What to Know About 988, the New Mental Health Crisis Hotline

The New York Times

By Dani Blum

Jul 12, 2022

The new national suicide hotline, which has expanded its focus to help callers experiencing a range of mental health emergencies, launches July 16.

Starting on Saturday, people who are experiencing mental distress will be able to dial just three numbers to reach the National Suicide Prevention Lifeline.

Anyone in the United States can text or call 988 to reach trained counselors who can help them cope with a mental health emergency, and direct them to additional resources for mental health and substance use treatment.

The Lifeline’s existing 1-800 number still works, but the service has gotten a makeover and will now be more able to address general mental health concerns and emotional distress, as well as suicide crises.

Here’s why the new telephone number is so important, and what you need to know about the hotline’s expanded focus as a “911” for mental health.

Why is there a new phone number?

In 2005, the U.S. Substance Abuse and Mental Health Services Administration launched the first suicide prevention hotline, 1-800-273-8255. People can still use that number to reach the Lifeline, but experts worried that the 11 digits were cumbersome to remember during a crisis and that too few people knew about the service.

“It’s a new number, but it’s not a new service,” said John Draper, the executive director of the Lifeline and an executive with Vibrant Emotional Health, a New York-based nonprofit, which administers the Lifeline.

The new 988 number is meant to provide a simpler way to get emergency care and to help callers access an expanded network of mental health professionals.

Employees and volunteers staffing the 24-hour hotline will be trained counselors. In some states, they will now also be able to connect callers with local crisis teams.

The line will be referred to as the 988 Suicide and Crisis Lifeline, to emphasize that the service is for people experiencing a mental health crisis of any kind, not just those involving suicidal ideation.

Who should call the hotline?

Anyone experiencing a mental health or substance use issue can call 988. Counselors on the other end of the hotline are trained in handling a wide range of mental health issues, including self-harm, addiction and suicidal ideation, said Hannah Wesolowski, chief advocacy officer at the National Alliance on Mental Illness.

“If someone has been through a traumatic event and is struggling to process it — and there are traumatic events happening throughout this country — this is a place to turn to,” she said.

You can also call on behalf of someone else. Counselors can offer guidance on helping a friend or loved one navigating a mental health emergency, and experts advise that people reach out particularly if a loved one reveals a plan to hurt themselves.

While some people struggling with mental health issues may not think their problem is severe enough to merit using the hotline, experts said that anyone who thinks they might need help should reach out.

“If you’re unsure, call,” said Dr. Robert Trestman, chair of the American Psychiatric Association’s Council on Healthcare Systems and Financing.

What happens when you call the hotline?

Ideally, when someone calls 988, they will first be connected to one of 200 local call centers, which can help connect them to community resources or dispatch emergency services if necessary. If those call centers are busy, the caller will be automatically directed to a national backup center.

Not every state has set up local crisis teams that can respond to a mental health emergency, although there is momentum for more areas to adopt a model like Georgia’s Crisis and Access Line, Ms. Wesolowski said, which enables hotline staffers to set up appointments for callers with community mental health providers.

But callers all over the country can reach a counselor simply by calling 988.

“Having an anonymous opportunity to speak to someone who knows what they’re talking about, who won’t be scared when you say, ‘I don’t know what to do, I’m thinking of hurting myself’ — this is an extraordinary option,” Dr. Trestman said.

Counselors talk through the root of someone’s distress — whether it stems from illness, job loss or family strain, for example. They help callers develop a “road map,” Dr. Draper said, with concrete next steps to take after they hang up, including thinking through who else they can turn to for help, like a therapist or clergy member.

While call lengths vary, they tend to last between 15-20 minutes, Dr. Draper said.

“When a person is in a crisis state, they’re so overwhelmed by the psychic pain they’re experiencing — it’s really hard for them to see all options and actually engage some of their natural coping mechanisms,” Dr. Draper said. Counselors can help “marshal some of those internal resources,” he said.

In an emergency, such as if the caller requires medical attention, 988 will collaborate with local police or hospitals to dispatch services. Beyond that, calls are anonymous. “It’s the same kind of confidentiality you would get at a doctor’s office or at a therapist,” Dr. Draper said.

What about reports that the hotline is understaffed?

In the months leading up to the new number’s launch, The New York Times and other news outlets have reported on looming fears that call centers will not be able to keep up with demand, partly because of insufficient funding, and partly because of a shortage of volunteers to staff the line.

Still, those behind 988 say they are confident the service can provide critical care.

“Does that mean there’s never going to be a wait?” Dr. Draper said. “I can’t promise that. But I can promise that if you hold on, you will eventually get a response from a counselor who’s going to listen to you and care about your situation.”