988 launched as a mental health alternative to 911 a year ago. Here's how the hotline is working to reach more people.

It's been one year since 988 launched. How does the hotline work? (Illustration by Katie Martin for Yahoo / Photo: Getty Images)
It's been one year since 988 launched. How does the hotline work? (Illustration by Katie Martin for Yahoo / Photo: Getty Images)

Last July, a line for psychological emergencies was launched with an easy-to-remember number: 988. Calling the 988 Suicide & Crisis Lifeline (formerly the National Suicide Prevention Lifeline) connects people to crisis counselors in the U.S. who are available 24/7 via call, text or chat.

It’s not a new lifeline, but the new number makes it more convenient to connect to the 200 local call centers that were established in 2005. It differs from 911, which focuses on providing emergency medical, fire and police services.

John Draper, executive director for what was then the National Suicide Prevention Lifeline, told Yahoo Life at the time of the launch, "The overwhelming majority of the time, having a thought about suicide in no way means the person is going to kill themselves; it means that a person is having more pain than they know how to deal with. And that's why it's so important they reach out to us — so we can help them deal with that, and we can give them many other options."

Why 988 is vital now

The launch of 988 comes on the heels of increased suicide rates. According to the Centers for Disease Control and Prevention (CDC), suicide rates increased 37% between 2000-2018 and decreased 5% between 2018-2020 — but nearly returned to their peak in 2021.

Rebecca Bernert, the director and founder of the Stanford Suicide Prevention Research Laboratory, calls suicide the “tragic outcome of medical illness and a complex array of risk factors.”

“COVID intensified many of these risk factors and challenged an already strained or overburdened health care system,” she tells Yahoo Life. “This increased risk among vulnerable individuals and further restricted access to care — a central barrier to prevention and our ability to intervene.”

Why not 911?

Draper said of 988, "My hope is that we'll forget all about 911 when we think about mental health and suicidal crisis over the coming generations."

That's because one issue with calling 911 for mental health emergencies is that it could lead to involuntary mental health treatment via the emergency room or a psychiatric hospital. Although the intent in that case is to resolve an emergency situation, it can backfire: Research shows that suicide rates increase after people are discharged from a psychiatric hospital, especially those who were sent there against their will. Those who did involuntarily receive treatment were also far less likely to disclose suicidal thoughts in the future.

Ashley Peña, executive director at Mission Connection, says it may be time to contact the hotline “when you are struggling with feeling hopeless, helpless, like a burden or alone, reach out.” She recommended that people also contact 988 “immediately” if they experience thoughts of hurting themselves.

How is 988 doing in its first year?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “Almost 98% of people who call, chat or text the 988 Lifeline get the crisis support they need and do not require additional services in that moment.”

A SAMHSA press release says that calls to the Lifeline have increased significantly since the launch of 988. Text contacts through the Lifeline increased by 1,135%, chats answered increased by 141%, and calls answered increased by 46%. People were also able to get in touch with a counselor more quickly, with the average speed of response for contacts decreasing from 2 minutes and 39 seconds to 41 seconds.

One potential issue 988 may run into is funding. Currently, in-state answer rates vary widely across states, from 55% to 98%, according to data from KFF, the Henry J. Kaiser Family Foundation. Although the federal government invested in 988’s launch and implementation, moving forward, it will be the responsibility of state and local governments to fund local crisis centers. As of June 2023, 26 states have enacted legislation to help support 988.

How 988 is improving

SAMHSA is trying to ensure that 988 is as accessible to as many people as possible. In the press release honoring 988’s first anniversary, Spanish text and chat services were announced as an additional feature.

The 988 lifeline already utilizes LanguageLine Solutions to provide translation services in more than 240 additional languages. Plans are also in the works to add video phone service to better serve the deaf and hard of hearing.

The lifeline is also partnering with Vibrant Emotional Health, which offers assistance to "LGBTQI+ youth and young adults under the age of 25 who want to connect with a counselor specifically focused on meeting their needs.” During the pilot program, which was launched in September 2022, 6% of calls, 11% of chats and 15% of texts routed to the 988 Lifeline network used counselors from Vibrant Emotional Health.

If you or someone you know is experiencing suicidal thoughts, call 988.

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