988 Suicide and Crisis Lifeline

What is 988?

From SAMHSA 988 FAQs: “Beginning July 16, 2022, 988 will be the new three-digit dialing code connecting people to the existing National Suicide Prevention Lifeline, where compassionate, accessible care and support are available for anyone experiencing mental health-related distress – whether that is thoughts of suicide, mental health or substance use 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.”

Is this number only for suicide-related crises?

No, 988 is a number to call for suicide, mental health and substance use-related crises or any kind of emotional distress — not just suicide-related crises. 

What is a mental health, substance use or suicide crisis?

A mental health or suicidal crisis is any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to function well in the community.

For example, a person in crisis may experience one or more of the following: actively thinking about suicide or self-harm; erratic, unusual, risky or harmful behavior; delusions, paranoia or other psychotic symptoms; or extreme withdrawal from everyday life.

Can I only call or text 988 if I am experiencing a life-threatening crisis?

No, you can call or text 988 for yourself or a loved one if you are in any type of emotional distress.

However, if you are not in a crisis, there are other services that may meet your current needs better, including a peer-support Warmline for emotional support or the NAMI HelpLine (1-800-950-NAMI or helpline@nami.org) for information, resources and support.

How can I reach 988? Only by phone?

You can call 988, text 988 or chat via the Lifeline’s website (988lifeline.org).

What happens when I call 988? What information will I receive, or does the Lifeline only offer immediate crisis support?

The goal of the 988 Lifeline is to provide free, confidential, immediate crisis intervention and support. When you call or text or chat 988:

1) You’ll hear a message that you’ve reached the National Suicide Prevention Lifeline – you are in the right place! If you are a veteran, you can press “1” to reach the Veterans’ Crisis Line or “2” to reach the Spanish subnetwork for the Lifeline.

2) If you don’t select either option, a trained crisis counselor will answer.

3) The counselor will listen to you to understand how your problem is affecting you or your loved one.

4) The counselor will provide support and share resources and referrals.

In some communities, the crisis line may be able to connect you to additional services or follow up with you to ensure you’ve connected with care (note: not all communities have this capacity).

Can I only call 988 for myself, or can I call for someone else I know or see in crisis?

You can call or text 988 if you are concerned about someone else in distress who may need crisis support.

What languages are offered through 988?

The Lifeline currently provides live counseling services via phone in English and Spanish. Translation services are available in an additional 150 languages. Text and chat are currently available in English only.

Are there services available for a person who is hearing impaired?

In addition to text and chat services, teletype (TTY) is also available. TTY users can use their preferred relay service or dial 711 then 988.

Will there be culturally competent support available?

As the workforce for the Lifeline network is being expanded, there are ongoing efforts to improve cultural competency training for Lifeline crisis counselors. However, as of now, not every counselor may have had this training.

Are there youth-specific supports available?

There is not a youth-specific hotline or dedicated crisis counselors for youth callers, although some states may have their own youth crisis line separate from the 988 Suicide and Crisis Lifeline network. Regardless, staff are trained to support anyone in a crisis. Expanded Lifeline trainings are being implemented to ensure 988 call centers can provide appropriate, culturally competent care, specifically focused on communities that are at higher risk for suicide, including youth.

Note that some states have youth crisis response teams in place, and there is a growing movement to provide more youth-focused crisis services across the country.

Will I be charged a 988 fee for calling the number?

No. The support and services received from 988 crisis counselors is provided free of charge. However, standard messaging and data rates may apply to those who text 988 from their mobile phone.

Do I need insurance to get help when dialing 988? Medicaid or Medicare?

No. The support and services received from the 988 crisis counselors is provided free of charge, regardless of whether you have health insurance coverage.  

Will 988 show up as a call on my phone bill? Is a call record created?

It will depend on your phone service whether a call or text to 988 will show up on your phone bill. Contact your phone service provider to learn more about how calls to 1-800 and other toll-free lines appear on your bill.

Does 988 collect my information/data? What do they do with that information?

All contacts with the 988 Lifeline from people seeking help are confidential. According to the Lifeline FAQs, information about callers/chatters/texters will not be shared outside the Lifeline without documented verbal or written consent from the person seeking help, except in cases where there is imminent risk of harm to self or someone else, or where otherwise required by law.

