Cain Brothers Industry Insights

Cain Brothers Industry Insights

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988 Launch Generates More Calls with Opportunities for Better Coordination as Funding Grows

February 1, 2023 - Banker Commentary by Erika Haanpaa

The 988 Suicide and Crisis Lifeline is an important step in getting people access to the critical care they need in times of mental health crisis. It is comprised of a network of more than 200 local crisis centers aimed to connect callers (or texters/chatters) with local resources and access to quality care across the country.

Since the launch of the 988 Lifeline in mid-July 2022, the service, which was previously the 10-digit National Suicide Prevention Lifeline, has seen a significant uptick in call volumes. From August – December 2022, the line received nearly 1.8 million calls compared to 1.3 million calls during the same period in 2021. Other statistics have improved as well since the implementation of the 3-digit number: answer rates have improved, increasing from 64% in December 2021 to 91% in December 2022, and wait times have decreased from nearly three minutes to under a minute, connecting more people real-time to these much-needed resources.

While the national statistics have improved significantly, there is a tremendous amount of variability in responses state to state; in some states, fewer than 10% of calls are routed to a national backup crisis center, and in others more than 30% of calls are routed to backup. The line, which allows callers to remain anonymous, does not presently use geolocation data to route calls, of which ~80% originate on cell phones, meaning that if someone moves to another part of the country while maintaining a prior number, the call will be routed to a counselor based in their previous location who is unlikely to be aware of the local resources available.

The availability of local community resources for continuing care also varies significantly state to state with a shortage of mental health professionals broadly and crisis-related mental health services. It falls to the states to ensure those services are available locally. Thus far, five states have passed comprehensive 988 legislation (California, Colorado, Nevada, Virginia, and Washington), and many others have partial or pending legislation to support the expansion of services.

At the federal level, the Fiscal Year 2023 omnibus spending bill included appropriations for several mental health-related initiatives, including a significant increase in funding for the 988 Suicide Prevention and Crisis Lifeline and Behavioral Health Crisis Services, which increased by $390 million to $502 million. The funding supports increases in capacity and infrastructure for youth callers, access to Spanish speakers, public awareness campaigns, and promotes follow-up care for individuals contacting 988.

Though we are still in the early phases of the implementation of the Lifeline, it marks a critical step in offering a simple, reliable way to allow people in crisis access to a mental health professional. Today, many of the calls can be managed telephonically, and, with additional resources deployed for behavioral health services at the federal and state level, there is an opportunity to leverage this access point to bring people into more holistic, integrated mental health services in their local communities.

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