A year since 988 started helping callers, here’s what experts want to see next

If you or someone you know is struggling with depression or suicidal ideation, you can call 988 to access the 988 Suicide & Crisis Lifeline or find help online at https://988lifeline.org/.

In the year since the launch of 988, the U.S. hotline has fielded almost 5 million calls, texts and chats, offering support to people in mental health crises. But officials say more federal and state dollars are needed to build and staff more call centers and meet the anticipated need.

Last July, 988 replaced the National Suicide Prevention Lifeline (which had a much longer phone number) with a three-digit number that is easier to remember and dial.

Chart by Megan McGrew/PBS NewsHour

In its first year, the new service received 2 million more calls than the former helpline number had received the previous year, said Health Secretary Xavier Becerra. He also announced Thursday the addition of Spanish call, text or chat options.

While the service is reaching some people, officials say far more needs to be done to raise awareness about this hotline and to boost infrastructure so that people have the resources they need when they seek help.

In the United States, a suicide takes place about once every 11 minutes, according to the Centers for Disease Control and Prevention, and it is the second-leading cause of death for preteens and young adults.

“Crises come and go, but you want to make sure people get help to prevent that from becoming a crisis again,” said Bob Gebbia, who leads the American Foundation for Suicide Prevention.

What is 988?

In 2001, Congress approved funding for a hotline designed to help prevent suicide by giving people someone to talk to and to connect them with mental health services if necessary. Four years later, the 10-digit National Suicide Prevention Lifeline was established.

But in the U.S. health care system, “often our services are so fragmented, they’re difficult to navigate even when you’re not in crisis,” Colleen Carr, director for National Action Alliance for Suicide Prevention, told the PBS NewsHour in 2022.

Given the complexities of mental health care access, concern grew that people might misdial the hotline number, and over time, demand grew for something easier to remember. In 2018, Congress passed the National Suicide Hotline Improvement Act to study how a three-digit number could make urgent mental health care more accessible.

WATCH: Biden administration rolls out new 988 suicide and crisis hotline

Ultimately, Congress agreed to spend $500 million on jumpstarting the 988 program. The Biden administration has devoted almost $1 billion to the service, including more than $200 million in May to in part help states and U.S. territories shore up access and infrastructure. It is up to state and local governments to continually fund call centers under the national mandate.

Chart by Megan McGrew/PBS NewsHour

More than 200 local call centers have been established in a nationwide network, with mobile crisis response units scattered across a handful of states. The change offered the mental health industry an opportunity to rethink “what crisis response should be in our communities,” Carr said. “We want to make it easier for people to reach out in their darkest moments.”

Average wait times have decreased over the last year from more than two and a half minutes to 41 seconds nationwide, according to Vibrant Emotional Health, the federal contractor that oversees the hotline.

Chart by Megan McGrew/PBS NewsHour

But more needs to be done as many people’s needs still go unmet, Gebbia said. Only one in four Americans are aware that 988 exists, and that “is still not nearly enough,” he added. “There are people who are in crisis who are not availing themselves of it.”

Some people seem apprehensive about calling the hotline because they think someone will show up at their house, Gebbia said. But he added that fewer than 5 percent of calls require in-person assistance to ensure someone in distress stays alive.

Chart by Megan McGrew/PBS NewsHour

It’s not enough to just have someone pick up the phone, according to Health Secretary Xavier Becerra, who spoke during a news conference at a New York City call center on Thursday.

The 988 call service must be further expanded, he said, adding, “We have to make sure the follow-up services are also there.”

Calls for funding

To deliver that expansion and improve this life-saving service, advocates are now asking Congress to increase federal funding to $836 million. Those additional dollars would fund more trained staff who could readily know what resources to offer a person in crisis and send mobile units to that person, if needed. Advocates for further funding the helpline have their work cut out for them on Capitol Hill, where this week some House Republicans unveiled an appropriations bill that slashed health care spending.

Chart by Megan McGrew/PBS NewsHour

So far, lawmakers in eight states have approved funds to help keep 988 running, but most states have not stepped up to offer financial support. In some places, arguments over whether consumers should spend more money to help fund the program (as is the case with 911 emergency dispatch services) have stifled potential support. Alabama House legislators, informed by opposition from telecommunications companies, recently pushed back on a bill that includes a surcharge on cellphone lines.

WATCH: Ohio lawmakers work to fund 988 suicide prevention hotline

Delaware, one of the latest states to allocate consistent funding for the hotline, passed a telecommunications bill in June that would add a 60-cent surcharge to people’s phone bills. That surcharge would add up to roughly $9 million each year and allow Delaware to operate a statewide 988 call center around the clock and staff mobile crisis response units, giving a person in crisis “someone to call, someone to respond and somewhere to go,” said state Sen. Nicole Poore, a Democrat who represents Delaware’s 12th District. She sponsored the bill, which awaits Gov. John Carney’s signature.

In Delaware over the next five years, calls to 988 are expected to increase 65 percent to serve more than 3,000 people each month statewide, Poore said. In her talks with lawmakers who were initially reluctant to ask Delawareans to pay more in taxes for this service, she said she told them: “‘Unfortunately, someone in your family is going to need that line, someone in my family is going to need it. Let’s not be naive, and let’s not ignore this.’”

Correction: Graphics for this story previously misstated the name of Vibrant Emotional Health. They’ve since been corrected and replaced. We regret the error.