The Lifeline protects all the confidential and identifying information shared. During your contact with the 988 Lifeline, you may voluntarily share certain information about yourself that could be identified, and that information may be documented in notes about your conversation. The center may also have access to the phone number or IP address you used to contact the Lifeline. You will never be required to provide other identifying information to receive help from the Lifeline. The Lifeline may use de-identified and aggregated data for reports to stakeholders, funders and policymakers about the numbers and types of conversations they have with people in crisis. They might also reference the general aggregate demographics of people seeking help from the Lifeline.

What is different after July 16, when 988 goes “live”?

988 “going live” marks the beginning of an easier way nationwide to access the National Suicide Prevention Lifeline through this easy-to-remember three-digit number. It also marks the formal expansion of the Lifeline to include helping people in mental health and substance use crises in addition to suicide crises.

July 16, 2022 was the deadline for every U.S. telephone provider to direct calls and texts to 988 to the pre-existing Lifeline network. The Lifeline has around 200 local call centers and national backup centers across the country to answer these calls. The 10-digit number is still active after July 16, 2022.

Local, state and national advocacy efforts are ongoing to connect the 988 Lifeline with a continuum of in-person crisis services, such as mobile crisis teams and crisis stabilization centers, for individuals who may need more support than can be provided over the phone. Unfortunately, these services are not in all communities right now and will take time to develop.

Why do we need a separate number from 911 for people in a mental health crisis? How are 988 and 911 different?

988 was created to improve access to crisis services in a way that meets our country’s growing needs around suicide, mental health and substance use-related crises – and make it easier to connect with a network of trained individuals ready to help. With 988, your call (or text or chat) is the intervention. Trained crisis counselors answer you and provide support, resolving most crises over the phone and reducing our current need for in-person response.

911 serves as an emergency and public safety dispatch system, where the focus is to collect information and dispatch Emergency Medical Services, fire and police as needed. When someone calls 911 for a mental health crisis, police are generally the only option that can be dispatched. However, people experiencing a mental health crisis need and deserve a more appropriate mental health response.

NAMI and other advocates are leading efforts to ensure people in distress or crisis contacting 988 can connect with a continuum of in-person crisis services, such as mobile crisis teams and crisis stabilization centers, for individuals who may need more support than can be provided over the phone. This effort is focused on diverting people with mental illness from the criminal justice system and helping people in crisis more quickly connect to effective mental health care. SAMHSA, which oversees the 988 Suicide and Crisis Lifeline, states, “Currently, fewer than 2% of Lifeline calls require connection to emergency services like 911.” Communities that currently have robust crisis services estimate that they dispatch mobile crisis response teams to less than 10-20% of crisis line callers — with most mobile crisis response dispatches resolved in the community and not requiring further intervention.

There are a lot of numbers in my community – 211, warmlines, etc. How are they different from 911 and 988?

211 generally serves as a health and social services information and referral line to help people connect with essential community services such as food banks, assistance paying for utilities, housing and much more. In some states, 988 call centers also answer 211 calls.

Warmlines provide emotional support and help people manage loneliness, mental illness symptoms and recovery. While the 988 Lifeline is meant to manage immediate crises, warmlines take an early intervention approach to easing struggle. Warmlines are typically free, confidential peer-support services staffed by volunteers or paid employees who have experienced mental health conditions themselves. In some cases, warmlines may be part of a 988 call center.

The NAMI HelpLine (1-800-950-NAMI or helpline@nami.org) is a free, nationwide peer-support service operating from 10 a.m. ET to 10 p.m. ET, Monday-Friday, providing information, resource referrals and support to people living with a mental health condition, their family members and caregivers, mental health providers and the public. HelpLine staff and volunteers are experienced, well-trained and able to provide guidance. The NAMI HelpLine is not part of the 988 Lifeline and is not a crisis line or suicide prevention line.

While individuals in a mental health-related crisis should now use 988, anyone experiencing an emergency that requires immediate medical attention should call 911. Depending on the details of a particular crisis situation, a 988 call may be transferred to 911 if needed, and vice versa.

All local helplines, warmlines and crisis/emergency lines should be working together to develop standard operating procedures to transfer calls to ensure that a person can connect to the help that best serves their needs, no matter what number they dial or text.

Will the Veterans Crisis Line go away with 988 or is it still its own line?

The Veterans Crisis Line (VCL) is not going away. Just like how 988 is making it easier for people in the U.S. to connect to the Lifeline, Veterans, Service Members and their families can call 988 and still press “1” to be connected to the VCL, which is run and staffed by the Veterans’ Administration. The VCL is also available by chat (VeteransCrisisLine.net/Chat) and text (838255).

