988 Frequently Asked Questions
These frequently asked questions are designed to help you better understand the 988 Suicide & Crisis Lifeline. SAMHSA regularly adds new FAQs and updates responses as we continue to talk with grantees and partners around the country.
FAQs About 988 Lifeline Services
The 988 Suicide & Crisis Lifeline, previously known as the National Suicide Prevention Lifeline, offers 24/7 call, text and chat access to trained crisis counselors who can help people experiencing suicidal, substance use, and/or mental health crisis, or any other kind of emotional distress. People can also call, text or chat 988 if they are worried about a loved one who may need crisis support.
The 988 Lifeline is a direct connection to immediate support and resources for anyone in crisis. Here are some of the many reasons people might decide to connect with the 988 Lifeline (MP4 | 19 MB).
The 988 Lifeline responds 24/7 to calls, chats or texts from anyone who needs support for suicidal, mental health, and/or substance use crisis, and connects those in need with trained crisis counselors. There are many reasons that people connect with the 988 Lifeline. Some examples in addition to thoughts of suicide are feeling overwhelmed with anxiety, sexual orientation worries, drinking too much, drug use, feeling depressed, mental and physical illness, loneliness, trauma, relationships, and economic worries.
Yes. 988 is the easy-to-remember number that reaches what is commonly referred to as the 988 Lifeline—a network of more than 200 state and local crisis contact centers funded by the U.S. Department of Health and Human Services through the Substance Abuse and Mental Health Services Administration and administered by Vibrant Emotional Health.
Yes. Anyone who needs suicide-, mental health- or substance use-related crisis support, or who has a loved one in crisis, can connect with a trained counselor by calling, chatting, or texting 988 (as long as telephone, cellular or internet services are available).
When someone calls 988, they first hear a greeting message. You are given choices of who to connect with in the greeting; the 988 Lifeline has specially trained counselors for Veterans (through the Veterans Crisis Line, operated by the Veteran’s Administration), Spanish speakers and LGBTQI+ youth and young adults. Your call is then routed to one of the national networks or a local 988 Lifeline network crisis center based on your selections and then based on your phone’s area code.
A trained crisis counselor answers the phone, listens to you, works to understand how your problem is affecting you, provides support, and shares resources, if needed. If your local crisis center is unable to take your call, you are automatically routed to a national backup crisis center. All these services are available in English and Spanish. The 988 Lifeline uses Language Line Solutions to provide translation to callers in more than 240 additional languages.
When someone texts 988, a trained counselor listens to you, works to understand how your problem is affecting you, provides support, and shares resources that may be helpful. Texting is available in both English and Spanish. When texting 988 in Spanish, you will be asked to type “Ayuda” to connect with a Spanish-speaking counselor. Veterans and service members who text 988 will be redirected to text 838255 to reach the Veterans Crisis Line, which is managed by the Veterans Administration. You will also be given an option to connect with an LGBTQI+-trained counselor. Text service is currently expanding so that an increasing number of texts are routing to local 988 Lifeline network crisis centers based on a texter’s area code.
Chat is available in both English and Spanish through the Lifeline’s website at 988lifeline.org/chat and linea988.org/chat. People seeking chat services are provided with a pre-chat survey before connecting with a counselor, who identifies the main area of concern. If there is a wait to chat with a crisis counselor, a wait-time message will appear. If demand is high, people are encouraged to look at the 988 Lifeline’s “helpful resources” while waiting. Once you are connected, a crisis counselor listens to you, works to understand how your problem is affecting you, provides support, and shares resources that may be helpful. Chat service is currently expanding so that an increasing number of chats are routing to local 988 Lifeline network crisis centers based on the information that you choose to supply in the pre-chat survey.
Yes, the 988 Lifeline works. Numerous studies have shown that most Lifeline callers are significantly more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful after speaking to a Lifeline crisis counselor. 988 Lifeline crisis counselors are trained to help reduce the intensity of a situation for the person seeking help and connect them to additional local resources, as needed, to support their wellbeing.
About 98% of people who reach out to the 988 Lifeline are helped by the crisis counselor, resources shared, or community connections made (without involvement of 911) during the call, text, or chat.
