As 988 crisis line marks one year, many Americans still don’t know about it

More than 4 million people have called the 988 Suicide and Crisis Lifeline since it launched last July. But a new poll from the National Alliance on Mental Illness (NAMI) found that 82 percent of Americans remain unaware of the 911 alternative for mental health crises.

The Hill hosted a discussion with lawmakers, mental health experts and advocates Thursday about increasing awareness and capacity of the hotline. 

Thus far, the Biden-Harris administration has invested $1 billion in the effort, much of which has gone into hiring crisis counselors and developing systems of support at the local and state levels, Department of Health and Human Services officials told CNN. Now, Hannah Wesolowski, NAMI’s chief advocacy officer, told The Hill’s Bob Cusack she is looking for funding dedicated to raising awareness.

“One point that often gets lost is that there has not been appropriations for an awareness campaign, so we can’t be surprised that awareness is low when we haven’t really invested in that wide-scale research and promotion,” Wesolowski said.

Wesolowski compared the potential campaign to smoking cessation campaigns, which required around $50 million to $100 million to “save lives” — though she said anything would have an impact.  

Thursday’s event, “Dialing into Mental Health: One Year of the 988 Suicide & Crisis Lifeline,” was sponsored by NAMI. 

Aside from raising awareness, policymakers and partners also need to build trust in the hotline, said Adrienne Breidenstine, vice president of policy and communication at Behavioral Health System Baltimore. 

In central Maryland, the system launched a 988 ambassadors program in which they work directly with trusted leaders in the community, aiming to create a “snowball effect” to spread the word that the hotline is a safe and reliable resource.

Even then, Breidenstine said it will probably take 10 to 20 years for a “culture shift” in which everyone knows they don’t have to call 911 when it comes to mental health.

While Baltimore has made some gains — decreasing their 988 response time to 10 seconds — Wesolowski said consistency across the country would be a challenge. 

“It’s going to be hard to tell people what to expect when they contact 988,” Wesolowski said. “For some people, the only in-person response that might be available might be police or EMS, it might not be a mobile crisis team made up of behavioral health responders.”

Sen. Catherine Cortez Masto (D-Nev.) added that it’s also important to bolster mental health services available to people after they make the call. 

The Behavioral Health Crisis Services Expansion Act, which she co-sponsored, would help facilitate the nationwide adoption of programs and services, such as behavioral health urgent care facilities and 23-hour crisis stabilization and observation beds.

“It’s one thing to have the 988 hotline but if you don’t have services to put them into, what do you do?” Cortez Masto said. “That, to me, is the essential part of all of this.”

Washington state House Speaker Pro Tempore Tina Orwall (D) shared a story about the potential impact of the crisis line. 

Having just lost his wife to cancer and struggling with PTSD, a veteran had remembered seeing something about calling 988 for mental health crises, so he picked up the phone and dialed. He recalled the woman on the other end speaking in a soft tone and telling him everything he needed to hear. 

“She’ll never know that she saved my life, but she did,” the veteran told Orwall.