Our Work Isn't Over: The New 988 Lifeline Still Needs Your Support

This past July, suicide prevention and mental health advocates made huge progress for crisis care in the U.S. After a decade-long effort, they succeeded in launching the 988 Suicide and Crisis Lifeline nationwide. The new 988 Lifeline (previously called the National Suicide Prevention Lifeline) has a memorable, three-digit phone number that has made it easier for people to reach a crisis center with just a call or text. The Lifeline operates 24/7 to offer free, confidential support for crises related to suicidal thoughts and behaviors, mental health, and substance use. This is a crucial resource for suicide prevention efforts.

The American Foundation for Suicide Prevention and our nationwide network of volunteer Field Advocates are proud of the role we played in supporting legislation that helped ensure the launch of 988. But 988's launch is only the beginning of achieving successful crisis care in communities across the nation. Challenges remain to make the Lifeline successful and accessible for all. Now that the Lifeline has a wider reach, its network of crisis centers also have growing demand. These centers need our support. Advocates, partners, and policymakers must take action to achieve the promise of 988. Luckily, there are simple ways we can all get involved.

Here's what you need to know: When 988 was made available nationwide, the call-center operator Vibrant Emotional Health and other partners anticipated greatly increased calls to the network. This raised concerns about call centers having the capacity to meet growing demand. In just the first month of 988’s launch, data confirmed that calls to the Lifeline increased nationally by 45%. Calls increased in 47 out of 50 states, ranging from a 10% bump in Alaska to a staggering 123% surge in Hawaii. In the majority of states, calls to the Lifeline grew between 31 and 49%, and those numbers are expected to increase.

At the federal level, advocates have secured increased funding for the Lifeline and its network in order to support the transition to 988. But even with increased federal funding, state support is still needed to meet current and anticipated demand for crisis calls and follow-up care.

Is state funding that important? Yes, absolutely. In-state Lifeline crisis call centers improve the effectiveness of crisis care. Ideally, a caller to the Lifeline is connected to a local center that is familiar with community needs, culture, and services. If a caller can’t get through to their local center, the call is then routed to one of several back-up call centers. But a locally answered crisis call offers the best chance of connecting callers to in-person crisis services in their area.

The benefit of increased state funding is clear. When local crisis support services receive the backing they need, they are able to save more lives. Additionally, effective early intervention will also help save money by reducing healthcare spending, preventing law enforcement involvement, and meeting community needs at scale.

Long-term, reliable investment within every state for local Lifeline call centers is critical to ensuring that callers will reach centers that are operational, ready to meet demand, and able to coordinate with local in-person services when needed. However, state legislative successes for these efforts have been mixed.

How do we move forward, then? AFSP and its national partners recommend that states financially support their in-state crisis call centers by implementing a monthly public service fee on all phone lines, the same way 911 is currently funded in every state. This method of funding is the most dependable, sustainable way to support in-state 988 Lifeline call centers and crisis response. It would guarantee that mental health crises are met with just as much urgency, safety, and comprehensive care as other emergencies. As of November 2022, though, only five states have enacted this recommendation: California, Colorado, Nevada, Virginia, and Washington.

As an example of how to get involved and support the Lifeline's crisis response system, we can look to Colorado. In 2021, advocates in Colorado successfully enacted a bill that implements monthly public service fees to help fund 988. The bill was supported at the 3rd Annual Colorado Suicide Prevention Advocacy Day, a combined effort by AFSP Colorado, NAMI Colorado, Mental Health Colorado, and the Suicide Prevention Coalition of Colorado. Through partnership and leadership, Colorado was prepared ahead of 988’s national launch. This is just one example of AFSP State Capitol Days making a difference!

Other states have been able to secure financial support through different, limited methods. Ten states have been able to allocate multiple years of funding for their state crisis call centers and crisis response, but that funding is only provided for a limited period of time. In 13 states, these services have been given support through one-time funding. These methods will provide support for the initial 988 post-launch period, but reliable funding will still be needed for the long term.

In 22 states and the District of Columbia, no legislation has been passed that will fund operations or crisis response for local 988 Lifeline call centers. In 20 of those states and the District of Columbia, crisis calls increased by an average of 51%, above the national average.

With 988 available nationwide and crisis calls already increasing in almost every state, there is no time to lose. Without full funding for the long term, many in-state crisis call centers are underprepared for increasing demand. We must ensure that communities have the capacity to answer mental health crises locally and sustainably.

The Time to Act for 988 Is Now – Here’s How You Can Help!

• Become an Advocate and Take Action! Sign up as an AFSP Field Advocate to get Action Alerts on 988 and crisis lines at the state and federal level at afsp.org/advocate.
• Get Involved Locally! Sign up for emails from your local AFSP Chapter and join your chapter's 2023 State Capitol Day at afsp.org/chapters.
• Learn Where Your State Stands! See how your state compares to AFSP’s 988 and crisis line policy priorities at afsp.org/statefacts.
• Be Informed! Learn more about what AFSP supports for 988 and crisis services at afsp.org/988.