“We have an opportunity with 988 to enhance existing crisis systems of care.” – Joan Gillece, Ph.D.

On Saturday July 16, 2022, the United States established a new three-digit Suicide and Crisis Lifeline – 988. This move to the three-digit number as part of the National Suicide Hotline Designation Act of 2020 is intended to serve as an easier number to remember than the toll-free hotline that had previously been in place. By calling 988, individuals are connected to one of more than 200 crisis centers across the country, which provide 24/7 assistance by mental health professionals.

Suicide accounted for nearly 46,000 deaths in the United States and was the second leading cause of death among individuals age 10 – 14 and 25 – 34 in 2020, according to the Centers for Disease Control and Prevention.

The federal Substance Abuse and Mental Health Services Administration (SAMHSA) will support 988, but the legislation also empowers states to take an active role. The federal Department of Health and Human Services has awarded almost $105 million to states and territories to support implementation.

The National Alliance on Mental Illness (NAMI) maintains a policy tracker enumerating state legislative and gubernatorial actions, including budgetary, programmatic, and policy changes focused on suicide prevention. NAMI has identified three pillars for an ideal 988 crisis response team, including crisis call centers, mobile crisis teams, and crisis stabilization programs. This concept relies on both telephonic and in-person supports for individuals in crisis.

According to Cherene Caraco, CEO of the Promise Resource Network, a trauma and suicide attempt survivor and Pathways to Resilience Advisory Committee member, “providing states and localities with flexibility was the right thing to do, and states should leverage on-the-ground experts, including peer run organizations, to establish approaches that address community need.”

The National Association of State Mental Health Program Directors has created and compiled a series of resources, including 988 playbooks for states, territories, and providers to aid in implementation. Director of NASMHPD’s Center for Innovation in Health Policy and Practice and Pathways to Resilience Advisory Committee member Joan Gillece, Ph.D. indicated “We have an opportunity with 988 to enhance existing crisis systems of care. In addition to providing easy access to supports, we can work to ensure that all Lifeline counselors have received trauma-responsive training and have information about local in-person resources to support callers.”

Pathways to Resilience is a national initiative promoting trauma-responsive policies and programs in every state. The goal of Pathways is to support states and localities in implementation of actionable and concrete trauma-responsive strategies, like 988, which represents a prime opportunity to meet state and community needs.