988: Why more people are using the national suicide and crisis lifeline — and what's next

Performance data is offering some insight into the new suicide and crisis prevention number that launched this summer as officials plan next steps for the national 988 lifeline.

The original lifeline was accessible by dialing 800-273-TALK. But in 2020, the bipartisan National Suicide Hotline Designation Act assigned the 988 dialing code and required phone service providers to operate through the new number by July 16, 2022. The 988 number connects users to a network of over 200 call centers that have been around since 2005, through which crisis counselors are available 24/7 via call, text or chat to help anyone experiencing suicidal thoughts or any mental-health-related distress.

So far, nationwide data on the lifeline is promising. The first full month of performance data in August showed a 45% increase in calls, texts and messages compared to the same month last year. And despite the influx of people reaching out,152,000 more contacts were answered, about 88% of people were connected with a crisis counselor, and the average length of time it took to answer contacts decreased from two and a half minutes to 42 seconds.

The Department of Health and Human Services said in a statement that this outcome "wouldn't have been possible without historic funding from the Biden-Harris Administration and Congress and collaboration among the federal, state/territory and local governments across the country."

“988 is more than a number, it’s a message: We’re there for you,” HHS Secretary Xavier Becerra said. “The transition to 988 is just the beginning. We will continue working toward comprehensive, responsive crisis care services nationwide to save lives.”

Although national backup centers are available to answer contacts that can't be responded to by local centers, the Substance Abuse and Mental Health Services Administration acknowledges that there's work to be done to improve responses by some states. The August performance data shows that in-state answer rates varied; for example, Florida received 11,391 contacts with an in-state answer rate of 58%, while Illinois received 12,322 contacts with an in-state answer rate of 85%.

"The federal government cannot do this work alone," SAMHSA said on its website. "Additional state and local investment is needed to further boost the response rates and staffing capacity of call centers facing the greatest demands."

Why has there been an increase in calls and messages?

Yahoo News spoke with April Naturale, interim executive director of the 988 Suicide & Crisis Lifeline, who said there are several reasons why more people are reaching out. In addition to the new 988 number being shorter and easier to remember, Naturale said switching the name from the National Suicide Prevention Lifeline to the 988 Suicide & Crisis Lifeline means “there’s less stigma attached to it.”

“People understand that they can call even if they’re not in a suicidal crisis,” she said. “So if they have mental health concerns, they can call as well. And that was a big reason for us changing the name as well, so that there was less hesitancy.”

She also said social media has been instrumental in getting the word out and encouraging engagement, especially among young Americans, who may find the text and online chat options particularly appealing. “We expect that to continue, and certainly we see this as a modality that the youth utilizes,” Naturale said.

Young people are particularly at risk of suicidal thoughts. According to SAMHSA, in 2020, 12% of adolescents ages 12-17 said they had serious thoughts of suicide, 5.3% made a suicide plan and 2.5% attempted suicide in the past year.

But Naturale added that the increase in calls since launching 988 doesn’t necessarily indicate that more people are suffering with mental health diagnoses. She said events such as a global pandemic, “issues of inequality in communities” and “mass violence incidents” can trigger “acute stress responses” that, with help, can be resolved over time.

“The research has shown that the numbers of people who actually go on to develop a diagnosable mental illness doesn’t increase, even with an increase in traumatic events,” she said. “We see instead an increase of people who are suffering with some acute stress responses, and acute stress responses tend to go down on their own with good coping, good social support and access to resources.

“So do we think that some of these shorter-term acute crises are being addressed by the 988 suicide and crisis lifeline? Absolutely,” she added.

What’s next for 988?

Naturale said 988 is working on developing a video phone option for deaf or hard of hearing Americans who use American Sign Language. While there’s no launch date yet, the network is looking at a full pilot this fall or winter.

“We’re also looking at next stages in developing a pilot for the LGBTQ+ community,” she said. “It’s part of a $7.2 million project funded by SAMHSA to provide persons under the age of 25 with the option of connecting to a counselor who’s specifically trained in the LGBTQ issues that those youth face today.”

Another priority going forward is improving responses to calls, messages and texts coming from tribal communities. SAMHSA recently announced a new $35 million grant opportunity to better support 988 services in these areas, which the agency said face "unique challenges to accessing technology and crisis services."

“This program aims to ensure that Native Americans and Alaska natives have access to culturally competent, trained 988 crisis support,” Naturale said. “Because what we know, as has been our theme around 988, is that when people are connecting with those who they feel understand them, accept how they feel, have some knowledge of their culture, it really helps in them connecting and having the type of engagement that can help add to a successful intervention.”