To make 988 truly transformative, here’s what needs to happen now
The new three-digit national suicide prevention and mental health crisis lifeline, 988, is set to launch on July 16. This is a watershed moment to reimagine our country’s crisis care system and how we implement safe, accessible, equitable, and police-free mental health services.
But with just under three months to the launch date, there is much more to be done concerning racial justice, youth inclusion, and public awareness — a new poll by The Trevor Project and Morning Consult finds that nearly 7 in 10 people (69 percent) had not seen, read, or heard much of anything at all about the launch of 988 in July.
When the National Suicide Hotline Designation Act was signed into law by President Trump in October 2020, formally codifying 988, it was the first bill to pass unanimously through Congress that included the words “LGBTQ.” The law provides funding, currently estimated at $7.2 million for specialized services for LGBTQ young people, a group consistently found to be at higher risk for suicide compared to their peers.
If implemented effectively, this bill could also be one of the most transformative pieces of legislation in history by providing an alternative to law enforcement referrals and response to mental health calls. On average, people with a mental illness are 16 times more likely to be killed by police officers. According to a Washington Post database of fatal U.S. shootings by on-duty officers, more than 1 in 5 people fatally shot by police have mental illnesses. For young people of color, people with disabilities, and LGBTQ youth, that number can be even more pronounced because of their interwoven identities.
The 988 lifeline is part of a broader package of crisis care best practices that includes mobile crisis response teams and stabilization facilities to prevent or ameliorate a behavioral or mental health crisis. It’s estimated that 80% of calls to 988 will end with support over the phone, maybe referrals to local mental health services. However, 20 percent could lead call centers to dispatch some type of first responder to the caller’s location, just like 911. And here is where states across the country, and the communities within them, are making many different choices.
Building out trauma-informed response teams — staffed by mental health professionals rather than police officers — would equip local crisis centers and national suicide prevention organizations like The Trevor Project with the non-punitive alternatives necessary to assist young people at imminent risk for suicide. This would not only move us toward more humane and effective in-person responses, but also could help build trust across communities to ask for help in the first place. A new poll finds adults place greater trust in emergency medical services, psychologists, and social workers to respond to a mental health crisis compared to the police.
For the new 988 system to be comprehensive and effective, it will need a trained workforce that is reflective of the community it serves and equipped to respond to their specific needs. Yet, the mental health and crisis care system is already experiencing a national workforce shortage and many states have yet to develop legislation to fully fund and implement 988.
Currently, only 14 states have enacted 988 legislation, including four states (Virginia, Nevada, Colorado, and Washington) that have passed legislation with “user fees” that will fund and sustain crisis services. Six states (New York, Oregon, Indiana, Illinois, Utah, and West Virginia) have passed legislation without user fees, and four other states have enacted legislation to study 988.
No state or federal legislation has specified how 988 will meet the needs of young people and marginalized communities, including accessibility for people with disabilities. These limitations will have huge implications for the successful implementation of 988, and if they are not addressed, 988 will perpetuate systemically racist structures, and contribute to the ongoing criminalization and brutalization of marginalized youth in crisis.
Congress, state legislatures, and government agencies can ensure 988 effectively meets the needs of young people across the country by passing the bipartisan 988 Implementation Act and developing federal legislation that specifically centers the needs of young people who are LGBTQ, people of color, and/or have a disability.
The 988 Implementation Act, spearheaded by Rep. Tony Cárdenas (D-Calif.), will provide federal funding and guidance for states to implement their crisis response infrastructure in an equitable and accessible way ahead of the July launch of 988. While The Trevor Project and the Center for Law & Social Policy (CLASP) support this legislation, we also recognize more needs to be done to ensure young people experiencing a mental or behavioral health emergency have access to humane, culturally competent, and responsive services instead of being subjected to punitive measures and violence.
Until Congress addresses these issues and recommendations, the launch of 988 on July 16 will only create more silos and disparate state-based policies. What’s needed are tangible action plans for the marginalized communities placed at highest risk for suicide because of stigma and victimization. Young people are already experiencing a mental health crisis — we must seize this opportunity to transform our entire crisis care system and give our young people the support they deserve.
Preston Mitchum is director of advocacy and government affairs at The Trevor Project and Whitney Bunts is policy analyst at The Center for Law and Social Policy.
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