988: Reimagining Crisis Response | NAMI: National Alliance on Mental Illness

Between 2016 and 2020, California’s National Suicide Prevention Lifeline call centers experienced a 67% increase in calls, CalMatters reports. Despite the increase, the in-state centers have been able to answer 90% of calls. | Courtesy Photo | Freepik

Augmented by George Schaefer | Contributed

Starting Saturday, July 16, every person in every community nationwide can dial “988” to reach trained crisis counselors who can help in a mental health, substance use or suicide crisis. Learn how 988 can help you in a crisis and what it might mean for your community with these FAQs.

988 is the first step in reimagining our crisis response, but there’s more work to do to ensure everyone receives the help they need — and deserve — in a crisis.

Too often, people with mental illness do not receive a mental health response when experiencing a mental health crisis. Instead, people in crisis often come into contact with law enforcement rather than a mental health professional. People in crisis deserve better. The lack of a robust mental health crisis system leads to tragic results. One in four fatal police shootings between 2015 and 2020 involved a person with a mental illness, and an estimated 44% of people incarcerated in jail and 37% of people incarcerated in prison have a mental health condition — and people with mental illness are booked into the nation’s jails around 2 million times every year. Millions more end up in emergency departments that are often ill-equipped to address mental health crises, often waiting hours or days to access care.

NAMI is committed to advancing efforts to reimagine crisis response in our country. We believe that every person in crisis, and their families, should receive a humane response that treats them with dignity and connects them to appropriate and timely care. NAMI is calling for a standard of care for crisis services in every community that includes — 24/7 call centers that answer 988 calls locally, mobile crisis teams and crisis stabilization programs — that end the revolving door of ER visits, arrests, incarceration and homelessness.

In 2020, the nation took a significant step forward with the enactment of the National Suicide Hotline Designation Act, a bill NAMI advocated for that created a nationwide three-digit number (988) to assist people experiencing a mental health or suicidal crisis. The Federal Communications Commission (FCC) determined that this number would be available — by both phone and text — in July 2022, and is now available in communities across the country.

988 FAQs

What is 988?

988 is the new three-digit dialing code connecting people to the existing National Suicide Prevention Lifeline (now the 988 Suicide and Crisis Lifeline) where compassionate, accessible care and support is available for anyone experiencing mental health-related distress — whether that is thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress. People can also dial 988 if they are worried about a loved one who may need crisis support.

The goal of the 988 Suicide and Crisis Lifeline is to provide immediate crisis intervention and support. When someone calls 988, a trained crisis counselor will answer the phone, listen to the caller, understand how their problem is affecting them, provide support and share resources, as needed. These crisis counselors will be able to resolve the urgent needs of the more than 80 percent of callers on the phone. For the remaining 20 percent, community services will differ, although NAMI is advocating for a full range of crisis services in every community. This work is ongoing (see FAQs to learn more about how 988 works and what to expect when you reach out to 988).

You can reach the 988 Suicide and Crisis Line by calling 988, texting 988 or chatting via Lifeline’s website.

Is this number only for suicide-related crises?

No, 988 is a number to call for suicide, mental health and substance use-related crises or any kind of emotional distress — not just suicide-related crises.

What is a mental health, substance use or suicide crisis?

A mental health or suicidal crisis is any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to function well in the community. For example, a person in crisis may experience one or more of the following: actively thinking about suicide or self-harm; erratic, unusual, risky or harmful behavior; delusions, paranoia or other psychotic symptoms; or extreme withdrawal from everyday life.

Can I only call or text 988 if I am experiencing a life-threatening crisis?

No, you can call or text 988 for yourself or a loved one if you are in any type of emotional distress. However, if you are not in a crisis, there are other services that may meet your current needs better, including a peer-support Warmline for emotional support or the NAMI HelpLine (1-800-950-NAMI or helpline@nami.org) for information, resources and support.

How can I reach 988? Only by phone?

You can call 988, text 988 or chat via the Lifeline’s website (988lifeline.org).

