The contestants on “Celebrity Jeopardy!” was perplexed last fall when asked about the new “3-digit national suicide prevention hotline” in the United States, which debuted in July.
“What is 311?” Comedian Iliza Shlesinger’s prediction was wrong.
As it turns out, he’s not alone. It’s been a year since the National Suicide Prevention Lifeline underwent a change, changing its 10-digit number to 988, but many people are unaware of the change or what the hotline provides.
The new number should make it easier for callers to connect with help when they’re having suicidal thoughts, experiencing emotional distress or having a crisis related to substance use, but only 17 percent of those Americans say they are very or somewhat familiar with it, according to a survey released Thursday by the National Alliance on Mental Illness. In addition, the survey found, people are still confused about what to expect when they call.
Many people still think that “you call 988 and — just like 911 — that means someone will be sent to you,” said Hannah Wesolowski, NAMI’s chief advocacy officer. “For the majority – almost all callers — that’s not really the case.”
Here’s a look at what everyone should know about 988 and the challenges ahead in continuing to fund and expand the network.
What should you know about 988?
The three-digit dialing code for the 988 Suicide and Crisis Lifeline became available in July last year after receiving bipartisan support. (President Donald J. Trump signed legislation establishing the new number in 2020.) Since then, more than five million calls, chats and texts have been routed to 988, a 66 percent increase from the previous 12 months, before the arrival of new number.
Nearly a million of those contacts were answered by the Veterans Crisis Line, which is linked to 988.
According to the survey, most people assume that calling 988 will automatically dispatch emergency services such as the police, or are unsure, but in reality, less than 2 percent of Lifeline calls require a connection to services like 911. In fact, 988 does not currently use geolocation, so callers to the hotline remain anonymous unless they choose to disclose identifying information. Part of the impetus behind the creation of 988 was to reduce reliance on law enforcement or emergency departments to handle mental health crises, and instead develop an expanded pool of services. , The The Substance Abuse and Mental Health Services Administration said. In some places, this includes mobile crisis teams and stabilization centers, which offer people a place to go that isn’t an emergency room.
But you don’t have to be in crisis or suicidal to call 988 and talk to a counselor. It is a free service available at all hours, day or night, for anyone who needs support.
“We hope that people will come to us before they have a mental health crisis,” said Tia Dole, chief officer of the 988 Suicide and Crisis Lifeline at Vibrant Emotional Health, the New York-based nonprofit that manages on Lifeline for SAMHSA .
Why are so few people aware of this?
The NAMI survey found that most Americans don’t know important facts about Lifeline or what to expect if they call.
This is partly by design. In the past year, none of Lifeline’s almost $1 billion in federal funding is earmarked for a public relations campaign. At first, advocates and administrators worried that promoting 988 too early might cause it to be overwhelmed by demand.
But the time has come to raise greater awareness, said Dr. Dole. Vibrant intends to start a campaign in the fall that will not only get the word out but also attempt to reduce some of the differences among people who understand and accept the 988.
According to NAMI, for example, Black people and adults 50 and older are the least likely to have heard 988. A Pew study released in April found similar results, and also discovered differences along economic lines: People who are richer or have a higher level of education are more likely to be aware of 988.
What other obstacles remain?
Besides increasing public awareness, one of the biggest problems facing the expanded network is long-term funding.
The national network has more than 200 call centers, mostly staffed by nonprofits with small budgets. Many rely on volunteers and private contributions.
The law that established 988 gave state lawmakers the option to raise money for call centers by adding a monthly fee to phone bills. But only until now a handful of states done.
The Biden administration’s 2024 budget proposal includes $836 million for 988, an increase of more than $300 million from the amount appropriated last year to bring Lifeline to life. But experts say more is needed, especially at the local and state levels.
In the coming year, the number of calls, texts and chats coming to 988 could be as high as nine million, nearly double the number of contacts in the first year, said Bob Gebbia, the chief executive of the American Foundation for Suicide prevention.
“That’s a huge increase, and we want to make sure there’s someone there to answer calls and texts and chats,” he said. “We need to have more funding.”
Network expansion is further complicated by a scarcity to behavioral health professionals. When local centers cannot pick up, calls are pushed to national backup centers, which can result in higher wait times or cause callers to drop calls.
Finally, the current method of routing callers by area code can be problematic if a person’s phone number does not reflect where they currently live. Crisis counselors who help people who live in other states may have more difficulty offering local referrals.
What is Lifeline doing right?
Lifeline experienced record demand last year, but managed to reduce the wait time for a response from an adviser.
“This means more people are getting help and they’re getting help faster, which is important for someone in crisis,” Miriam E. Delphin-Rittmon, the head of SAMHSA, said in a statement on Thursday
Before 988 was implemented, it could take several minutes to reach someone. Now the average response time has dropped from 2 minutes and 39 seconds to 41 seconds, according to SAMHSA. Wait time can vary greatly, however, depending on location or time of day.
Another big change: The new Lifeline has invested in answering texts and chats. In the past, Lifeline had capacity to handle only 56 percent of text messages and 30 percent of chats. So far, recent data indicates that the new Lifeline answers a higher proportion of chats and texts in general.
Overall, “I’m convinced it helps save lives,” Mr. Gebbia said of 988.
What next?
The need for Lifeline is expected to increase in the coming years as mental illness continues to be a major public health problem. Anxiety and depression are prevalent, especially among young people: A KFF analysis census data found that half of adults ages 18 to 24 reported symptoms of anxiety and depression in 2023, compared with nearly one-third of adults overall. In addition, the suicide rate has increased by 35 percent in the past two decades.
In addition to serving the general population, 988 Lifeline also seeks to provide assistance tailored to specific groups. Lifeline now offers an LGBTQ “subnetwork” for under-25s and this month launched text and chat options in Spanish.
In addition, said Dr. Later this year Lifeline plans to add video phone service for the deaf and hard of hearing.
If you are having suicidal thoughts, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources. You go here for sources outside the United States.