988 Frequently Asked Questions
Full 988 implementation requires a bold vision for a crisis care system that provides direct, life-saving services to all in need. This leads to many questions about 988. We at SAMHSA welcome these questions.
The 988 Suicide & Crisis Lifeline (formerly 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 dial 988 if they are worried about a loved one who may need crisis support.
The Lifeline accepts calls, texts, and chats from anyone who needs support for a suicidal, mental health and/or substance use crisis.
Yes. 988 is built off of the 10-digit number. Using either number will get people to the same services. In the end, 988 is an easier-to-remember way to access a strengthened and expanded network of crisis call centers.
The 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.
Chat is available in both English and Spanish through the 988 Lifeline’s website at 988lifeline.org/chat. People seeking chat services are provided with a pre-chat survey before connecting with a trained crisis 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 can access 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.
When someone texts 988, they are responded to by a group of 988 Lifeline crisis centers that answer both chats and texts. This service is currently expanding to increase local and state-level response. Once you are connected, a trained crisis 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.
Yes, the 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.
Almost 98% of people who call, chat or text the 988 Lifeline get the crisis support they need and do not require additional services in that moment. The 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.
988 was established to improve access to crisis services in a way that meets our country’s growing suicide and mental health-related crisis care needs. 988 provides easier access to the Lifeline network and related crisis resources, which are distinct 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 federal, state, and local levels as our country continues to improve the coordinated and appropriate response to mental health and substance use crises.
Currently, a small percentage of Lifeline calls require activation of the 911 system when there is imminent risk to someone’s life that cannot be reduced during the 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 Lifeline is to provide support for people in suicidal crisis or mental health-related distress in the moments they most need it and in a manner which is person-centered. The vast majority of those seeking help from the Lifeline do not require any additional interventions at that moment. Currently, fewer than 2% of Lifeline calls require 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 coordinated response is intended to promote stabilization and care in the least restrictive manner.
All Lifeline crisis centers adhere to the Lifeline’s Imminent Risk Policy, which means that crisis center staff work through active engagement to provide support and assistance for people at risk in the least restrictive setting possible. In fact, most contacts with the Lifeline are resolved by the Lifeline itself, by chat or phone, in a manner that does not require additional immediate intervention.
In most states, the 211 system provides health and social service assistance information and referrals. At the same time, 988 crisis counselors will 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 Lifeline centers also respond to 211 contacts. We envision that 988 crisis centers will need to continue to coordinate with 211 and other warmlines. This will help ensure an all-inclusive approach regardless of which number a person may use first.
There are ongoing efforts to improve cultural competency training for 988 Lifeline crisis counselors. Some examples of related improvements to 988 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.
- 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.
The 988 Suicide & Crisis Lifeline (988Lifeline on social media and on the web) is the new name for the former National Suicide Prevention Lifeline. It’s important to understand that 988 connects people to more than just a “suicide” line; 988 is a service for anyone who is suicidal or experiencing a mental health- and/or substance use-related crisis. For partners talking about 988, it’s important that we don’t call this only a “suicide” lifeline, but instead refer to it as the 988 Suicide & Crisis Lifeline.
Yes. 988 is the easy-to-remember number that reaches what is commonly referred to as the Lifeline—a network of more than 200 state and local call centers funded by the U.S. Department of Health and Human Services through the Substance Abuse Administration and administered by Vibrant Emotional Health. Formerly known as the National Suicide Prevention Lifeline, the full name has changed to the 988 Suicide & Crisis Lifeline.
Anyone in a U.S. state, territory, or tribe who needs suicide or mental health-related crisis support, or who has a loved one in crisis, can connect with a trained crisis counselor by calling (multiple languages), chatting, or texting 988 (as long as the caller has telephone, cellular, or internet services available to them).
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.
Yes. Anyone who needs suicide or mental health-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 the caller has telephone, cellular or internet services available to them).
