988 Is the New National Mental Health Hotline

Starting July 16, anyone in the United States experiencing a mental health crisis can text or dial 988, the new National Suicide Prevention Lifeline.

The 988 number was established to address the growing suicide and mental health-related crisis care needs in the U.S., according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

In 2020, the Lifeline answered more than 2.1 million calls and over 200,000 chats. Officials said they hope the three-digit number will be easier to remember than the 1-800 number, making emergency mental health care more accessible.

Alex Stavros, chief executive officer of Embark Behavioral Health, a U.S.-based behavioral health and mental health treatment provider, said the 988 number will increase mental health awareness as it becomes more commonplace.

“One of the big issues with mental health these days is one over lack of awareness, both around the underlying feelings and around ‘how do I go get help?’” Stavros said.

When a physical emergency occurs, most people know they can call 911, but few people know what to do during a mental health crisis, Stavros added.

For example, he added, sometimes individuals who display signs of a panic attack may assume they are dealing with an alternative physical health issue. Social stigma might also keep mental health conversations in the dark, harming someone’s ability to respond to emotional distress.

“There’s general stigma around mental health where if I’m having a panic attack, or having issues with anxiety, a lot of people might not feel comfortable asking [for help],” Stavros said.

Mentioning 988 in media will help popularize the number as a tool for responding to mental health crises. “If the number becomes more visible in media, and movies, and newspapers, you’re gonna start to feel more comfortable just calling,” Stavros said.

How Does 988 Work?

Before 988, Americans could call 1-800-273-8255 or text “TALK” to number 741741 to reach the suicide prevention hotline. Stavros said the former hotline was a long number that people “had to Google.”

The new 988 number will operate similarly: It is a 24-hour hotline where people can quickly reach a trained counselor by calling or texting.

People can call the number if they have suicidal thoughts, or they can dial on behalf of a loved one whom they think is struggling. But Stavros emphasized that 988 is meant to serve people who have a mental health crisis of any kind, not limited to those who have suicidal ideations.

If someone is experiencing depressive thoughts or feeling unloved or unsafe, “those feelings are enough to call 988,” he said.

When people call 988, a trained counselor will listen and talk them through the situation. In some cases, the counselor may refer the caller to additional resources, including outpatient behavioral health services, mobile crisis teams, home-like crisis stabilization, residential treatment, or emergency stays.

Will 988 Really Help?

The current mental health crisis is “an epidemic” that demands better access to high-quality services, Stavros said. Suicide is a leading cause of death among youth ages 10 to 14 and adults 25 to 34, according to the Centers for Disease Control and Prevention (CDC).

A 2020 survey showed that the suicide rate in the U.S. has risen in the past two decades, and in recent years the U.S. has had the highest suicide death rate compared to 10 other high-income countries.

The researchers suggested solutions such as implementing a wider range of care to help people with mild to moderate mental health symptoms and integrating physical and mental care.

Studies also show that, in the U.S., many people with mental health problems lack the physical or financial resources to get the help that they need.

Improving mental health care requires efforts beyond staffing crisis call centers with well-trained responders, such as aftercare centers that can foster healing and care, Stavros said.

In a report on the necessity of 988, the Bipartisan Policy Center has called upon Congress to invest in behavioral health services, including funding to implement 988 and build out the U.S. crisis system. The think tank also advised SAMHSA to support states in filling behavioral care vacancies and to create a scorecard to assess 988’s success in different states.

The hotline is not a federal initiative, so its success would vary widely across states. With the former Lifeline, some states struggled to respond to crisis calls of their own residents. Many of them rerouted the calls out-of-state, with Nevada answering only 65% of Lifeline calls in May, Politico reported.

State-based funding for 988 likewise varies. Some states have not secured permanent funding, while others have imposed small fees on calls from cell phones. For instance, Washington state imposes a 24-cent-per-line tax—rising to 40 cents in 2023—to fund hotline services.

The hotline will be a work-in-progress, Stavros said, but the work is needed.

“We have to start somewhere,” he said. “We want to be patient. We’re going to need time to work out the kinks.”