Kathleen M. Pike, PhD


Urgent and sometimes terrifying, time is of the essence when it comes to a mental health crisis. People need to know they are not alone and need to know where to turn for help. Launched last month, 988 is the new Suicide & Crisis Lifeline in the United States. Easy to remember, 988 is the 911 for suicide and mental health concerns, delivering appropriate and effective support to anyone and everyone across the country when needed.

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With more than 240 million calls per year to 911 for a whole host of issues – an average of 7.6 calls every second – 988 will better serve callers whose needs are specifically related to mental health. It is anticipated that 988 will receive more than seven million calls, chats, and texts within the first full year of its launch.

1. What is 988? It is the newly-launched official three-digit number people can dial from anywhere in the United States to be connected to the national suicide and mental health hotline. Previously known as the Suicide Prevention Lifeline, 988 Suicide & Crisis Lifeline provides free, confidential support 24/7. 988 is a network of more than 200 call centers around the country. In a joint effort by the Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), the Department of Veteran Affairs, and administered by the non-profit organization Vibrant Emotional Health, people can call, text, and chat to connect with counselors specially trained to support people at times of emotional crisis. 988 is the first network of local and national services that are systematically connected across the US.

2. What about the Suicide Prevention Lifeline number? Launched in 2005, the 10-digit number for the Suicide Prevention Lifeline (800-273-8255) still works. Either number will get callers to the same services. Establishing 988 makes the emergency number for mental health and substance use concerns easier to remember. It also makes clear that 988 is not exclusively for people who are suicidal (which was also true for the  Suicide Prevention Lifeline despite its name). It is for anyone seeking support and guidance for a mental health or substance use crisis, whether for themselves or loved ones. 

3. What about 911? The vast majority of calls to 911 have nothing to do with crime or violence, thus a police response is not necessary or, in many cases, helpful. A study of 15.6 million 911 calls made between January 2019 and November 2021 from the police departments of nine cities found that in seven of the cities (Baltimore, Burlington, Cincinnati, Hartford, New Orleans, New York, and Tucson) less than 3 percent of calls involved violence that posed imminent threat or danger to others. In two cities (Detroit and Seattle), 7 percent of the calls involved violent crimes. Although many police forces are training their teams to provide appropriate services to callers who have mental health and substance use crises, establishing civilian teams that are specially trained is an essential step towards decriminalizing mental illness, reducing the risk of re-traumatization, and getting people to appropriate care most effectively.

4. How does 988 work? The 988 Lifeline supports people experiencing a suicidal crisis or mental health-related distress and assists people worried about someone in crisis. According to SAMHSA, fewer than 2 percent of 988 calls require additional emergency services. If a dispatcher or counselor determines that a safety or health issue warrants additional support, they will enlist law enforcement and/or emergency medical services for support. Such situations include when a suicide attempt is in progress or someone needs urgent medical care, for example. The central aim is to provide care and stabilization in the least restrictive manner. 

5. What will it take for 988 to succeed? 988 will fill a critical gap in mental health crisis care, decreasing adverse events and reducing suicides. In 2018, the previous administration signed the National Suicide Hotline Designation Act, making 988 a national reality. The current administration has increased funding. In our hyper-polarized society, 988 has widespread support from all sectors of society. Such support will be critical for 988 to deliver on its promise. 988 is just getting launched, and there are significant concerns about training, capacity, and long-term funding. Still, demonstration projects indicate that when mental health professionals serve as first responders to mental health crises, we reduce incarceration and hospitalization rates and improve overall health outcomes.

No one wants to be in a situation that requires calling 988. But a much worse scenario is experiencing a mental health crisis and not having 988 to call. 988 is a major step forward in reimagining mental health care at times of crisis. More volunteers and paid employees are needed. Consider getting involved. More information can be found at 988lifeline.org.

Picture of Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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