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Teenager Dialing

Launching 988 nationally to support a continuum of care in mental health

Renee Gross, JD
Renee Gross, JD
Senior Health Policy Consultant, Kaiser Permanente Institute for Health Policy

As a volunteer counselor for crisis support services in my county, I answer calls from people in crisis who come from all different walks of life. Their stories reflect a tapestry of emotions, challenges, and social circumstances. I am often struck by a caller’s willingness to share their life experiences and struggles, and desire for human connection as part of their path forward.  

Informed by this experience, I was interested to learn that these services would soon be readily available to more people in crisis. In 2020, Congress enacted laws and the Federal Communications Commission issued regulations that designate 988 as the new three-digit number for our national suicide prevention and mental health crisis hotline. The goal of this simplified number is to make it easier to remember for those who experience mental illness and their families, who might not otherwise know how to quickly access crisis help. It may make safety planning easier for clinicians and their patients who can feel paralyzed during a crisis and unable to remember a complex rescue plan. 

988 comes at a critical time when the COVID-19 pandemic and the resulting economic recession have negatively affected many people’s mental health. With this transition, effective in July 2022, comes many benefits and some potential challenges.  

The new emergency number presents an opportunity to create a continuum of care that ensures appropriate responses to mental health crises and increases equity when it comes to receiving mental health care. If operationalized successfully, more response services, such as mobile crisis teams, will be available regardless of who or where people are or why they are calling. There are many possible benefits and opportunities associated with this new resource: 

  • Reeducate the public about how to help those in crisis by using an easy-to-remember number, resulting in more people getting help in a timely and appropriate manner.  
  • Reduce stigma associated with mental illness and seeking out help.    
  • Use technology for real-time coordination across a system of care and leverage data for performance improvement, prevention strategies, and accountability across systems.  
  • Support the development of a system of regional or statewide crisis call centers that provide high-touch support to individuals and families in crisis. 
  • Reallocate law enforcement resources to be applied to non-mental health emergencies.  

With change also comes challenge. Congress passed the National Suicide Hotline Designation Act, allowing states to administer small user fees to pay for the efficient and effective routing of calls, personnel, and the provision of acute mental health crisis outreach and stabilization services. States must identify funding to effectively operate and implement 988 and they are at different stages of this process.

Experts expect 988 to generate a greater call volume – from 4 million in 2021 to 13 million by 2026. With this growth, states and mental health providers are concerned about coordinating care and responses while providing services in a culturally competent manner. We know that the need for services will put greater demands on mental health providers, a profession facing countrywide shortages.

In Oregon and Washington, Kaiser Permanente is working with state leadership to access information about members who call 988 or their local crisis line so that we can coordinate immediate appointments with a health care clinician. Additionally, our Northwest region is increasing the number of behavioral health consultants in all primary care clinics to help meet the increased demand for mental health services. 

While 988 holds the promise of significantly strengthening our country’s mental health crisis care, its success hinges on our nation’s crisis infrastructure and the ability of states and providers to respond to the call.  


Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. All calls are confidential. You can also text the Crisis Text Line available 24 hours a day, 7 days a week. Text “HOME” to 741741. 

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