Someone to Call. | Someone to Come. | Somewhere to Go.

Summary

• In 2010—2020, over 480,000 individuals in the United States committed suicide, a 12 percent increase from the decade prior.
• On July 16, 2022, the federal government will roll out the national “988” hotline for suicide prevention and mental health crises that will route calls to the National Suicide Prevention Lifeline (Lifeline).
• With the enactment of the new 988 hotline, there is an opportunity to create a continuum of crisis support with ample funding that ensures adequate response to mental health crises.

The Mental Health Crisis in the United States

As of 2021, nearly 20 percent (50 million) of adults in the United States reported suffering from a mental illness and despite this ever-increasing number, less than half receive adequate treatment. During the COVID-19 pandemic, approximately two in five adults reported symptoms of anxiety or depressive disorders, a figure that rose drastically from one in ten adults prior to the pandemic. Although rates of mental illness symptoms have declined since the United States eased restrictions, data shows the impact of events, such as pandemics, on mental health outlasts the physical impacts, suggesting that the need for mental health services will increase in the coming years.

With more than a third of Americans living in Health Resources and Service Administration designated Mental Health Professional Shortage Areas, access to mental health services is lacking and the need for expansion of our fragmented system is critical.

The 988 Implementation Act

On July 16, Substance Abuse and Mental Health Services Administration (SAMHSA) and the federal government will implement the new, easy to remember, 9-8-8 health crisis service hotline to strengthen the mental healthcare system capacity. The hotline will create a national network of local crisis centers to answer calls and texts, expanding access to evidence-based community mental health services. 988 will not be an entirely new Lifeline, but instead will provide a more efficient and effective way to reach the Lifeline nationwide.

The bill, which was passed on October 17, 2020, requires the expansion of access to behavioral health services, with the main focus being the 988-telecommunication system. The bill provides federal support, guidance, and funding to states to assist with the implementation of 988 and other crisis services and is fortified by national back up centers in place to meet demand. The aim is to ensure Americans are able to connect with trained mental health and behavioral specialist’s crisis help centers, and not just be a number to call.

The 988 Implementation Act will:

• Fund the rollout, public services, and development of the new 988 hotline through assistance for regional and local crisis call centers, supplying resources for focused services for underserved populations.
• Safeguard access to crisis care by requiring that all health insurance plans cover crisis services.
• Expand the Mental Health Crisis Response Partnership Pilot Program to generate or improve mobile crisis team response, connecting people in crisis to help and health maintenance.
• Support behavioral health crisis response on the ground through grants that assist capital strategies involving crisis receiving and health maintenance programs and call centers.
• Establish a national suicide prevention awareness campaign, as well as increased awareness of 988, in collaboration with a wide assortment of stakeholders.

The Lifeline Response Process

The SAMHSA administration of the Lifeline to Vibrant Emotional Health, a partner of SAMHSA since the creation of Lifeline in 2005. The Lifeline is available nationwide, 24 hours a day, seven days a week, and includes the Veteran Crisis Line. When someone experiencing a mental health crisis calls or messages the 988 Lifeline, they are directed to the nearest local crisis center. If the nearest center is overwhelmed, they are directed to a subnetwork of federal backup call centers. Once a user is connected with a specialist, they can share what is going on and staff can assist them immediately. The call centers will also provide information and rapid linkage to psychiatric evaluation and initiation of treatment. Call center staff will have improved training in emotional distress and suicidal crisis management, as well as the knowledge to provide connections to local resources and ongoing care. The call centers also have the ability to dispatch mobile crisis teams instead of using EMS or law enforcement, which will ideally lead to more favorable outcomes during a mental health crisis situation.

What the Future Holds

While the 988 Lifeline does not address all of the upstream determinants of mental health that lead to suicidal ideation, it is a vital and progressive move towards destigmatizing mental health and increasing the funding and resources devoted to such an important cause. The Lifeline will open the door for the millions of Americans suffering with mental illness and provide hope to those in underserved communities, addressing the unique needs of at-risk groups such as youth, rural populations, racial/ethnic minorities, and LGBTQ+ individuals. 988 is expected to fill in the gaps in mental health crisis cares and diminish unfavorable results and suicide, but uncertainty still remains.

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