People using the 988 Lifeline are not required to provide any payment or insurance information to receive support. However, standard data rates from telecommunication mobile carriers may apply to those who text to the 988 Lifeline. If monetary assistance is needed for communications needs due to data rates, please see www.fcc.gov/lifeline-consumers for more information.
The people answering the 988 Lifeline are located in more than 200 local and state-run crisis centers. They will listen, support, assess your situation, share resources, and make community connections. Average wait times can vary based on usage surges and other factors. At the time of publishing these FAQs, average time to answer once you have completed the greeting is typically under a minute. Sometimes, the wait may be longer; please know that your reachout is important and that a caring counselor will respond as soon as they can.
Yes, anyone located in a U.S. state, territory or tribal land with access to telephone, cellular, or internet services can connect to a trained counselor by calling, chatting, or texting 988.
SAMHSA’s longer-term vision is that the transition to 988, which began in July 2022, will spur the growth of a robust crisis care system across our country that links callers to community-based providers who can deliver a full range of crisis care services (like mobile crisis teams or stabilization centers). Currently, these crisis care services do not exist in all areas of the country, and it will take time and sustained support for this crisis care system to evolve.
Veterans, Service Members, and their families can call 988 and press option 1. To learn more, please visit www.veteranscrisisline.net/about/what-is-988. This process is the same as it has been in the past for Veterans; however, it’s now simpler with the shortened 988 number.
Yes. Although the 10-digit number was transitioned to the easier-to-remember “988” in July 2022, it remains functional and will connect you to 988 Lifeline services.
FAQs About the Difference Between 988, 911 and 211
The 988 Lifeline was established to improve both accessibility of crisis services and to meet the nation’s growing suicide and mental health-related crisis care needs. The 988 Lifeline provides easier access to mental health crisis care through a 200+ network of crisis call, text, and chat centers, separate from the public safety purposes of 911, where the focus is on dispatching emergency medical services, fire, and police, as needed.
SAMHSA is working towards a long-term vision of strong coordination between the two services so people in crisis get to the most appropriate care needed in that moment. SAMHSA is actively working with 911 counterparts at the federal, state, and local levels as our country continues to improve crisis care systems.
Currently, a small percentage of 988 Lifeline callers require activation of the 911 system, and most of those are done with the consent and cooperation of the caller. This occurs when there is an imminent risk to someone’s life that cannot be reduced during the 988 Lifeline call. In these cases, the crisis counselor shares information with 911 that is crucial to saving the caller’s life.
The primary goal of the 988 Lifeline is to provide support for people in suicidal crisis or mental health-related distress in the moments they need it most and in a manner that is person-centered. The vast majority of those seeking help from the 988 Lifeline do not require any additional interventions at that moment. Currently, fewer than two percent of Lifeline calls require a connection to emergency services like 911. While some safety and health issues may warrant a response from law enforcement and/or Emergency Medical Services (namely when a suicide attempt is in progress), the 988 Lifeline coordinated response is intended to promote stabilization and care in the least restrictive manner.
Every 988 Lifeline crisis center adheres to the 988 Lifeline’s Suicide Safety Policy (PDF | 490 KB), which means that crisis center staff actively engage with people at risk and provide support and assistance for people at risk in the least restrictive setting possible. In fact, most peoples’ needs are resolved in their call, text, or chat connection with the 988 Lifeline counselor and do not require additional immediate intervention.
Sources of federal funding for 988 are separate from those of the 911 system. Additionally, the 2020 Hotline Designation Act (PDF | 242 KB) permits states to apply specific 988 telecommunication fees to support crisis services in a manner that is distinct from fees used to support 911 operations. State and local support of both 988 and 911 are necessary to advance the health and well-being of our communities.
In most states, the 211 system provides health and social service assistance information and referrals. The 988 Lifeline crisis counselors provide support for people in suicidal crisis or mental health-related distress in the very moments they need it most. While generally being different in scope, these systems need to be aligned, and in many cases, local 988 Lifeline centers also respond to 211 contacts. We envision that 988 Lifeline crisis centers will need to continue to coordinate with 211 and other warmlines. This will help ensure a collaborative approach regardless of which number a person may use first.
