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Every person nationwide can call or text 988 or online chat with 988lifeline.org to reach trained crisis counselors who can help in a mental health, substance use or suicide crisis. Learn how 988 can help you in a crisis and what it might mean for your community with these FAQs.
988 is the first step in reimagining our crisis response, but there’s more work to do to ensure everyone receives the help they need — and deserve — during a crisis.
Too often, people with mental illness do not receive a mental health response when experiencing a mental health crisis. Instead, people in crisis often encounter law enforcement and crowded emergency departments rather than a mental health professional. People in crisis deserve better. The lack of a robust mental health crisis system leads to tragic results. According to a database maintained by The Washington Post, one in five fatal police shootings since 2015 involved a person with a mental illness, and approximately 2 million times each year, someone with a mental illness is booked into jail — an estimated 44% of people incarcerated in jail and 37% of people incarcerated in prison have a mental health condition. Millions more end up in emergency departments that are often ill-equipped to address mental health crises, often waiting hours or days to access care.
NAMI is committed to advancing efforts to reimagine crisis response in our country. We believe that every person in crisis, and their families, should receive a humane response that treats them with dignity and connects them to appropriate and timely care. NAMI is calling for a standard of care for crisis services in every community that includes — 24/7 call centers that answer 988 calls locally, mobile crisis teams and crisis stabilization options — that end the cycle of ER visits, arrests, incarceration and homelessness.
In 2020, the nation took a significant step forward with the enactment of the National Suicide Hotline Designation Act, a bill NAMI advocated for that created a nationwide three-digit number (988) to assist people experiencing a mental health or suicidal crisis. The Federal Communications Commission (FCC) determined that this number would be available — by both phone and text — in July 2022, and is now available across the country.
988 is the three-digit dialing code connecting people to the 988 Suicide and Crisis Lifeline, where compassionate, accessible care and support is available for anyone experiencing mental health-related distress — whether that is thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress. People can also contact 988 if they are worried about a loved one who may need crisis support.
The goal of the 988 Suicide and Crisis Lifeline is to provide immediate crisis intervention and support. When someone contacts 988, a trained crisis counselor will answer, listen to the person, provide support and share resources, as needed. Crisis counselors are trained to help in a variety of crisis situations, and no one is required to disclose any personal information.
For most people, calling, texting or chatting 988 is the intervention. Crisis counselors will be able to resolve the urgent needs of the majority of callers on the phone or via text or chat, reducing the need for an in-person response overall. Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA), which oversees the 988 Suicide and Crisis Lifeline, states that, “Currently, fewer than 2% of Lifeline calls require connection to emergency services like 911.” However, NAMI is advocating for everyone to have resources like mobile crisis teams in their community (see below). Communities that currently have robust crisis services estimate that more than 80% of crises are resolved on the phone, and mobile crisis teams, staffed by behavioral health professionals, are dispatched when an in-person response is needed. Most crises that receive a dispatch are resolved in the community. The work is ongoing to make this system available everywhere. (see FAQs to learn more about how 988 works and what to expect when you reach out to 988).
While an easy-to-remember number is important, we need more than a number. We need crisis response services that provide a mental health response to mental health crises.
In addition to calling on federal policymakers to require that crisis services be covered by all health insurers and to provide substantial funding to states to build out crisis services, mental health advocates need to urge their state leaders to take action. Advocates must educate state policymakers about how our current response to crisis falls short, and how a reimagined crisis response system will help. This system should include:
The legislation that created 988, which routes calls through the 988 Suicide and Crisis Lifeline (previously referred to as the National Suicide Prevention Lifeline), expanded the scope of the Lifeline to include mental health crises. Recognizing that this expanded scope and greater visibility for the Lifeline would create greater demand and expectation of response, the legislation also allows states to charge fees on phone bills to help fund these services. Many NAMI State Organizations across the country are working with state policymakers to implement state legislation that outlines the crisis services that will be available statewide to respond to the needs of people calling 988 and implement these fees, which are similar to 911 fees, or other funding sources.
Learn more about model state legislation to build 988 crisis response services.
Want to know what your state legislators are doing to support 988 and crisis response? NAMI has an up-to-date, interactive map tracking legislation across the country.
Mental health advocates across the country have the power to demand that a comprehensive crisis system be offered in every community, to every person who needs it. You can help by making legislators aware of both the problem — our inadequate crisis system — and the solution. Here are six ways you can act today:
NAMI and Ipsos have released several waves of polling that show broad support for funding 988 and building a full crisis response system.
Fall 2021 (conducted Oct. 22–25, 2021, and surveyed 2,049 U.S. adults)
Spring 2022 (conducted May 20-22, 2022, and surveyed 2,049 U.S. adults)
Fifteen of the nation’s leading mental health professional organizations, advocacy groups and funders published this plan offering federal and state policymakers an evidence-based toolkit for implementing a continuum of mental health and substance use care in conjunction with the federally mandated 988 crisis hotline for mental health emergencies
Additionally, SAMHSA released National Guidelines for Behavioral Health Crisis Care to help mental health authorities, agency administrators, service providers, state and local leaders think through and develop the structure of crisis systems that meet community needs
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