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 988 Lifeline provides live crisis center call, text, and chat services in English and Spanish and uses Language Line Solutions to provide caller translation services in more than 240 additional languages.
The Lifeline currently serves TTY users either through their preferred relay service or by dialing 711 then 1-800-273-8255. Lifeline also offers services through chat and text. Lifeline is in the process of expanding to video phone service to better serve deaf or hard of hearing individuals seeking help through the Lifeline/988.
To connect immediately with a Spanish-speaking trained crisis counselor, text “Ayuda” to 988. If you text a different word in Spanish, you will be prompted to text “Ayuda”.
To chat with a Spanish-speaking trained crisis counselor, go to linea988.org/chat and fill out and submit the form on the chat page.
When you reach out to the 988 Lifeline, the trained crisis counselor who responds to you will know your phone number if you call/text or your IP address if you use chat. Beyond that, they will not know who you are or where you are located. You are not required to provide any 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 Lifeline crisis counselor has to connect with 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 the 988 Lifeline does not have access to your precise location when you reach out.
Yes. In fall 2022, the 988 Lifeline began a pilot program to offer specialized call, text, and chat supports for lesbian, gay, bisexual, transgender, queer, questioning, and other sexual and gender minority (LGBTQI+) youth and young adults. The program aims to support people under the age of 25 who reach out to the 988 Lifeline and want the option of connecting with a counselor specifically focused on meeting the needs of LGBTQI+ youth and young adults. The specialized services are currently available by call, text, and chat services 24/7.
The Biden-Harris administration has increased federal investments 18-fold (from $24M to $432M) for this national priority. Congress has provided the Department of Health and Human Services workforce funding through the American Rescue Plan and the Bipartisan Safer Communities Act. Also, the President’s Fiscal Year 2022 budget request provides additional funding for the Lifeline itself and for other existing federal crisis funding sources. 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.
There are several existing federal resources that can be leveraged to support 988 implementation. Examples from SAMHSA include the crisis set-aside through the Mental Health Block Grant as well as 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 | 1.2 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. Regarding the transition to 988, states are at varying degrees of readiness for the volume increases expected from moving to the 3-digit code. 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 and territories 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 to prepare for the transition to 988, both now and in the months ahead. 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, yet very few states have done this so far. 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.
SAMHSA provided all states and territories an opportunity to apply for funding to support 988 implementation designed to build local 988 capacity; only two states (AK and RI) did not apply, though SAMHSA is in close collaboration with them. In April 2022, SAMHSA awarded nearly $105 million in grant funding, provided by the American Rescue Plan, to 54 states and territories. Regardless of whether a state or territory received funds through that specific grant program, SAMHSA works with all states and territories to partner around enhanced crisis service capacity. 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 | 1.2 MB).
In future years, 988 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.
Sources of federal funding for 988 are separate from those of the 911 system. Additionally, the 2020 Hotline Designation Act 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.
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 provided resources for 988 partners to use when communicating about 988 to their audiences, such as content and graphics for social/digital sharing. HHS is working with Congress to ensure federal resources for a national campaign to advertise or promote awareness of 988 to the public.
Anyone who needs suicide or mental health-related crisis support or has a loved one in crisis can connect with a trained crisis counselor by calling, chatting, or texting 988 (if the caller has telephone, cellular, or internet service available to them). This is true for Tribal nations, as well. However, SAMHSA recognizes the unique challenges to accessing technology and crisis services in Tribal nations and is committed to strengthening Tribal crisis service access and supporting coordination efforts with the existing 988 Lifeline infrastructure. SAMHSA is specifically supporting the 988 Lifeline crisis response needs in tribal communities through the FY2022 988 Tribal Response Grants and the FY23 988 Tribal Response Grant programs. SAMHSA has included requirements in the 988 Lifeline State and Territory grant program for states and territories to coordinate training, response, and resource connections with Tribal nations to ensure supportive response for tribal contacts to the 988 Lifeline, while maintaining respect for Tribal nation sovereignty.