FAQs About How 988 Addresses Diverse Populations
The 988 Lifeline currently requires that all network centers adhere to specific standards regarding Suicide Risk Assessment and Imminent Risk interventions — however, each crisis center also develops their own specific training to meet organizational needs. The 988 Lifeline Core Clinical Training is self-paced online training that covers essential skills for crisis counselors who answer calls, chats, or texts within the 988 Lifeline network. Development of additional training is ongoing to address the specific needs of populations at higher risk of suicide.
There are ongoing efforts to improve cultural competency training for 988 Lifeline crisis counselors. Some examples of related improvements to the 988 Lifeline are that:
- Spanish-speaking crisis counselors are answering calls, texts, and chats in Spanish.
- LGBTQI+ trained crisis counselors answer calls, texts, and chats in a specialized LGBTQI+ youth and young adult service.
- Deaf and Hard-of-Hearing people can communicate with counselors in American Sign Language.
- The 988lifeline.org website has improved information related to mental health wellness in the Black community.
- The 988 Lifeline has specific tools for crisis counselors, such as Spanish-language clinical guidance resources, Deaf and Hard of Hearing best practices for callers/chat visitors, an LGBTQI+ guidance document, and an American Indian/Alaskan Native tip sheet.
Callers who are Deaf, DeafBlind, DeafDisabled, Hard of Hearing, and Late-Deafened can directly dial 988 on a videophone or click the "ASL Now" button on 988lifeline.org to connect with crisis counselors who can communicate in ASL and are trained in working with the Deaf and Hard of Hearing community.
Yes. Lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI+) youth and young adults under the age of 25 who want to connect with a counselor specifically focused on meeting their needs can call 988 and select option 3, text “Y” to 988 or access the service via chat.
Anyone who needs support for a suicidal, mental health and/or substance use crisis, or who has a loved one in distress, can connect with a trained counselor by calling, chatting, or texting 988 (if telephone, cellular, or internet service is available). This is true for Tribal nations, as well.
SAMHSA recognizes the unique implementation barriers and challenges facing Tribal nations and is supporting coordination efforts with the existing 988 Lifeline infrastructure. SAMHSA expects states and territories to coordinate with Tribal nations to ensure a supportive response for tribal contacts to the 988 Lifeline, while maintaining respect for Tribal nation sovereignty.
Additional efforts are underway to partner with Tribal nations to expand the 988 Lifeline in these communities, including training counselors who are culturally and linguistically aware. SAMHSA is supporting a crisis center academy for Tribal grantees who are building or enhancing crisis services for their community. We’ve also expanded the 988 Lifeline partner network to include Tribal communities as part of SAMHSA grantmaking.
FAQs About Federal/State Roles and Funding
The Biden-Harris Administration has made unprecedented investments to support the 988 Suicide & Crisis Lifeline – so far the investment is nearly $1 billion. Prior to this investment, the 988 Lifeline, which has existed since 2005, had been long underfunded and under-resourced. Congress has provided the Department of Health and Human Services funding through the American Rescue Plan, the Bipartisan Safer Communities Act, and Fiscal Year budgets. At the state and territory level, in addition to existing public/private sector funding streams, the National Suicide Hotline Designation Act of 2020 allows states to enact new telecommunication fees to help support 988 operations. The National Alliance on Mental Illness (NAMI) tracks state legislation for 988 funding at ReimagineCrisis 988 Crisis Response State Legislation Map. That total does not include funding for mobile crisis response, certified community behavioral health clinics, or dedicated crisis care-related funds within SAMHSA’s Community Mental Health Services Block Grant, all of which are also critical components supporting the crisis care system.
There are several existing federal resources that can be leveraged to support 988 implementation. Examples from SAMHSA include 988 Lifeline grants to states, territories, and tribes; the 988 Lifeline crisis center follow-up grant; the crisis set-aside through the Mental Health Block Grant; and funding through the Certified Community Behavioral Health Clinic (CCBHC) program. States are also able to leverage Medicaid dollars and State Opioid Response grants. States can find descriptions of these funding sources in the 988 Convening Playbook for States, Territories, and Tribes (PDF | 1.1 MB).
