A new national suicide hotline, 988, becomes operational nationwide tomorrow, July 16. People experiencing a mental health emergency, such as suicidal thoughts, a substance-use crisis, or any other emotionally distressing event, will be able to call during times of crisis, but operators will also be available via text and online chat (at https://suicidepreventionlifeline.org/chat), according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
The 988 hotline will essentially replace the National Suicide Prevention Lifeline (1-800-273-TALK); however, the previous hotline will not be discontinued when 988 is rolled out, and callers will be directed to the same services offered via 988. Mental health experts say the new hotline will provide necessary updates to the services currently provided by the 1-800 number, chief among them a focus on sending trained experts to respond to mental health emergencies rather than law enforcement who are unfamiliar with protocols when approaching suicidal individuals.
Suicide hotlines are a crucial aspect of mental health services: In 2021 alone, 3.6 million people reached out to the National Suicide Prevention Lifeline, Dani Bennett, a press officer at the SAMHSA, tells SELF.
One major improvement is that the new number will be easier for people to remember during a mental health emergency. “The traditional number is hard to remember. When we have a medical emergency, we immediately know 911,” Robert Gebbia, the chief executive officer of the American Foundation for Suicide Prevention, tells SELF. “This is similar. When there’s a mental health crisis, people will remember 988.”
Experts expect the convenience of the new hotline to increase the number of callers. “We think there will be an increase in call volume,” Gebbia says. In fact, the SAMHSA predicts that the call volume will double within 12 months of the transition to 988, Bennett says.
Continue below to read how they think the new system will save lives and what exactly will happen when someone reaches out to 988 for help.
What happens when you call 988?
When a person contacts the updated suicide prevention hotline, they’ll be directed to a local crisis center (based on their area code). If nobody at the local center is available to take their call, the caller will be directed to a backup crisis center. They’ll be able to speak to a trained crisis counselor in either English or Spanish; additionally, automated translation services for over 250 additional languages will be available, according to press materials from SAMHSA.
The local crisis centers are funded through state and federal funding as well as private contributions, Gebbia says.
The operators handling incoming calls will be specially trained.
When someone dials a suicide hotline, the counselor who picks up on the other end has to efficiently deescalate the situation, Marianne Goodman, MD, a clinical professor at the Icahn School of Medicine at Mount Sinai and director of the Suicide Prevention Research and Care Center at James J. Peters Department of Veterans Affairs Medical Center, tells SELF. She cites a 2011 study published in Suicide and Life-Threatening Behavior, for which 153 suicide attempt survivors were interviewed. Researchers asked them how long it took to attempt suicide after they had decided to attempt suicide. Nearly a quarter (24%) of participants said it took less than five minutes. “There’s a very small window between when somebody has the urge and actually acts on the urge. You’ve got to act quickly,” Dr. Goodman says. “You really need people who have an elevated level of expertise.”
Counselors answering calls for 988 will be trained to stay calm while working with people having suicidal thoughts, and to engage them in conversation. They will also be trained to make decisions about when an in person response is needed (more on this later) versus when a caller can benefit from guidance given over the phone. An in person response isn’t always necessary, and whether it is or not depends totally on the specifics, Dr. Goodman says. For instance, if the caller already has a plan in place—and has the means to achieve that plan—that may necessitate an on the ground response, especially if the caller plans to use a firearm currently in their possession. But if the caller has a more elaborate plan that involves many steps, a crisis counselor may be able to intervene over the phone. Counselors also take into consideration whether the caller’s consciousness has been altered (for instance, if they’ve been drinking). Crisis counselors have to evaluate these factors—and more—to make quick decisions that can save lives.
This is why having local counselors who are trained to treat mental health emergencies, specifically, is crucial, since operators at other emergency lines may not be as equipped to help this population. The SAMHSA notes that the services provided by 988 will be “distinct from the public safety purposes of 911,” which are focused on dispatching fire, police, and EMS as needed.
988 will rely less on police to help people with suicidal thoughts.
One of the main differences between calling 988 and 911 for a mental health emergency comes down to what happens when that in person response is needed. When a person calls 911 for a mental health emergency, law enforcement officers are dispatched to help people considering suicide. “They take you, often, to the emergency department because they don’t know what else to do,” Gebbia says. “This needs to change and rely more on trained mental health professionals who can diffuse the situation.”
Some states already have mobile crisis teams that can respond to suicide attempts without intervention from law enforcement, Bennett says. The goal of 988 is to keep the response person-centered—meaning law enforcement and/or EMS personnel aren’t contacted unless safety and health concerns warrant it (for instance, if a suicide attempt is in progress), Bennett says. Some states are already doing this, and Gebbia says Arizona and Oregon (among others) have seen better outcomes for the patient by dispatching mobile care teams as opposed to law enforcement.
Mobile crisis teams aren’t currently available everywhere, though. The SAMHSA’s long-term vision for 988 is that it spurs the growth of a nationwide crisis care system that can handle mental health emergencies without relying on police. These crisis teams will know mental health practices, Gebbia explains, and know when a suicidal person would receive better care at, for instance, a mental health facility than the emergency department.
The new hotline’s success hinges on public awareness.
Public health professionals at every level need to start promoting the new number to raise public awareness, Dr. Goodman says. In addition to posting physical announcements about the new hotline in hospital and clinic waiting rooms and other health care settings, providers need to tell their patients about the new number and the services that come with it, Dr. Goodman says.
Gebbia agrees that a well-executed awareness campaign is key: “This is a lifesaving service” that requires community investment, he explains.
“If we’re really going to bring down suicide rates, these hotlines are critically important,” Dr. Goodman says. “And they absolutely save lives.”
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