(Trigger Warning: Talk of Suicide) Very Well Mind: The New 988 Suicide Hotline Is Going Live, But Rollout Won't Be Easy

"Suicide continues to be a leading cause of death year after year in the US. Nearly 46,000 people died by suicide in 2020—that's one death every 11 minutes.

But in 2020, a new law created an easy-to-remember mental health emergency hotline at 988 in the hope of providing some relief.

This number, which goes live on July 16, will replace the current National Suicide Prevention Lifeline, 1-800-273-8255 (TALK). Since its founding, the Lifeline has received over 20.4 million calls from people in distress and has provided local, customized support.

Historically, less than 2% of Lifeline calls involve emergency services, and many callers that were experiencing suicidal ideations report that the call prevented them from killing themselves.

But with a new number that's easier to remember, call volumes are expected to surge, and some experts are worried that the system is far from prepared.

Disjointed and Disorganized Rollout

In moments of distress or concern, someone can call or text 988 and be connected to mental health, suicide prevention, and substance use disorder counselors. Implementing this new number is part of a larger push to make mental health and substance use disorder services easier to access.

In an ideal scenario, when a caller dials 988, they will be connected to a trained crisis counselor who will listen empathetically and ask the right questions to get all the information necessary to provide support.

While most crises can be de-escalated over the phone, some callers will need physical intervention, and in those cases, the operator will dispatch a mobile crisis team to the caller's location.

While the idea is flawless in theory, mental health advocates have raised concerns about a "disjointed and disorganized rollout" of the new number.

Benjamin Miller, PsyD, president of Well Being Trust, notes that leaders and lawmakers were given two years to draft, propose, pass, and implement legislation to ensure the success of 988 on its first day live.

"And yet, just weeks before 988 was scheduled to roll out, we still had half the states in the country with no comprehensive legislation on how to fund and staff 988 call centers and responders in their states, as well as a supermajority of citizens who have little to no idea what 988 is or what to expect if they need to contact it," Miller says.

Call-In Concerns

One of Miller's biggest concerns is wait times. Calls are fielded through state crisis centers, which are critically underfunded and, consequently, understaffed.

Without proper funding and staffing, higher call volumes could leave callers in distress during crucial moments.

"Most callers should still be able to get through to a counselor but may experience significant wait times in a queue before their call is answered," Miller says. "That is at least until our lines are fully staffed and financially supported."

This new number is also an attempt at moving away from relying on police to solve mental health issues, which can be dangerous or even deadly for certain groups, such as people with autism, Black people, or transgender people.

However, as of now, for callers who require a physical intervention, they still may be met with a police response and an emergency room visit if a specialized mental health care facility isn't available nearby, Miller points out.

"The promise of 988 is that you would be met with a health care response and not a law enforcement response. This will be our reality, it just may take a bit more time to get right," Miller says.

Hope Ahead

When an in-state crisis center is unable to address high call volumes, calls are transferred to national back-up crisis centers. While this can still be helpful to the caller, it becomes less efficient in connecting the caller with localized support.

To address this, in 2019, Vibrant Emotional Health, the nonprofit administrator of Lifeline, awarded millions of dollars in grants to 12 states to help bolster their crisis centers that field Lifeline calls.

“Building capacity within local and state-affiliated crisis centers that are part of the Lifeline network is a key strategy for strengthening our national mental health safety net and saving lives,” said Kimberly Williams, president and CEO of Vibrant Emotional Health, in a release.

Action like this, in the form of legislation and government funds, will be necessary to ensure the eventual success of this new mental health hotline.

Despite the massive undertaking of implementing the hotline and getting the public up to speed, Miller remains optimistic about its potential to save lives and fundamentally change the way we think and talk about our mental health needs.

He hopes that one day, it will be as widely known as dialing 911 in an emergency.

"I think that, eventually, we can reach the same place, where someone can witness a person in a mental health crisis and say, 'Call 988,' and that person can quickly get the mental health help or support they need," he says.

What This Means For You