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3 Ways for Providers to Improve 988 in Year 2
As we head toward 2024, we enter a time of reflection where we look back on what we’ve accomplished and what we look forward to in the new year. Particularly, 2023 was noteworthy as we celebrated the first full year since the debut of the 988 Suicide & Crisis Lifeline. It was a successful start for 988 with nearly 5 million calls, texts, and chats, helping people in crisis and their loved ones receive the services they need. Nevertheless, there’s always reason to look ahead and seek improvement in the next year to overcome the stigma that continues to stifle our national discourse on mental health.
Reason to be Hopeful
First, the good news: In our increasingly complex society, the bipartisan efforts that joined together around 988 are rare. Its very existence represents a significant step forward.
As Editor-in-Chief of The Hill, Bob Cusack, noted while moderating “Dialing Into Mental Health,” a panel at The National Press Club on the first anniversary of 988, “I’ve been covering government since 1995. I honestly think this [988] is one of the best things government has ever done.”
It’s important to note that $1 billion in federal funding has been put into the crisis lifeline and the independently run crisis centers within the 988 network. In time, those in emotional distress or suicidal crisis who reach out to 988 for assistance will be connected not just to crisis intervention-trained operators, but ones in their area with access to nearby resources.
More importantly, 988 has had the positive impact we all hoped for. The transition from the former 1-800-273-8255 crisis number to an easy-to-remember mental health equivalent of 911 had the desired effect. In comparison, when the former National Suicide Prevention Lifeline launched in 2005, it received only 46,000 calls in its first year.
Additionally, Americans experiencing a mental health crisis finally had access to a network of 200 crisis centers designed to deliver the type of emergency mental health response that can de-escalate a mental health issue.
One can also argue that 988’s very existence marks a significant step forward in efforts to eliminate the stigma so long associated with mental health issues. Clearly, these are reasons to celebrate and applaud those who made 988 possible.
Keys to Year Ahead: Sufficient Resources and More Awareness
When the Consolidated Appropriations Act was passed in December 2022, it included a number of provisions to improve 988’s coordination, standardization, and evaluation. However, long-term sustainable funding to provide sufficient crisis response varies state-by-state and has led to mixed sentiments about the lifeline. While resourcing continues to be an uphill climb, states are already working on innovative solutions including telecom fee legislation or building out their behavioral health crisis continuum to connect those in crisis with additional services.
Still, the most crucial obstacle is lack of awareness. A recent survey released by Pew Charitable Trusts found that only about 13% of people “have knowledge of both 988’s existence and purpose.” A survey by NAMI came to a similar conclusion. Only 17% of Americans say they are “somewhat familiar with the lifeline” and only 4% say they are “very familiar with it.”
Based on these findings, it will be vital for everyone in our community—including those experiencing a mental health crisis, their loved ones, practitioners, and officials shaping public policy—to keep the following 3 imperatives in mind in the year to come:
- Continue to spread the word. While a federal awareness campaign is in the works, it falls on all of us to broadly promote 988. Just as widespread efforts made 911 synonymous with getting help from first responders, nationwide familiarity with 988 will only be achieved if we all pitch in. The 988 Partner Toolkit from the Substance Abuse and Mental Health Services Administration offers materials and guidance everyone can use to promote 988 within their own organization, on social media, and in conversations. We must also continually stress that 988 is not just for those contemplating suicide. It is for anyone experiencing a mental health or substance use crisis.
- Advocate for peer groups. Marginalized and underrepresented communities often lack support for mental health issues, including suicide ideation and substance abuse that 988 is designed to address. Fortunately, efforts are underway to ensure that those who contact 988 experience the solace peers provide – Washington State’s Native and Strong Lifeline for Native Americans, the Veteran’s Crisis Line (988 then press 1), and Vibrant Emotional Health’s pilot for LGBTQI+ youth are examples of how peer support can make 988 even stronger. We can build on these efforts by looking for opportunities to support and apply our own experience with our peers.
- Create trust by educating callers on what to expect. NAMI’s survey also found that 58% “somewhat trust” that 988 will address their needs. We can build on this—and address concerns many people have when divulging mental health issues—by providing education on what callers should expect when dialing, chatting, or texting 988. Finally, we must stress that 988 is anonymous and that in some areas, local resources may not be available just yet, but will be in the future as the network receives additional funding.
The 988 Suicide and Crisis Lifeline has the potential to help millions of Americans live healthier and happier lives. It is our job to help spread the word and convey the powerful message that has long eluded efforts to provide mental health services: You are not alone. Help from someone who cares is just 3 numbers away.
Andrew Sassani, MD, is a vice president at Magellan Healthcare, and its chief medical officer for California overseeing mental health services.
The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.
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