As of July 16th, people across the U.S. can call 988 on landlines or cell phones to be connected to the National Suicide Prevention Lifeline or a similar crisis hotline or call center. The previous number, 1-800-273-8255, remains active, but 988 will be easier for many to remember and easier for raising awareness about the resource. 

We’ve compiled a short FAQ that includes things you need to know about 988 to help educate your patients and others about this life-saving resource. Some of the information comes directly from the 988 Lifeline website which also has a wealth of resources for those at higher risk for suicide.

‍Quick Review: What is 988 Again? 

The 988 number was established by the National Suicide Hotline Designation Act of 2020. Calling 988 will connect a caller anywhere in the U.S. with a crisis center staffed by trained crisis volunteers or social workers. Texting can also be used with this number. 

‍Is 988 Only Offered in English? 

The immediate service is offered in English or Spanish (press 2 after dialing), but interpretation services are available in more than 250 languages. Unfortunately, text and chat services are only in English at this time. For those who are deaf or hard of hearing, texting and chatting are available at 998, or, they can use a texting telephone (aka TTY) with their local relay service or dial 711 then 988.

What Happens When Someone Calls? 

According to the Lifeline website, callers will initially hear the following automated greeting: “You have reached the National Suicide Prevention Lifeline, also serving the Veterans Crisis Line. Para Español, oprima numero dos. If you are in emotional distress or suicidal crisis or are concerned about someone who might be, we are here to help. If you are a U.S. military veteran or current service member or calling about one, please press 1 now. Otherwise, please hold while we route your call to the nearest crisis center in our network.”

After this automated message, the caller will hear hold music while they are connected to a skilled, trained crisis counselor. The “counselor will answer the phone, listen to the caller, understand how their problem is affecting them, provide support, and share resources if needed.”

The crisis center the caller will be connected to is based on their area code. Each crisis center determines its own hours of operation and coverage area based on zip code, area code, county, or state. If the caller’s local crisis center is unavailable at the time of the call, the call will be routed to the national backup network.

What Happens When Someone Texts or Chats With the Lifeline?

Those who contact the Lifeline by texting 988 will complete a short survey to provide information about their situation. They then will be connected to a trained crisis counselor who will speak with them, provide support, and connect them with resources if needed. The same format is used if someone contacts the Lifeline through the online chat option. 

Is the Lifeline Only for People Considering Suicide?

No. 988 is intended to be a crisis hotline for people who need other mental health support or for those experiencing a substance use crisis.

‍What’s the Difference Between 988 and 911?

Calling 911 will connect someone to a local dispatcher who will send out emergency services depending on the need. This could include fire, police, or ambulance services and is reserved for situations of immediate danger. 988 is for emergencies involving someone who is suicidal but is also for non-emergency situations where someone needs mental health or substance use support. 

According to the Lifeline website, “988 was established to improve access to crisis services in a way that meets our country’s growing suicide and mental health-related crisis care needs,” without putting the entire burden on fire, police, and emergency medical services. 

Can Calling 988 Lead to a 911 Call?

Some people are concerned that calling 988 means the police will automatically be called. That is not true, though there is a possibility that some 988 calls will lead to a 911 call if there is an imminent risk to someone’s life and the situation cannot be deescalated during the Lifeline call. Less than 2% of Lifeline calls result in a call to 911.

Most calls include the crisis counselor asking the caller if they want to be connected to emergency services. Still, in some rare circumstances, the crisis counselor may decide to call emergency services without first getting permission from the caller. For example, this would occur if they believe the life of the caller or someone else is in immediate danger.

The website notes, “While some safety and health issues may warrant a response from law enforcement and/or emergency medical services (namely when a suicide attempt is in progress), the 988 coordinated response is intended to promote stabilization and care in the least restrictive manner.”

Can Calling 988 Lead to a Psychiatric Hospitalization?

The Department of Health and Human Services (HHS) website does not directly answer this question; instead it states that all “crisis centers adhere to the Lifeline’s Imminent Risk Policy, which means that crisis center staff work through active engagement to provide support and assistance for people at risk in the least restrictive setting possible.” 

What that does not mean is that a person will not be hospitalized. Concerns about the possibility of involuntary psychiatric hospitalizations resulting from 988 calls have arisen. Right now, it’s hard to assess the chance as little information is available about how often this has occurred. A crisis counselor may determine that a person’s life is at risk and that they need to call 911. If emergency medical services are dispatched, it is possible that the call could result in hospitalization in states where the laws permit it.

Will the Counselor I Speak to Understand My Culture?

The HHS FAQ notes that the department has been stepping up its effort to train crisis counselors in cultural competency, though this will be an ongoing effort. According to the website: “In 2021, there were several activities addressing this, including updating pages on the Lifeline website and creating specific tools for crisis counselors, such as Spanish-language clinical guidance resources, deaf and hard of hearing best practices for callers/chat visitors, an LGBTQ+ guidance document, an American Indian/Alaskan Native tip sheet and more.”

Where can I get more information? 

You can go directly to the 988 FAQ here.