What’s the difference between the National Suicide Prevention Lifeline and 988? The Disaster Distress Helpline and 988?

The Lifeline is 988. 988 is just the new easy-to-remember nationwide number (instead of the previous ten-digit number) connecting people in need to the National Suicide Prevention Lifeline, a 24/7 network of around 200 crisis call centers across the US. By calling or texting 988, you will be connected to free, confidential, compassionate, trained crisis counselors if you or someone you know is experiencing mental health-related distress — whether that is thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress. You may also hear this Lifeline referred to as the 988 Suicide and Crisis Lifeline — it all refers to the same resource.

SAMHSA’s Disaster Distress Helpline (1-800-985-5990) provides 24/7, 365-days-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters. If you are experiencing emotional distress related to a specific disaster such as a tornado, hurricane, mass shooting, etc. you can reach out to SAMHSA’s Disaster Distress Helpline. 

Will the National Suicide Prevention Lifeline’s ten-digit number (1-800-273-8255) go away?

No. The 10-digit number 1-800-273-8255 (TALK) did not going away after July 16, 2022. Using either 988 or 1-800-273-8255 (TALK) will get people to the same services provided by the Lifeline.

Will my state and local crisis line or warmline stop operating?

It depends. For the most part, warmlines will continue to operate separately from the 988 system. However, many states have worked to bring all the mental health and crisis lines in their state into one network, so that they all can be reached by dialing 988. Please check your state mental health agency’s website to learn what resources are available in your area.

What training do 988 staff receive?

All Lifeline network call centers are required to meet specific standards regarding Suicide Risk Assessment and Imminent Risk interventions, but each Lifeline-affiliated crisis call center may develop additional training for crisis counselors to meet organizational needs.

The Lifeline is currently developing the Lifeline Core Clinical Training which will be a self-paced online training that will cover essential skills for crisis counselors who answer calls/chats/texts within the Lifeline network. More training is also being developed to address the specific needs of populations at higher risk of suicide.

When I call 988, how do I connect to a local call center? Will they know my physical location? Will they track me?

Your location information is not collected and used by the 988 Suicide & Crisis Lifeline. Calls are routed to a 988 crisis call center based on the caller’s area code because more exact physical location data is not available to the Lifeline network. This is different from 911, which uses geo-routing to determine a caller’s closest 911 call center.

According to the Lifeline’s FAQs, in some rare situations where there is imminent risk of harm to self, “Lifeline counselors must provide what information they have to 911 operators — the caller’s/text user’s phone number or the chat user’s IP address — to enable them to do whatever they can to locate the individual.” However, this information is not always accurate or enough to locate an individual, and it is only used when someone’s life is determined to be at risk.

As part of the National Suicide Hotline Designation Act of 2020, the Federal Communications Commission (FCC) submitted a report to Congress about implementing geolocation for 988 to better determine a contact’s location. The report recommended that an advisory committee be established to learn more about key issues related to 988 and geolocation. That committee has not yet been convened. It is possible that in the future the FCC and Congress may take action in order to allow for more specific location information to be collected and used in order to better direct calls to the nearest call center rather than by area code.

Is my community ready?

How much capacity a community has to answer local calls varies, but all Lifeline call centers are connected to a national back-up network that can answer calls when a local center cannot.

The Lifeline has been active since 2005, and 988 is leveraging that existing network. Immense work has been done since Congress authorized 988 in 2020 to build up call center capacity.

We know that some people need more help than can be provided over the phone. Many communities are building up not only their call center capacity, but also related crisis services, like mobile crisis teams, which provide an alternative to law enforcement involvement, and crisis receiving and stabilization facilities, which provide an alternative to emergency departments.

July 16 was not the end of these efforts; we will continue to advocate to ensure this crisis continuum of care is available across the country.

What can I do to help my community improve crisis response after 988 goes live?

You can do a lot. The work to successfully ensure there is a crisis system that supports 988 callers in your community is up to you and your local policymakers. Work with your state and local mental health agencies to learn more about their plans for 988 and related crisis services in the coming weeks, months and years. Attend public meetings, share your personal story and stay up to date on local developments. If you have time and experience, also consider volunteering at a local call center that could use support to meet increased call volume.

