Friday, July 15, 2022

988 Suicide Prevention, MH Crisis Hotline Launched but Many States Unprepared

The nationwide 988 suicide prevention and mental health crisis line launched on July 16, although many states have not yet enacted legislation that would ensure there are crisis services available so 988 callers actually receive the kind of help they need.

The Federal Communications Commission approved 988 in July 2020. As of the launch date, all phone service providers were required to direct all 988 calls to the existing National Suicide Prevention Lifeline (1-800-273-TALK). This includes all telecommunications carriers and interconnected and one-way Voice over Internet Protocol (VoIP) service providers. The current Lifeline phone number is still in operation.

So far only four states—Colorado, Nevada, Virginia, and Washington—have passed comprehensive 988 legislation that includes funding to help 988 function as intended. This legislation allows them to build their local call center infrastructure, manage the increases in call volume that are expected when 988 goes live, and create new local crisis services to serve those in need. These states also included in their legislation an ongoing means of funding the new crisis services by tacking a small user fee onto each phone line, residential and commercial, as has been done for 911 for decades. Several other states have passed infrastructure laws but do not include user fees or appropriations to support mental health infrastructure.

Yet 37 states have not passed 988 legislation at all. People in those states will be able to call 988, but beyond that, little will change.

The number for crisis services switched to 988 in July, "but that’s the only thing that we can take for granted here,” Eric Rafla-Yuan, M.D., APA’s 2021 Jeanne Spurlock Congressional Fellow, told Psychiatric News. “Everything else that happens when someone calls that number is still up in the air in these states. This is why advocates are needed at the state and federal levels to obtain the resources and support to make sure the needed changes happen.”

Last month a report by the RAND Corporation revealed that many state, regional, and county behavioral health program directors felt unprepared for the transition. In a survey of 180 such directors, more than half (51%) reported that they had not been involved in the development of a strategic plan related to the launch of 988. Similarly, only 16% of respondents reported that they had helped develop a budget to support 988 operations.

APA is working with its district branches to advocate for legislation supporting 988 implementation in states that have not yet done so. In March, APA joined a coalition to drive awareness and support among state and municipal officials for the nationwide transition to the new 988 hotline.

APA urges members in states that have not passed legislation to implement 988 to contact their district branch and get involved in advocacy on this issue. For more information, contact Erin Berry Philp of APA’s Division of Government Relations. To track what your state is doing to enact legislation that will support 988, visit

For related information, see the Psychiatric News articles “988 is Coming, But Most Localities Still Not Prepared” and “AMA House Approves Publicity for 988 Awareness, Other Mental Health Measures.”

(Image: iStock/martin-dm)

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