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    9-8-8: What to Expect

    Apr 19 2022

    By Collin Shumate, M.D.,
    APAF Public Psychiatry Fellow,
    Resident University California Davis

    A Life Saving Idea, Part 1

    In October 2020, the United States Congress passed the bipartisan National Suicide Hotline Designation Act, which designated the three-digit phone number “9-8-8” as the new-and-improved, easier-to-remember suicide lifeline. 988 goes live on July 16, 2022. The idea is simple, but the implementation is not. The basic idea is that 988 will be much easier to remember than the current suicide lifeline number (800-273-TALK), and thus much more accessible for the American people. The same way people call 911 for a life-threatening emergency, people will soon be able to dial 988 to connect to a national network of local crisis centers, which provide “free and confidential emotional support to people in suicidal crisis or emotional distress,” 24/7. An estimated 30% of calls to 911 may be more appropriate for this new 988 service.

    A Life Saving Resource

    The National Suicide Prevention Lifeline (named slightly differently than the above law passed by Congress) is a crucial service for mental health. The service answered roughly 2 million calls in 2020. When people call into the service, they receive free and confidential counseling. People can also be connected to local mental health services or emergency rooms if needed for acute stabilization of a mental health or substance use condition. The Lifeline’s call centers are currently funded mostly by state and local governments, in addition to philanthropic efforts.

    What Can We Expect?

    After the transition to the simpler “988” number, Pew Charitable Trusts predict the Lifeline will answer more than 24 million calls, texts, and online chat requests by 2027 – a notable uptick in the number of people accessing the service. This will require significantly more personnel than currently staff these centers. Per the law which established 988, a state may impose and collect a fee for providing 988 related services. However, most states have so far been unable to pass legislation to fund these expanded services.

    Although the 988 lifeline is due to go live July 16, 2022, much work is left to be done. The 988 lifeline is not fully funded, and it may not have adequate staffing in its initial days. Most people – including health care providers – are not aware of this pending change, although public campaigns are expected to spread the word before and after launch. Much like in the early rollout of the 911 emergency number, call wait times may be longer than desirable, or the service may not live up to its full potential immediately. However, one can imagine the potential for a much better functioning emergency system that allows easy access to the 988 phone number, and in which patients in crisis can easily be connected to mental health crisis workers who can divert patients as necessary to psychiatric treatment. Hopefully, these efforts will also reduce the deadly interactions that patients in mental health crisis sometimes have with law enforcement.

    To Be Continued…

    Please stay tuned for future editions of this blog series. In future blogs we will further analyze pending legislation which will assist with the 988 rollout, and imagine the optimal crisis continuum of care which can reduce incarceration and create a mentally healthy nation for all Americans.