988 is officially live — here’s what people should know

With last week’s official launch of 988, the number to contact the National Suicide Prevention Lifeline, individuals seeking help for suicide prevention or a mental health crisis will be quickly connected to a trained crisis counselor who can provide support over the phone and dispatch a mobile response unit, if necessary, to take that person to a place where they can get more help. 

At least, that’s what is supposed to happen.

Unfortunately, despite knowing this day was coming for nearly two years, many states remain woefully unprepared for the anticipated increase in emergency calls. Perhaps even worse, over three-quarters of Americans polled at the end of May claimed they had never heard of the hotline. This is a recipe for disaster, and unless state leaders immediately make the necessary investments to properly fund and publicize 988’s services, the hotline’s efficacy — as well as the public’s trust — will be dramatically undermined. 

988 is the product of the National Suicide Hotline Designation Act of 2020, a federal law aimed at creating an easy to remember, easy to access pathway to mental health care when people need it most. Essentially, it is designed to function as the equivalent to the 911 emergency number, but for mental health emergencies rather than medical ones. 

In light of this hotline’s rollout, it’s imperative that people who need to contact 988 understand how it helps to facilitate an effective crisis response system and to have realistic expectations when they reach out. This is just the beginning — good things take time to get right. 

First, people in crisis need someone to talk to. Though most people who contact 988 should be able to get through to a trained crisis responder who can offer assistance, depending on where you live and your call center, you may be required to spend time in a queue while call centers get up to speed with staffing.

Second, an in-person response should be available for mobilization if necessary. According to National Suicide Prevention Hotline data, a majority of crisis calls can be resolved remotely; less than 2 percent require the dispatch of emergency services. Ideally, mobile crisis teams with trained mental health professionals should respond to 988 calls, but for now most callers may still get a response from law enforcement and/or EMTs. 

Third, those experiencing extreme mental health or substance use crises should be transported safely and expeditiously to a facility that can properly treat, observe and care for them. If those facilities are not available, individuals in crisis who call 988 may be taken to hospitals or emergency rooms to receive immediate care.

Beyond simply providing a shorter number to the National Suicide Prevention Lifeline, 988 has the potential to revolutionize mental health care. An effective, fully-funded system would knock down barriers, ensuring equitable care is available to everyone, regardless of background or socioeconomic status. Acting as a kind of Trojan horse, 988’s implementation can serve to more broadly address America’s worsening mental health crisis. 

The numbers make it clear that help can’t come soon enough. Rates of anxiety and depression are skyrocketing among Americans of all ages and backgrounds. Data compiled from 2020 showed the highest number of deaths of despair — from alcohol, drug use and suicide — in the United States in a single year on record. 

While the purpose of 988 is commendable, the logistics of its mandated nationwide launch have been hampered by an inconsistent approach from individual states’ leaders and a lack of consistent federal funding. Despite being required to do so, as of late June, a number of states did not yet have new legislation regarding the funding or staffing of 988.

Yet, it’s not too late for state and community leaders to right the ship by building out a robust continuum of mental health and crisis care. Yes, a sufficient number of counselors and responders must be trained to help in an emergency. But it’s equally critical that communities invest in both preventative care, such as public education and mental health screenings, and post-crisis care to help its members remain stabilized. 

This is not the time to lose faith and dwell on the shortcomings of 988’s flawed rollout. This is the beginning of an important new phase in mental health care — one in which communities are equipped to handle the mental health needs of their residents, reduce reliance on police and hospitals for mental health treatment, and get people in crisis the support they need. 

After all, 988 can — and will — save lives if given the chance.

Benjamin F. Miller, a clinical psychologist by training, is president of Well Being Trust and chair of the advisory board of Inseparable, two mental health organizations.