We also need your help advocating for policies and funding that will support building a full system of mental health crisis care in every community. Our policymakers — at the local, state and federal levels — need to act so we can #ReimagineCrisis. Some states have already passed legislation to start this effort, but far more haven’t. Learn about legislation or funding in your state specific to 988 and crisis services here. But the work doesn’t stop there — we need the federal government to act, too. Join our advocacy, contact your members of Congress and share your story at nami.org/crisisadvocacy.

Why haven’t I heard about 988 before now?

988 was not available to everyone until July 16, 2022, so there have not been widespread communications about this new number to make sure that people are calling the correct phone number to reach the National Suicide Prevention Lifeline. Now that 988 is available everywhere, you will likely start hearing more about it.

A widespread public awareness effort will not be launched until at least early 2023 to give the system time to build more capacity to answer the increased number of expected calls. However, as a mental health advocate, we encourage you to let people know that this lifesaving, easy-to-remember number is now available.

I’m undocumented — is my communication confidential?

Your immigration status is not required information to receive help from 988. You are never required to provide your immigration status to receive health or mental health services. For more information about your rights please visit the National Immigrant Law Center (NILC) or League of United Latin American Citizens (LULAC) resource pages.

It’s an emergency. Should I call 988 or 911?

This will depend on your situation. When you call 911, you are connected to an emergency dispatcher who will consider whether to dispatch Emergency Medical Services, fire and/or police responders to your location. Often, in mental health crises, law enforcement is the primary service dispatched.

When you call or text 988, you will be connected to a trained crisis counselor who will answer the phone/text, listen to the person, assess the problem, provide support and de-escalation, and connect to mental health resources as needed and as available. For most contacts to 988, no in-person response is dispatched.

When an in-person response is needed, we are advocating for  mobile crisis teams to be available everywhere, comprised of health and behavioral health professionals, rather than law enforcement. However, some communities may still only have law enforcement as an option for dispatch, and 988 counselors will coordinate with 911 and law enforcement to provide in-person response services based on the Lifeline’s imminent risk policy.

If someone is in physical danger, 911 may be most appropriate in order to quickly dispatch Emergency Medical Services.

To get help planning for a crisis, please visit the NAMI website and learn more from NAMI’s Navigating A Crisis guide or contact the NAMI HelpLine for other resources and support.

How will 911 be connected to 988?

Crisis call centers within the 988 Lifeline have policies in place that guide how a call center might contact 911 if it is necessary to dispatch an in-person response to save someone’s life. Please see the Lifeline’s policy on imminent risk to better understand under what limited circumstances any available information might be shared with 911 to dispatch emergency services.

While there is no universal interoperability between 911 and 988, much work is being done at the state and local level to coordinate between local 988 and 911 centers. This work is focused on developing additional policies and procedures so that 911 operators can handoff to the 988 crisis system as often as appropriate.

Will law enforcement respond when I call 988? Will there be an in-person response if I call 988?

As stated by SAMHSA, “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.”

However, many communities do not have robust mobile crisis teams or non-law enforcement responses available if an in-person response is needed. A major goal of the #ReimagineCrisis campaign is to ensure this is available everywhere.

Learn what resources and services are connected with 988 in your community. Contact your department of behavioral health, state mental health authority or department of human services to learn more. You can also reach out proactively to your local crisis call center that is part of the 988 Lifeline network to ask them about resources, as well as their policies and procedures for interacting with local emergency response such as law enforcement.

What does imminent risk mean?

The term “imminent risk” means that death or serious physical harm could occur within a short time and is used across the emergency response system, including Emergency Medical Services, law enforcement or behavioral health. The 988 Suicide & Crisis Lifeline defines this in the 988 Lifeline’s Imminent Risk Policy. According to the policy, imminent risk is determined through engagement with the caller and a series of questions can be asked to determine if the caller “both has a desire and intent to die and has the capability of carrying through with [their] intent.” If the call taker believes that the caller is at “imminent risk,” steps may be taken to contact local emergency response services to conduct an active rescue, which may include law enforcement involvement (see above).

Can 988 share my information/conversations with law enforcement?

Calls to the 988 Suicide & Crisis Lifeline, and the information shared by callers, is confidential. However, if during a call the 988 staff believes that the person calling is at imminent risk (see above), they may determine that it is necessary to contact local emergency response services to initiate an active rescue. In these rare instances, the 988 call center may provide what available information they have to 911 that is critical to saving the caller’s life.