What happens when I call 988? What information will I receive, or does the Lifeline only offer

immediate crisis support?

The goal of the 988 Lifeline is to provide free, confidential, immediate crisis intervention and support. When you call or text or chat 988:

1. You’ll hear a message that you’ve reached the National Suicide Prevention Lifeline – you are in the right place! If you are a veteran, you can press “1” to reach the Veterans’ Crisis Line or “2” to reach the Spanish subnetwork for the Lifeline.

2. If you don’t select either option, a trained crisis counselor will answer.

3. The counselor will listen to you to understand how your problem is affecting you or your loved one.

4. The counselor will provide support and share resources and referrals.

In some communities, the crisis line may be able to connect you to additional services or follow up with you to ensure you’ve connected with care (note: not all communities have this capacity).

Can I only call 988 for myself, or can I call for someone else I know or see in crisis?

You can call or text 988 if you are concerned about someone else in distress who may need crisis support.

What languages are offered through 988?

The Lifeline currently provides live counseling services via phone in English and Spanish. Translation services are available in an additional 150 languages. Text and chat are currently available in English only.

Are there services available for a person who is hearing impaired?

In addition to text and chat services, teletype (TTY) is also available. TTY users can use their preferred relay service or dial 711 then 1-800-273-8255.

Will there be culturally competent support available?

As the workforce for the Lifeline network is being expanded, there are ongoing efforts to improve cultural competency training for Lifeline crisis counselors. However, as of now, not every counselor may have had this training.

Are there youth-specific supports available?

There is not a youth-specific hotline or dedicated crisis counselors for youth callers, although some states may have their own youth crisis line separate from the 988 Suicide and Crisis Lifeline network. Regardless, staff are trained to support anyone in a crisis. Expanded Lifeline trainings are being implemented to ensure 988 call centers can provide appropriate, culturally competent care, specifically focused on communities that are at higher risk for suicide, including youth.

Note that some states have youth crisis response teams in place, and there is a growing movement to provide more youth-focused crisis services across the country.

Will I be charged a 988 fee for calling the number?

No. The support and services received from 988 crisis counselors is provided free of charge. However, standard messaging and data rates may apply to those who text 988 from their mobile phone.

Do I need insurance to get help when dialing 988? Medicaid or Medicare?

No. The support and services received from the 988 crisis counselors is provided free of charge, regardless of whether you have health insurance coverage.

Will 988 show up as a call on my phone bill? Is a call record created?

It will depend on your phone service whether a call or text to 988 will show up on your phone bill. Contact your phone service provider to learn more about how calls to 1-800 and other toll-free lines appear on your bill.

Does 988 collect my information/data? What do they do with that information?

All contacts with the 988 Lifeline from people seeking help are confidential. According to the Lifeline FAQs, information about callers/chatters/texters will not be shared outside the Lifeline without documented verbal or written consent from the person seeking help, except in cases where there is imminent risk of harm to self or someone else, or where otherwise required by law.

The Lifeline protects all the confidential and identifying information shared. During your contact with the 988 Lifeline, you may voluntarily share certain information about yourself that could be identified, and that information may be documented in notes about your conversation. The center may also have access to the phone number or IP address you used to contact the Lifeline. You will never be required to provide other identifying information to receive help from the Lifeline. The Lifeline may use de-identified and aggregated data for reports to stakeholders, funders and policymakers about the numbers and types of conversations they have with people in crisis. They might also reference the general aggregate demographics of people seeking help from the Lifeline.

Why are we getting 988 and how will it work?

What is different after July 16, when 988 goes “live”?

988 “going live” marks the beginning of an easier way nationwide to access the National Suicide Prevention Lifeline through this easy-to-remember three-digit number. It also marks the formal expansion of the Lifeline to include helping people in mental health and substance use crises in addition to suicide crises. July 16, 2022 is the deadline for every U.S. telephone provider to direct calls and texts to 988 to the pre-existing Lifeline network. The Lifeline has around 200 local call centers and national backup centers across the country to answer these calls.

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