Most states appear unprepared for national suicide hotline 988 to take effect

Shirin Ali | June 7, 2022
·3 min read

Story at a glance

  • The National Suicide Hotline Designation Act made 988 the new national suicide hotline number, able to receive phone calls and text messages.

  • States are expected to support 988 by imposing phone line fees, but only 13 have enacted legislation that addresses funding the new hotline.

  • Illinois, Arizona, Connecticut, Iowa and Maryland are among those states that have not introduced any legislation that addresses the 988 hotline.

The U.S. is weeks away from launching a three-digit National Suicide Prevention Hotline, able to receive phone calls and text messages, but most states are unprepared for the roll out.

Starting on July 16, anyone can call or text 988 in order to access the U.S. suicide hotline. It’s an initiative that began under former President Trump when the National Suicide Hotline Designation Act was signed into law. It requires every state to implement the necessary telecommunications systems to enable phone calls and text messages to 988.

The law aimed to establish a shorter, universal phone number for people to access suicide prevention support.

However, most states don’t seem prepared to launch 988, with only 13 having enacted legislation that directly addresses implementing and funding the new hotline, according to National Academy of State Health Policy (NASHP).

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Washington state is among those ahead of the game, enacting legislation last year that added a 24-cent fee per line to residents’ monthly phone bill in order to fund 988. That fee is expected to bring in about $46 million annually to cover most of the cost of expanding the state’s suicide call center.

California has introduced legislation that takes a similar approach, adding 80 cents per month to phone line bills in the state, however the bill is still working its way through the state’s Senate.

Illinois, Arizona, Connecticut, Iowa, Maryland and many more states have not introduced any legislation that addresses 988, despite a federal mandate.

The U.S. Department of Health and Human Services tried to jumpstart the 988 initiative, introducing a $177 million fund to strengthen and expand the existing hotline network operations and telephone infrastructure. An additional $105 million was earmarked to help states increase necessary staffing across the country’s crisis call centers.

However, a report by the Substance Abuse and Mental Health Services Administration (SAMHSA) estimated the 988 hotline will require a continued partnership between federal agencies and states.

Though SAMHSA offers states grants to fund their local 988 hotline efforts, most local crisis centers receive only $2,500–$5,000 per year to support calls, texts, and chats, and many rely on unpaid staff to manage demands.

In order to help states support 988, Trump’s Designation Act authorized states to impose cell phone fees, though with just weeks left until the new three-digit hotline goes live, most have yet to do so.

SAMHSA estimated about $110 million will be needed annually to fund the operations of the hotline, along with $560 million to scale up local crisis centers to be able to answer all calls promptly and hire and train necessary staff.

The estimated average cost per contact is $82 for a 988 call center.

Offering a national suicide hotline similar to 911 is critical, as SAMHSA noted that over the past 3 years, the overall volume of people calling into the current national lifeline number, 1-800-273-TALK, ‚ — including calls, chats, and texts — has remained above 3 million each year.

Suicide data collected by the Centers for Disease Control and Prevention (CDC) showed the country’s national suicide rate grew by 30 percent from 2000 to 2020.

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