Successful 988 implementation requires ongoing investment and engagement from states and territories. The National Suicide Prevention Lifeline has been available to all states since its launch in 2005. The Biden-Harris administration has significantly increased the federal government’s contribution to supporting the 988 Suicide & Crisis Lifeline. Most of these funds have gone to Lifeline crisis centers around the country, and to states, territories, and tribes to build up their local crisis call center workforce. SAMHSA will continue to partner with states, providing a network infrastructure as well as state support through funding opportunities, coordination, and technical assistance.
We recognize the important and timely work of states/territories towards building and operating a successful 988 Lifeline crisis care network of services. To assist, SAMHSA is funding and working with states/territories directly on critical efforts they will need to undertake in support of 988 at their local and community levels. For instance, the National Suicide Hotline Designation Act of 2020 gave states the ability to enact new telecommunications fees to financially support 988 operations. Success of 988 will rest heavily upon state, territorial and local leadership in leveraging the resources already available, in addition to making new investments. We will continue to work in close partnership with them to meet the crisis care needs of people across our country. HHS has several funding sources to support 988 and integrated crisis care. States, territories, and tribes are encouraged to explore which funding resources are helpful to them. States can find descriptions of these funding sources in the 988 Convening Playbook for States, Territories, and Tribes (PDF | 1.1 MB).
In future years, 988 Lifeline funding needs will depend on contact volume to the crisis centers and resource needs for full implementation. This may include support to strengthen network operations, strengthening local crisis center capacity, improving public awareness of 988, and improving follow up and linkage to local, crisis care services. Any future federal funding needs will be put forth in subsequent Presidents’ budget requests.
As a component of SAMHSA’s funding, states/territories are required to address outreach and engagement strategies for populations at higher risk of suicide (many of whom are communities of color and historically marginalized groups), including plans for how they will measure effectiveness in improving outcomes and access to services across populations.
As Vibrant Emotional Health is the administrator of the National Suicide Prevention Lifeline, it was essential to invest heavily in network infrastructure in order to strengthen and expand the network to meet the expected increase in demand when transitioning to 988. This includes strengthening national back-up capacity to address expected contact volume while states and territories continue to expand local services.
SAMHSA and Vibrant have been working to raise awareness of the 988 Lifeline through co-hosted events with state and local partners across the country and through targeted campaign ads. These campaigns include general awareness of the 988 Lifeline and its specialized services, what to expect when contacting 988 and when to use it. SAMHSA has also provided funding to states for communications. In addition, SAMHSA continues to work with Congress on federal funding for a national campaign to both create awareness and to encourage use of the 988 Lifeline. SAMHSA provides social media, branded photos, print materials, branding and logo guidelines, and other materials in a 988 Partner Toolkit for anyone to use when communicating about the 988 Lifeline to their audiences. SAMHSA also supported 988 Formative Research to inform 988 messaging efforts around the country.
The 988 Lifeline provides an easy-to-remember way for people who are struggling or in crisis to reach out for help. This is an opportunity to strengthen and expand the Lifeline network and to build a robust crisis response system that links people in crisis to community-based providers who can deliver a full range of crisis care services, if needed (like mobile crisis teams or stabilization centers). This more robust system will be essential to meeting crisis care needs across the nation.
Significant investments of almost $1 billion from the Biden–Harris Administration have helped strengthen and expand the 988 Lifeline capacity, supporting more people in crisis. The President’s Budget for Fiscal Year (FY) 2024 includes $10.8 billion for SAMHSA, $3.3 billion over the agency’s FY 2023 enacted budget. The FY 2024 budget proposal continues to support the President’s Unity Agenda to address the national mental health crisis and overdose epidemic.
For FY 2024, the proposed amount is $836 million, an increase of $334 million, to the 988 Suicide & Crisis Lifeline. The requested funds, to be dispersed to states, local crisis centers, tribes and tribal organizations, and the system administrator, would scale and strengthen the 988 Lifeline crisis care network to respond to the 6 million contacts anticipated by FY 2024.
FAQs About Privacy, Call Routing, and Network Functioning
When you reach out to the 988 Lifeline, the crisis counselor who responds to you will know your phone number via call or your IP address if you are using chat. Beyond that, they will not know who you are or where you are located. You are not required to provide personal information to receive support from the 988 Lifeline.