988 provides an easier-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.
Having enough capacity to meet the growing demand for suicide and crisis care needs across the country is the primary focus of SAMHSA’s 988 efforts. This includes strengthening and expanding crisis call center services. It also means improving follow up and linkage to local in-person crisis services and access to community prevention tools and resources, as well as residential and outpatient care.
FAQs About Call Routing, Privacy, Network Functioning
People contacting 988 are not required to provide any personal data 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 988 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.
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.
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 | 448 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.
Currently, calls to 988 are automatically routed to the closest 988 Lifeline crisis center based on the area code of the phone being used. Because people commonly keep their same mobile phone numbers even when they’ve moved to other cities (or perhaps they call 988 when they are traveling), this means that a caller can be routed to a crisis center that is not in their same area. If the person wants to be connected to additional local services or requires emergency service, they may need to disclose their actual location to the 988 Lifeline crisis counselor. In some instances, when there is serious risk to life and a person poses an immediate danger to themselves or others, a crisis counselor is required to use 911 to help reach a caller even without their permission (this occurs in fewer than 1 % of calls to the 988 Lifeline).
In 2020, Congress designated the new 988 dialing code to operate through the existing National Suicide Prevention Lifeline, and the FCC ordered all 988 calls to be directed to the Lifeline telephone infrastructure. The Lifeline is made up of about 200 local crisis centers across the country, which are equipped to provide 24/7 call, chat, and text services. Across many evaluations, the Lifeline has demonstrated effectiveness in reducing suicidality, and provides a robust foundation upon which to build 988.
Although we have made significant progress in improving Lifeline response rates, scaling the size of the network and building the Lifeline workforce, there is more work to be done. For years, this network has been massively underfunded and under-resourced.
The federal government is responding to these resource challenges with unprecedented levels of funding – representing an 18-fold increase this year from the previous year – and has mounted an all-of-government approach to partner with state and local leaders to improve system capacity and performance and ultimately improve the health of our nation.
However, the federal government cannot do this work alone. Additional state and local investment is needed to further boost the response rates and staffing capacity of call centers facing the greatest demands.
The 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 Lifeline Core Clinical Training, currently under development, will be a self-paced online training that will cover essential skills for crisis counselors who answer calls/chats/texts within the Lifeline network. Additional training is being developed to address the specific needs of populations at higher risk of suicide.
The Lifeline greeting states that calls may be monitored or recorded for quality assurance purposes. Additionally, crisis centers in the Lifeline network may independently use call recordings for training purposes, dependent on the best practices of the center.
It’s also important to note that people contacting 988 are not required to provide any personal data 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.
No. Many states and localities operate a significant number of crisis centers separately from the Lifeline network.
Veterans, Service Members, and their families call 988 and press option 1. To learn more, please visit https://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.
Unfortunately, the Lifeline has been historically unfunded and under resourced since it was stood up in 2005. While we have come a long way in recent years and dedicated an unprecedented amount of resources to towards strengthening crisis care in the U.S., it will take time for 988 and the broader crisis response system being built to grow and evolve. One of the most urgent needs involves staffing at crisis centers, and we encourage anyone interested in serving in these critical positions to visit the 988 jobs web page.
July 16, 2022, is a date set by the FCC by which all phone service providers must direct all 988 calls and chats to the existing National Suicide Prevention Lifeline. July 16 is the start of a transition, not the end, and there is still a lot of work to be done. The Biden Harris Administration has made significant strides in strengthening and expanding the existing National Suicide Prevention Lifeline, and we expect the 988 Suicide & Crisis Lifeline will continue to grow and evolve in the coming months and years. We must have our eye on sustainable, long-term change – let us remember, it has taken over 5 decades for 911 and emergency medical services to grow and expand in our country. With 988, we’re poised for a much faster transformation.