Sustainable funding still needed for new 988 Lifeline number, advocates say

As the National Suicide Prevention Lifeline prepares for the launch of its new three-digit number, 988, on July 16, experts said Thursday they're excited about the opportunity to reimagine crisis care in the U.S., but building out the system will take time.

"We know that the 16th is the start of a transition, and not an end," Dr. Miriam Delphin-Rittmon said during a press call hosted by the National Action Alliance for Suicide Prevention at Education Development Center. Delphin-Rittmon is the assistant secretary for mental health and substance abuse at SAMHSA, the Substance Abuse and Mental Health Administration, a branch of the Department of Health and Human Services.

"There's still a lot of work to be done, we know, to strengthen and transform the crisis-care continuum," she said.

The Lifeline has been in operation using a 10-digit number since 2005 and has been underfunded and understaffed since its inception, advocates say. Ahead of the launch of the new number, which experts anticipate will create a dramatic increase in call volume, workforce capacity issues continue to be a concern.

As of December 2021, the Lifeline was only able to answer about 85% of calls coming through nationwide, according to an appropriations report from SAMHSA.

Answer rates vary from state to state, but those calls are answered at the local level when possible. When a local call center isn't able to answer a call, it gets forwarded to one of the national backup call centers.

The Biden administration has allocated $272 million in federal grant money for states, territories and the national backup centers to help fund the implementation of the new number. An additional $150 million was recently added to that effort as a part of the gun violence legislative package passed by Congress in late June.

That federal funding, hailed by advocates as an unprecedented investment, has already made a difference, Delphin-Rittmon said Thursday.

She explained that the Lifeline's ability to respond has increased amid the wave of federal funding.

In May, Delphin-Rittmon said, the Lifeline was able to answer 27,000 more calls, 27,000 more chats and 3,000 more texts, compared to February.

Despite the increases in capacity, experts say more state-level investment is needed to ensure this system holds up long-term.

HHS Secretary Xavier Becerra echoed this sentiment last Friday while speaking with reporters, saying the new number, "will work, if the states are committed to it."

"It is up to states to step up to the plate and create the funding [to increase capacity]," said Angela Kimball, senior vice president for advocacy and policy for the mental health policy coalition, Inseparable.

Four states have passed cell phone fees to help fund the call centers and crisis response at the state level, and some others have allocated funds from their yearly budget. But, Kimball said, "a lot of states have allocated insufficient resources to actually build a system that has the capacity to respond like people need."

"That's going to take people stepping up and demanding that elected officials invest," she added. "It's not going to happen for free."

In addition to the federal funding, SAMHSA has developed a jobs portal for call center jobs across the country to try to help address the workforce issues in the states.

"Crisis care is a priority as it hasn't been in the past," said Colleen Carr, director of the National Action Alliance for Suicide Prevention.

"988 is really a transformational moment in our nation's response to mental health and suicide prevention," Carr continued. "And to achieve its full promise, it's going to require long-term commitment and resources to ensure that anyone in crisis has access to quality and compassionate crisis care, when and where they need it."

The long-term goals for crisis care response, advocates say, includes not just call centers but mobile crisis response teams and crisis stabilization units for people experiencing issues that cannot be deescalated over the phone. Experts say this continuum, as it's called, will take even longer to develop than a consistent call response.

These sorts of resources, when available, can provide a professional, compassionate response, Kimball said.

Her own son has struggled with his mental health, she explained, and once needed the help of a mobile crisis team, which was able to deescalate the situation and get him the help he needed.

"This, honestly, is the kind of respectful, humane recovery-oriented response that everyone in crisis needs and deserves," she said.

988 is the first step in making that continuum a reality, she added, saying, "No one's worst day should ruin their chance to live their best life."

If you are struggling with thoughts of suicide or worried about a friend or loved one, call the National Suicide Prevention Lifeline at 1-800-273-8255 [TALK] for free, confidential emotional support 24 hours a day, seven days a week.