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• Posted January 30, 2025

Crisis Services Haven't Adapted To New 988 Suicide Hotline

Most community crisis services did not expand following the launch of the 988 Suicide & Crisis Lifeline, potentially blunting the effectiveness of the hotline, a new study says.

Walk-in psychiatric services, mobile crisis response units and suicide prevention programs all declined following the launch of the 988 line in July 2022, researchers reported in a new study published Jan. 29 in JAMA Psychiatry.

“The lack of meaningful growth in most crisis services may limit the long-run success of 988, in particular if callers feel that reaching out to 988 fails to result in access to appropriate sources of care,” lead investigator Jonathan Cantor, a policy researcher at the nonprofit research organization RAND, said in a news release.

The 988 Lifeline provides a single easy-to-remember phone number for people in a suicidal or mental health crisis. It replaced the National Suicide Prevention Lifeline, which had been reachable through a 10-digit 800 number.

The line is intended to help counsel people in crisis and, if necessary, connect them with a variety of mental health services.

However, researchers suspected that mental health emergency response systems might not have been able to rapidly beef up their operations to handle the potentially increased workload from an easier-to-use crisis line.

For example, the U.S. continues to have a shortage of psychiatric beds in many regions, as well as a limited and unevenly distributed mental health care workforce, researchers noted.

For the new study, they analyzed federal data regarding the availability of crisis services offered by mental health treatment facilities between November 2021, prior to the 988 lifeline’s launch, and June 2023.

They found that:

• Emergency psychiatric walk-in services declined from 32% to 29% at facilities.

• Mobile crisis response dropped from 22% to 21% of facilities.

• Availability of suicide prevention services declined from 69% to 68%.

The only type of psychiatric assistance that increased following 988’s launch involved peer support services, which connects people in crisis with others who have lived through similar situations. Those programs increased from being available at 39% of facilities to 42%.

Public mental health facilities had the highest odds of offering these four crisis services, followed by not-for-profit facilities.

For-profit mental health facilities consistently offered the most limited services when it came to crisis response, researchers found. Those constitute about a quarter of all mental health facilities in the U.S.

Researchers noted that in 2023, only eight states set aside money for mental health services in response to 988’s launch.

“Mental health officials and policymakers should consider strategies to boost the financing and availability of crisis services at mental health treatment facilities to meet increased demand generated by the 988 Suicide and Crisis Lifeline,” Cantor said.

If you or someone you know is in crisis, call the 988 Suicide and Crisis Lifeline.

More information

The 988 Suicide & Crisis Lifeline has more about services offered by the hotline.

SOURCE: RAND, news release, Jan. 29, 2025