisis services. In 2021, the Lifeline received 3.6 million calls, chats and texts, which includes over 540,000 calls routed to the Veterans Crisis Line – this number is expected to at least double within the first full year of 988 implementation. 

The July 16 transition to 988 is a great step forward and the beginning of the transformation. Just as it took many years for 911’s infrastructure to become what it is today, there is still much work to be done at the federal, state and local levels to expand crisis response capacity.  

While the Lifeline is itself a point of de-escalation and intervention, the ultimate vision for 988 is to have robust, in-person crisis services available in every community in the country. In other words, a viable alternative to calling 911 for anyone experiencing a mental health or substance use crisis. 
But there is another piece to this complicated crisis care puzzle. 

The expansion of Certified Community Behavioral Health Clinics (CCBHCs), which will receive funding through the Bipartisan Safer Communities Act, will help accelerate that timeline and supplement the ability of communities to respond to calls for help.  

Earlier this week, I joined President Biden, a bipartisan group of lawmakers and mental health and substance use care advocacy organizations to commemorate the new law. It provides a historic amount of funding to increase access to comprehensive mental health and substance use services, including millions in new funding for the Lifeline and for mental health awareness training programs. But most transformative, is the expansion of CCBHCs nationwide.  

CCBHCs are clinics that offer an expanded range of services, including 24/7 access and crisis services – to anyone who walks in the door, regardless of their ability to pay. At a minimum, CCBHCs provide prevention treatment and planning, 24/7 mobile crisis teams, suicide prevention, crisis stabilization, and extensive post-crisis care. Three out of four CCBHCs already operate a crisis call line, including through the Lifeline network.  

Originally implemented in eight (later 10) states through a Medicaid demonstration, their results are stunningly successful. CCBHCs reduce wait times and emergency room visits, reduce homelessness and expand states’ capacity to address the overdose crisis. 

Allowing all states the opportunity to apply for comprehensive CCBHC funding puts us on a fast track to fulfill the promise of 988. The increased presence of CCBHCs in communities nationwide will help ensure someone calling 988 not only has someone to talk to but someone to come to them or someplace to go, if needed.  

July 16 is just the beginning. More funding for the Lifeline is still needed and states must now act to take advantage of the CCBHC opportunity in front of them. But together, we’re well on our way to transforming mental health and substance use crisis care in America.  

Chuck Ingoglia is a licensed social worker and president and CEO of the National Council for Mental Wellbeing, a membership organization that drives policy and social change on behalf of over 3,100 mental health and substance use treatment organizations.