If a 988 Lifeline crisis counselor makes an effort to gather information during a call, text, or chat, it will be to: 1) save lives; 2) connect people to ongoing support; and 3) evaluate 988 Lifeline services.
In rare situations when a 988 crisis counselor has to reach out to a 911 dispatcher because of concerns about an immediate risk to life, 911 may be asked to initiate a precise geolocation lookup with the Internet Service Provider or wireless carrier. This is needed because 988 does not have access to your precise location when you reach out.
People who call, text, or chat the 988 Lifeline are not required to provide any personal information to receive services. SAMHSA recognizes the importance and the expectation of privacy when a person contacts 988. The network system has several safeguards to address concerns about privacy.
Any effort to obtain demographic information from those who use the 988 Lifeline will serve three primary purposes: 1) to save lives; 2) to connect people to ongoing supports; and 3) to evaluate system needs and performance, particularly ensuring that gaps and inequities are being addressed.
The 988 Lifeline greeting states that calls may be monitored or recorded for quality assurance purposes. Additionally, crisis centers in the 988 Lifeline network may independently use call recordings for training purposes, dependent on the best practices of the center.
However, it’s important to note that people contacting the 988 Lifeline are not required to provide any personal information to receive services. SAMHSA recognizes the importance and the expectation of privacy when a person contacts the 988 Lifeline. The network system has several safeguards to address concerns about privacy.
No. The Lifeline administrator, Vibrant Emotional Health, is a not-for-profit organization with a primary mission to support emotional wellbeing for all people, and it does not sell Lifeline data.
Currently, calls to the 988 Suicide & Crisis Lifeline are routed to the nearest geographic 988 crisis call center based on the defined location of the first six digits (area code and prefix) of the caller's phone number, regardless of the actual location of the caller. This means that a wireless call could be directed to a 988 crisis call center that is not the nearest one to the person reaching out for support. For example, if a person experiencing a crisis in Colorado dials 988 using a cell phone number with a New York area code, that person is routed to the New York call center covering that area code rather than the call center aligned to their physical location in Colorado.
Georouting is a way of directing phone calls locally without including the caller’s precise location information in the transferred call data. If used, it would mean that when a person calls the 988 Lifeline, their call would be connected automatically to a crisis call center near their physical location. With geo-routing, the routing and service providers would not receive detailed information about the exact location of callers.
Geolocation, or automated location information, would include the precise location in the transferred call data, so that emergency responders could know where to go in case of an emergency.
The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Federal Communications Commission (FCC) are currently exploring technology solutions to improve routing of 988 Suicide & Crisis Lifeline calls. The 988 Lifeline has successfully tested a method of routing wireless 988 calls to a crisis call center near the physical location of the caller rather than by their phone’s area code. This is called “georouting.” The goal is to help people in crisis get local support wherever they are, regardless of their phone number’s area code, while taking into consideration the privacy and security of callers. This test, which did not involve real-time calls, explored a routing method that directs the caller to a 988 crisis call center based on cell tower location and wire-center boundaries. The precise location of the caller would not be received by the 988 Lifeline as part of the routing method that was tested. This test involved one wireless carrier. The results will be the foundation of further work with service providers/carriers to explore this potential solution for 988 calls.
As SAMHSA and the FCC are evaluating options to improve routing, we invite carriers across the country to join us in the process and contribute to our shared goal of ensuring local 988 Lifeline access while continuing to safeguard the privacy and security of callers.
No, geolocation services are not enabled for 988. The Lifeline currently automatically routes calls by area code to the nearest crisis center based on the area code of the caller’s phone number. Call routing and geolocation are related location issues but involve different technical, legal, privacy, and cost considerations. As part of the 2020 Designation Act, the Federal Communications Commission submitted a report (PDF | 447 KB) examining the feasibility and cost of including an automatic dispatchable location that would be conveyed with a 988 call. Within that report, the FCC recommended that Congress require that a multi-stakeholder group be convened to further examine the key issues and collaborate on potential next steps. The FCC held a 988 Geolocation Forum in May 2022 and the agency is actively analyzing the information gathered during that forum, including whether potential routing improvements could help callers to 988 connect to the regional call centers where they are located without sharing specific geolocation information.
