Behind the numbers: 988 crisis lifeline answers over 10 million contacts since its debut

The lifeline, formerly a 10-digit number, transitioned to three digits in July 2022 as part of the Biden-Harris administration’s strategy to “address our national mental health crisis.”

Since 2022, the administration has invested over $1.5 billion in the effort, including expanding access to services for Spanish speakers, LGBTQI+ youth and young adults, and people who are deaf or hard of hearing, according to HHS.

Those in crisis can reach the lifeline through a phone call, text, web chat and video chat. This year, text messages to 988 have increased 51% and calls 34% from the year before, a sign of the effects of expanded services, according to senior administration officials.

Last year, text messages through the lifeline increased 1,135%, chats answered increased 141% and calls answered increased 46%, a report from the department showed.

The lifeline has made 110,000 contacts in Spanish with 475,000 with LGBTQI+ youth and young adults this year, the new report says. About 20,000 videophone contacts in American Sign Language were made, and 1.2 million calls were answered by the Veterans Crisis Line through 988’s Press 1 option.

“988 is available to everyone,” emphasized Andrea Palm, deputy secretary of the US Department of Health and Human Services. “Having someone on the other end of the line to listen and provide support makes a difference. It really does save lives, and that’s what this is all about.”

This year, HHS expects to roll out georouting technology to route 988 callers and texters based on their physical location versus their area code, the agency says. The move, which would follow an April proposal from the Federal Communications Commission, is expected to improve cell phone users’ connectivity to local services and maintain additional privacy.

The agency also pointed to the bolstering of a national backup system. Funneling federal funding to this system will help ensure that all contacts to 988 are able to be answered, regardless of a state’s local capacity.

A 911 for mental health crises

In 2022, the year 988 debuted, suicide deaths reached a record high in the US, according to provisional data from the US Centers for Disease Control and Prevention. In 2021, the US surgeon general called for the implementation of a national prevention strategy in response to suicide rates that have been rising for decades.

988, like 911, is easy to remember. The switch to the three-digit lifeline saw an over 45% increase in overall contact volume in just the first month, according to HHS.

“To remember 10 digits to call for help is not easy. That’s why 911 is only three digits.” said Hannah Wesolowski, chief advocacy officer at the National Alliance on Mental Illness or NAMI. “Transitioning to a shorter number and a number that is focused on our wider array of mental health crises, not just suicide, opens up the door for people to reach out and be connected to the support they need.”

The hundreds of thousands of people who have contacted 988 in the past two years and the growth in its usage reflect the need for increased mental health services nationwide, she said.

Behind the numbers

Despite 988’s growth, 3 in 4 Americans say they are not content with mental health treatment in this country, a July poll from the National Alliance on Mental Illness found.

The NAMI/Ipsos poll also found that only 23% percent of Americans say they are familiar with 988. This is an increase from 17% in June 2023 but has not changed since October.

“We need that number much higher,” Wesolowski said. “This data speaks to the urgency of having awareness so people who need help can get connected to that help.”

However, the poll showed 72% of Americans said they are comfortable contacting the lifeline. Of those who had contacted 988 this year or whose loved one had done so, nearly 7 in 10 said they had received some or all of the help they needed. This sentiment is up 55% from June 2023, according to NAMI.

HHS is prioritizing raising awareness about the lifeline and emphasizing that 988 is available not only for crises but for anytime someone needs to talk, according to senior administration officials.

What happens when you contact 988

When someone calls 988, they first hear a greeting message. They are given the option to connect with specialized services and subsequently routed to a national network or local 988 Lifeline network crisis center.

According to the Substance Abuse and Mental Health Services Administration, a trained crisis counselor answers the phone, listens to the caller, works to understand how the problem is affecting them, provides support and shares resources, if needed. Similarly, users can receive care through texting 988, an increasingly popular option.

On a call with reporters Tuesday, Palm shared anecdotes from the progress the lifeline has made, emphasizing the real-life impact of the calls that make up this year’s 988 data.

“A really important point are countless stories of real people whose lives have been changed forever,” she said, sharing the story of Florida 988 counselor Kelly, who joined the service after losing her 18-year-old son to suicide.

“She believes that if 988 had been in existence for her son, that it would have saved his life,” Palm said.

After the call

The lifeline has reached millions in crisis since its debut, but what happens after they hang up the phone?

Although the vast majority of calls do not escalate to emergency services being dispatched, users who need more help than can be provided over the phone or by chat may be contacted by local services, including mobile crisis and law enforcement teams.

“We know [a police response] is not the best response for people in crisis,” Wesolowski said, pointing to the need for mental health professionals to respond to cases of mental health crisis.

According to senior administration officials, one of the goals of the lifeline is to divert from unnecessary police response and to ensure that users are safe while providing support based on individual needs, something that may require coordination between 988 and law enforcement.

Next steps for 988

According to Palm, the administration still has more work to do to reach people who need help.

“Not everyone can access the support they need. And in other cases, stigma prevents them from reaching out at all,” she said.

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Studies have shown that after speaking with a trained crisis counselor, most callers feel more hopeful and less depressed, suicidal and overwhelmed. Collaboration on the federal and state level for continued support of 988 is necessary for the success of the program to continue this impact, according to Palm and senior administration officials.

“In the two years since we launched 988, it’s become one of the most effective first line responses that we have to help individuals who feel alone and without options,” she said.

“Make no mistake, 988 saves lives,” Neera Tanden, White House domestic policy adviser, said on Tuesday’s call.

“As a country, we have a moral obligation to be there for each other, to reach out to offer help for just a listening ear.”

The Biden-Harris administration's strategy to address the national mental health crisis also focuses on improving health through the use of the 988 lifeline. With the increase in contacts to 988, the administration aims to improve cell phone users' connectivity to local services and maintain privacy by implementing georouting technology.

Despite the growth of 988, many Americans are not satisfied with mental health treatment in the country, and only a portion is familiar with the lifeline. Therefore, raising awareness about 988's availability and its purpose as a resource for individuals in need of mental health support is crucial.