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What’s the 411 on the new 988 hotline? 5 questions answered about a national mental health service

March 28, 2022
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What’s the 411 on the new 988 hotline? 5 questions answered about a national mental health service
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The 988 Lifeline will connect callers with specialists trained to assist with mental health crises, including psychotic symptoms and substance abuse.

Beginning July 16, 2022, people struggling with mental health crises can call 988, a new number focused on providing lifesaving suicide prevention and crisis services. But 988 is not just a shorter, easier-to-remember replacement for the current suicide hotline. Congress and the Federal Communications Commission also established the 988 Lifeline to address longstanding concerns in mental health care.

_The Conversation asked Derek Lee, a PhD student at Ohio State University in Counselor Education and Supervision and a therapist, to explain the new service and how it is different from the old hotline. Lee’s academic and research focus is on suicide, including training, intervention and prevention.

Table of Contents

  • What is 988?
  • Can people still call 1-800-273-TALK?
  • What’s wrong with the old number?
  • How will 988 be different?
  • Where will the money come from to pay for all this?
  • Why is all this happening now?
  • Who does 988 benefit?

What is 988?

The three-digit number is part of a new national mental health program. In 2020, the Federal Communications Commission designated 988 as the help line number, and Congress authorized funding for the 988 Lifeline Program.

Can people still call 1-800-273-TALK?

Sure. The soon-to-be old number has been operational since 2005, but it will not be going away just yet. July 16 is when 988 goes live nationally and callers can begin using it. Starting that day, calls to 1-800-273-8255 will route to the 988 Lifeline. But texting for the 988 Lifeline isn’t yet available, so anyone who wants to text or chat can still use the 1-800 number.

What’s wrong with the old number?

The system behind it, including its 200 call centers currently in the national crisis line network, according to a 2019 report on the program.

A major problem is that call centers don’t always have the staff or the technology to handle growing numbers of calls.

Calls that in-state centers are unable to answer get rerouted to centers out of state through the system’s backup network. This gives callers a longer wait time, after which the out-of-state center might not be able to connect the caller with local services. Or the incoming calls might simply “bunch up,” creating a telephone logjam, and leave callers waiting on hold “too long,” a time period the report does not define.

The report does note, however, that there isn’t a consistent standard for wait times, staffing or other operational aspects of the call centers. State governments regulate them, and they are independently operated.

How will 988 be different?

Vibrant Emotional Health, the nonprofit that administers the crisis line program, promises improvements in what it calls “call center capacity.” But Vibrant hasn’t fully laid out what the improvements will look like. Congress hasn’t either, but the Behavioral Crisis Services Expansion Act introduced last year requires call centers to “offer air traffic control-quality coordination of crisis care in real-time.”

Where will the money come from to pay for all this?

The shift to 988 comes with funding at the state and federal levels, as well as federal oversight to assure equitable access. Initial funding is coming through federal channels, including the American Rescue Plan, Community Mental Health Services Block Grant and President Biden’s proposed 2022 fiscal year budget. Most of the long-term funding will come from individual states.

Why is all this happening now?

Much of the discussion began during the pandemic, which really brought mental health issues to the forefront. A study of 8 million calls to help lines in 19 countries and regions found that call volumes jumped during the initial wave of coronavirus infections. At the six-week peak, the total number of calls was 35% higher than before the pandemic.

In the U.S., the coronavirus national emergency
and the widespread lockdown that followed brought nationwide increases in the number of people struggling with depression, anxiety and other mental conditions. Alcohol use increased, particularly among women and college students.

Who does 988 benefit?

Anyone who needs help with their mental health, particularly people in crisis. A major goal of the 988 Lifeline is creating equity in mental health services, especially for those who have not always had consistent or reliable access to mental health care.

For example, Vibrant has announced plans for its new system to help set up virtual visits with mental health professionals for those who can’t travel to in-person appointments, like people with disabilities or those in rural areas. Vibrant also said that the 988 Lifeline will provide telephone interpreter service in Spanish and over 150 additional languages.

[Interested in science headlines but not politics? Or just politics or religion? The Conversation has newsletters to suit your interests.]

The Conversation

Derek Lee does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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