No. Many states and localities operate a significant number of crisis centers separately from the Lifeline network.
FAQs About Mobile Crisis Care
Mobile crisis teams, also known as mobile crisis outreach teams or mobile crisis outreach, are a critical component of an effective and trauma-informed mental health and substance use system of care. Mobile crisis teams support people in their community environments where people are comfortable to avoid unnecessary law enforcement involvement, emergency department use, and hospitalization.
Mobile crisis units are optimally staffed by mental health and substance use treatment and recovery professionals, paraprofessionals and peer support workers to respond to people experiencing emotional and substance use distress in the community as an alternative to law enforcement. While there are situations where the presence of other first responders is necessary for safety purposes, the goal of this service is to provide individualized, health-first responses to mental health and substance use crisis situations.
The main objectives of community-based mobile crisis intervention services are to provide rapid response, individual assessment, and crisis resolution by trained mental health and substance use treatment professionals, paraprofessionals and peer support workers.
Teams typically will:
- Triage/screen a person’s immediate needs, including explicitly screening for suicidality
- Assess a person’s emotional health condition
- Deescalate/resolve the crisis
- Provide peer support by people with lived experience in recovery from an emotional or substance use health condition
- Coordinate with medical and behavioral health services for follow-up care
- Create a safety plan with the person
- Connect the person to community support and follow-up care
The two primary models are:
- Mobile crisis teams, in which a team of behavioral health staff and peers respond to the person in crisis, and
- Co-responder teams, in which a team including law enforcement or emergency medical staff and a mental health professional respond jointly.
The appropriate approach in a given situation in a particular community will depend in part on the assessment of risk and imminent threat, as well as the service availability, laws and regulations of the community’s jurisdiction. A small community that has no mobile crisis capacity and that shares mental health staff with other communities may face different constraints than a large urban community with greater resources.
SAMHSA’s long-term vision is for full access to mobile crisis services across all communities. Currently, mobile crisis services and the mobile crisis models used at the state, territory, Tribal, and local levels vary around the country. The availability and number of mobile crisis services has been rapidly expanding over the last several years.
Mobile crisis services are ideally available 24/7; however, their availability currently varies by the location. Services can be provided in the home or any community-based setting where a crisis may be occurring. In most cases where mobile crisis teams exist, a two-person crisis team is on call and available to respond. Some units use telehealth as a component of the service delivery. The team may be comprised of professionals and paraprofessionals (including trained peer support providers) who are trained in crisis intervention skills and in serving as the first responders to people needing help on an emergency basis.
The training varies according to the individual mobile crisis program. In general, mobile crisis responders are trained in trauma-informed care, de-escalation, cultural sensitivity, acute behavioral health screening and assessment, crisis intervention, safety planning, and harm reduction.
There are a range of federal resources available to support mobile crisis services, including the Mental Health Block Grant and State Opioid Response programs, the Certified Community Behavioral Health Clinics, and the Community Crisis Response Partnerships program. Some states also include mobile crisis services in their respective state Medicaid plans. States that choose to cover community-based mobile crisis intervention services under Medicaid and, pursuant to section 9813 of the American Rescue Plan Act of 2021, can receive an enhanced federal medical assistance percentage of 85% if the services meet certain requirements.
The goals of mobile crisis are to provide assessment, de-escalation, treatment intervention, safety planning, and referral in community settings and in a manner that minimizes the need for hospitalization. Not everyone who experiences suicidal thoughts will require involuntary transport or hospitalization. Mobile crisis teams can do a suicide risk assessment to determine the best type of help needed and how to get the person in need that help. When mobile crisis teams determine that hospitalization is necessary due to imminent safety concerns, the team works to engage the person in crisis and meet the preference of the person. Involuntary hospitalization may be needed in circumstances of imminent risk where the other efforts are not successful.
Billing will depend on the specific policies of the organization or jurisdiction providing the mobile crisis service. There are existing payment codes that permit payment of the services through public and private payers. SAMHSA recommends that nobody should be denied or delayed access to services based on their ability to pay; this is the standard practice of most mobile crisis teams.