Policy and Practice | October 2022

from our partners By Danielle Stumpf, Roshani Khatri, Laura Perez, Kat Crumpton, and Stephanie U'Ren

The 988 Suicide & Crisis Lifeline: Components of Successful Implementation

M any people experiencing mental health distress call 911 because it is a widely known emergency number and easy to use. Recent data have shown that people using 911 to get help with serious mental illness do not get the right care at the right time, and some even end up in law enforcement custody, rather than being seen by a mental health professional. The 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) is the new three-digit, nationwide phone number that is locally operated and offers 24/7 access via call, text, and chat to trained crisis counselors who can help individuals experiencing mental health related distress. Mental health-related distress can include substance use crisis, suicidal thoughts, depression, or any emotional distress. The 988 Suicide & Crisis Lifeline is also available for indi viduals worried about a loved one who might need crisis support services. Its goal is to provide accessible and imme diate crisis intervention and support to every individual in need. 988 State Implementation andTop Challenges As of August 2022, 23 states 1 have passed legislation to facilitate the implementation of the 988 Suicide & Crisis Lifeline. Colorado, Nevada, and Washington enacted legislation with user fees to support 988 operations and provide financial sustainability for the system. Several states have established advisory groups or planning commit tees with representatives from state agencies, health providers, law enforce ment, emergency medical services, and

other partners to better coordinate the system and identify policy levers. Implementing a three-digit number for behavioral health emergencies in every state and providing 24/7 primary coverage through in-state call centers have presented certain challenges to states across the nation. As states prepare to launch the 988 hotlines, they have encountered key issues around infrastructure, workforce, 911 integration, the readiness of the crisis care continuum, cultural competence, and performance management. Solutions for State Agencies To address these key issues, states should consider the following to aid in the successful implementation of the 988 Suicide & Crisis Lifeline. Assess State Needs to Successfully Implement the 988 Suicide & Crisis Lifeline Despite meeting baseline require ments for the implementation of the

988 Suicide & Crisis Lifeline, state agencies are struggling to implement it. By performing a structured needs assessment, state agencies can evaluate their infrastructure, policies and pro cedures, funding, and workforce needs to better understand their readiness to implement and capability to sustain the 988 Suicide & Crisis Lifeline. This assessment provides insight for state agencies to understand their strengths, challenges, and areas of opportunity, and it should evaluate: n State infrastructure. It is impor tant to assess the infrastructure across the crisis care continuum to help ensure a smooth transi tion for individuals who need care quickly. Successful implementation should take certain considerations into account during the planning process, such as including all the interested parties representing diverse populations.

See 988 on page 33

Illustration by Chris Campbell


Policy&Practice October 2022

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