Assessing the Rollout of the New 988 National Suicide Prevention Lifeline

On July 16th, 2022, the new 988 Suicide & Crisis Lifeline 988 dialing code for the National Suicide Prevention Lifeline was implemented. The 988 shortcut was designed to ensure easier access for anyone in a mental health crisis in need of urgent care, providing them with free, 24/7 access to trained counselors and resources.

Originally launched in 2005, the crisis line is now made up of more than 200 local centers across the United States. While the transition to the new dialing code has been underway for more than two years – to give both state and federal governments enough time to prepare for the transition –  many states did not have coordinated behavioral health services in place before the shortcut was established. The results of the launch have been mixed, with a less than smooth transition in those states who failed to properly prepare for the changeover.

As we shine a spotlight on Suicide Prevention Month this September, it feels like an appropriate time to examine how the 988 hotline has been performing, and where there’s still room for improvement. 

The New 988 Suicide & Crisis Lifeline by the Numbers

Over its 20+ year history, the National Suicide Prevention Lifeline has served more than 23 million people. While this is a remarkable achievement, the new 988 number has the potential to do so much more based on predictions of future usage.

Nationally, the hotline saw a 45% increase in call volume following the introduction of the 988 number. Although the precise usage numbers are not yet available, prior to the launch, the organization administering the new lifeline predicted that 13- 41 million individuals would be using the service every year by 2026.  

While the 988 Suicide & Crisis Lifeline is available to all Americans, response centers run by individual states are responsible for answering calls coming in from a particular area. This means that wait times and available resources can vary widely depending on where the individual in crisis is calling from. 

On a national level, one in six calls to the hotline – about 1.5 million – ended before ever reaching a counselor, leaving much room for improvement.

Here’s a sampling of what various states have been experiencing since the rollout of the 988 number. To see a comprehensive list by state, click here.

  • King County, Washington State saw a 25% uptick in calls. Not surprisingly, it is one of only four states that adopted legislation to help fund the program.  
  • Crisis Support Services of Nevada, the partner that operates the 988 crisis number in Nevada, reports they’ve experienced a 30% increase in calls. As a result, they increased their staff by 35 people in the last three months.
  • In Missouri, call volumes for the local 988 line also increased by 30%, with more than 4,000 people reaching out in July alone.
  • Wyoming has just five staff spread across two 988 call centers. They answered 111 calls in July and missed 16 because staff were occupied with other callers.
  • Pennsylvania has 13 call centers that service the state and are regularly able to meet between 80% to 90% of demand. Unfortunately, that means 10-20% of people in emotional distress were unable to reach a trained counselor.

Why is This So Important?

Suicide is the second leading cause of death for young people and the 12th leading cause of death in the United States. In 2020, there were over 1.2 million suicide attempts and 46,000 reported deaths by suicide. 

Among youth, behavioral health visits to the emergency room are rising, pointing to a worrying trend that could lead to increased suicides among the vulnerable population of youth aged 12 to 17. Based on the most recent Youth Risk Behaviors Survey from 2019, 8.9 percent of youth in grades 9-12 reported that they had made at least one suicide attempt in the past 12 months.

By making suicide prevention resources both widely available and easy to access, we can help prevent many Americans from taking their own lives or engaging in other forms of self-harm.

A Careful Watch on Trends

While the number of deaths by suicide peaked in 2018 and then declined in both 2019 and 2020, researchers are still hard at work determining how the events of the last few years – including the pandemic –  impacted suicidality and suicide attempts. And while risk factors for suicide that include depression, substance use, stress and anxiety increased in 2020, current evidence shows that suicides during this period declined overall.

Even though deaths by suicide in the United States may be on a decline, it’s critical to work hard to continue to support intervention and resources for the signs of suicidality – especially with our youth. By treating mental health concerns like depression, substance use disorder and anxiety early, and offering resources for people in crisis, we can reach people before they lose their life to suicide.

What’s Next for the Hotline

As the 988 hotline continues to receive more calls, call centers in many states are still looking for volunteers, interns, and staff that can help them ensure all callers receive a quick and compassionate response. If you have the skills and desire to help, reach out to a help center and become a volunteer. 

Hotline organizers are also hoping to offer more mobile crisis capability and the ability to rapidly dispatch teams of trained mental health experts by 2025. By facilitating the training of more alternate emergency response personnel, they can take some of the load off 911 and provide care that is more tailored to mental health emergencies. This work will require ongoing support from community organizations, state governments, and federal agencies.

To-date, the work that the 988 Suicide & Crisis Lifeline has done has been nothing short of incredible and has saved countless lives from death by suicide. The foundation for comprehensive care and resources is there, and now everything built on top will only further serve the public and help prevent suicides.

If you or someone you know may be in a mental health crisis or is considering suicide, contact the National Suicide Prevention Lifeline at 988 or call 1-800-273-8255. The Crisis Lifeline is accessible 24 hours a day in both English and Spanish.

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