New Suicide Hotline 988 Serves as a Vital Resource to People in Crisis

Suicide affects millions of people every year. One percent of all deaths globally are attributed to suicide, and in the United States, a person dies by suicide every 11 seconds.

The risk of self-harm is particularly acute among young people. While suicide is the 12th-leading cause of death for all Americans, it ranks second among those aged 10–14 and 29–34. Suicide rates are particularly high among LGBTQIA+ and Indigenous youth. In part due to stigmas surrounding mental health, current and former members of the military and law enforcement are also at a heightened risk.

To address this ever-present problem, the United States established the National Suicide Prevention Lifeline (NSPL) in 2005. In 2022, thanks to the advocacy of organizations like the nonprofit American Foundation for Suicide Prevention (AFSP), the lifeline was made reachable for anyone in the United States via an easy-to-remember three-digit dialing code: 988. Let’s learn more about this change and how the lifeline can help people in crisis.

History of Suicide Prevention

Efforts to address suicide in the United States trace as far back as 1958, when federal funding enabled Los Angeles to open the country’s first crisis center. Suicide did not gain traction as a serious public health problem, however, until the 1990s. Following the influential 1998 National Suicide Prevention Conference, the federal government took several mitigating steps, including publishing the National Strategy for Suicide Prevention. These actions led to the creation of the NSPL.

Administered by the Substance Abuse and Mental Health Service Administration (SAMHSA), NSPL began operations in 2005. In the first year, its 109 crisis centers received approximately 50,000 calls. The following year brought a Spanish-language option for callers, and in 2013, English speakers could chat online with an NSPL counselor. The lifeline continued to grow over this time, expanding to 165 call centers by 2014, when it received more than 1.5 million calls.

Transition

Progress on making NSPL a three-digit number came in 2018 when Congress passed the National Suicide Hotline Improvement Act. Along with addressing NFPL’s effectiveness, the law instructed SAMHSA to examine whether it was feasible to create a three-digit hotline.

These efforts resulted in the National Suicide Hotline Designation Act of 2020. Sponsored by then-Colorado senator Cory Gardner, the law instructed the Federal Communications Commission to assign “988” as the universal code for the hotline. The FCC set a deadline of July 16, 2022, for telecommunication providers to activate the code for calls and texts.

Following the law’s passage, stakeholders began work to ensure the new hotline would be sufficiently funded ahead of its launch. According to AFSP, its advocates met with members of state governments hundreds of times; additionally, they sent elected officials tens of thousands of messages.

Some states, in turn, passed legislation to prepare for what they expected to be a significant increase in call volume to crisis centers. States and territories ultimately secured $105 million to upgrade their relevant systems, with this funding coming as part of a larger $432 million investment from the federal government. As a testament to AFSP’s advocacy, this funding was 18 times larger than the federal investment from the previous year.

Stats

As planned, the National Suicide Prevention Lifeline, now renamed the 988 Suicide and Crisis Lifeline, launched on July 16, 2002. It immediately began achieving its aim to support more people in crisis.

In its first full month of operations, 988 was contacted over 413,000 times, a 45 percent increase from August 2021. These contacts include calls, texts, and chats, as well as more than 52,000 calls from veterans, who have had access to their own support service, the Veterans Crisis Line, since 2007.

Along with drawing a higher call volume, 988 significantly shortened its average response time. In August 2021, people reaching out to the lifeline waited an average of two and a half minutes across phone, text, and chat services. Thanks in part to the sizable investments in 988, the response time fell to 42 seconds in August 2022. For people in crisis, these nearly two minutes can make all the difference.

Continued Steps

While suicide advocates find the early success of 988 encouraging, organizations like AFSP note that more work needs to be done. Text services, for instance, are currently available only to English speakers, and existing staffing levels are not always sufficient, particularly during busy weekend hours.

Another issue is the inconsistency of services. Unfortunately, all but a few states have failed to secure funding beyond what’s been provided federally. This translates to fewer counselors and longer response times in states where shoring up 988 has been less of a legislative priority.

Similarly, tribal communities still face significant gaps. In September, the Department of Health and Human Services responded to this disparity by announcing $35 million in 988 funding for tribal communities. In a proclamation on World Suicide Day 2022, President Biden also proposed a $22.8 billion federal investment in mental health services.

According to AFSP, the prevailing aim of 988 is to replace 911 as the go-to number for people in crisis. While the proposed federal funding will help 988 to get closer to this goal, AFSP encourages its members to keep the pressure on lawmakers to ensure the hotline can become the resource so many Americans need.

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Harvey Bell

Harvey Bell serves as a managing director, team leader, and senior portfolio manager with Morgan Stanley in West Orange, New Jersey.