How to Use 988 to Respond to Behavioral Health Crisis Calls

Nationwide, communities are starting to build comprehensive and coordinated crisis systems to improve responses to people experiencing a behavioral health crisis and reduce overreliance on law enforcement officers in these situations. Typically, crisis responses originate from people calling the general 911 emergency line for help. However, this is an inefficient way to connect people to immediate behavioral health services, as it overburdens the 911 system and may introduce law enforcement to situations that do not require a police response. In 2020, the Federal Communications Commission (FCC) and Congress established a universal phone number for behavioral health crises and suicide preventions to directly connect people to crisis responders—988. 

The three-digit number offers an opportunity for states and local communities to change the way they respond to people in behavioral health crises and redefine the role of law enforcement and 911. This brief highlights important facts about the new dedicated crisis line and offers tips to help communities prepare for its national launch in 2022.

Five Things to Know about 988

1. The line will launch nationwide in July 2022 and directly route people to local call centers within the National Suicide Prevention Lifeline Network.¹ The free, dedicated 988 line will provide around-the-clock support for people who are experiencing a behavioral health crisis. Individuals dialing 988 will be connected to a local crisis call center in their community. These local call centers will be held to standards defined by the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Suicide Prevention Lifeline—a national network of crisis centers providing services to people in crisis.²

2. Calls will be answered by trained crisis operators. Call center operators will be trained to assess and de-escalate crises over the phone, connect callers to additional services, and in some locations, where available, dispatch mobile crisis teams to situations that require an immediate, in-person response. Operators will also work closely with local emergency responses, including 911 and law enforcement, to route calls when incidents require more than a behavioral health response.

3. Collaboration with local law enforcement will be essential. Law enforcement agencies and 911 call centers will likely continue to be the default for most people to call when they need help. Therefore, law enforcement will still need basic training in de-escalation and how to identify people experiencing a behavioral health crisis—a great opportunity for cross-systems collaborations to provide training. Communication and dispatch policies should also be established in collaboration with 988 planning committees to make clear when law enforcement officers will be deployed and how mobile crisis teams can call for law enforcement backup.³

4. The dedicated line will be an important component of a network of local crisis responses. The new dedicated crisis line should be part of a larger, comprehensive, coordinated crisis system that connects people to the most appropriate intervention for their needs. While many situations can be addressed over the phone by trained call takers, others may require more intensive responses such as mobile crisis teams and short-term crisis stabilization services.

5. States and local communities will need to work together to effectively implement 988. States and local communities will need to ensure that 988 operates effectively (i.e., calls are appropriately addressed in collaboration with community resources) and is adequately resourced. There are multiple federal funding streams (mostly through SAMHSA) that also support the development of crisis services, including the operation of crisis lines. But states should not rely on this funding alone.⁴ Federal law allows for states to collect a fee on all phone bills, similar to 911, to help pay for 988 operations and crisis services. Many states have initiated legislation that establishes this fee as one way to ensure that 988 is adequately funded. States should also work closely with local communities to define the types of services that will be available when people call 988 and to establish plans for implementation, oversight, and reporting.