9-8-8 Mental Health Helpline Rolls Out Nationally

Beginning July 16, 2022, anyone experiencing a mental health crisis can call a new 24-hour hotline, and if needed, a mobile crisis team will be immediately dispatched to help them.

The 9-8-8 number replaces the old number, 800-273-8255, and is expected to be easier to remember and serve as the 9-1-1 equivalent for mental health emergencies.

Jon Krohmer, MD, recently retired director of the National Highway Traffic Safety Administration’s Office of EMS, updated attendees of the Gathering of Eagles conference on the implications of the 9-8-8 system June 16, 2022 in Hollywood, Florida.

The Lifeline is a national network of over 180 local, independent, and state-funded crisis centers equipped to help people in emotional distress or experiencing a suicidal crisis, explained Krohmer. There are non-Lifeline local crisis centers throughout the country in addition to Lifeline ones.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead federal agency on the 9-8-8 initiative, in partnership with the Federal Communications Commission and Department of Veterans Affairs.

Not Prepared

Though it’s coming out in less than a month, few hands in the audience went up when Krohmer asked whether anyone was familiar with the 9-8-8 initiative and how 9-1-1 will coordinate with it.

“This is going to significantly impact all of us,” Krohmer said, adding that the EMS system is not adequately prepared for it.

“There are going to be a lot of hiccups,” he said.

Beginning July 16 calls made to the 9-8-8 line will be directed to a local crisis center based on the area of the caller. If the local center does not answer within a set time requirement, the call is rolled up to a national crisis line.

Historically and currently, 9-1-1 and crisis centers operate in parallel missions with little collaboration, explained Krohmer. No Lifeline or local crisis hotline has location information on callers. Currently the caller’s area code may be used to identify a PSAP to notify when an emergent response is needed, but this won't help if the caller is away from their home area code.

Also, there is no transfer to 9-1-1 of the actual 9-8-8 call in most settings, said Krohmer, unless the crisis center is colocated with the 9-1-1 center.

Crawford Mechem, MD, EMS medical director for the Philadelphia Fire Department, added other issues and potential barriers to implementation. For one, Philadelphia’s response to emergencies is heavily 9-1-1 based, Mechem said, and circumventing the 9-1-1 system on behavioral crisis calls runs the risk of not dispatching police or EMS when they are needed. All entities offering emergency services must collaborate to avoid redundancy, gaps in care, and responses to unsafe scenes, Mechem stressed.

“These are some of the hiccups that have not been addressed,” Krohmer said, adding there is strong collaboration in some communities but not others. “We’ve got a number of things to work out.”