988 – The Suicide and Crisis Lifeline in the United States

At the national level, the Substance Abuse and Mental Health Services Administration (SAMHSA) leads the 988 initiative in partnership with the Department of Veterans Affairs (DVA) and the Federal Communications Commission (FCC) to plan and implement this 3-digit telephone code to strengthen and expand the existing National Suicide Prevention Lifeline. In Connecticut, the Department of Mental Health and Addiction Services leads the state’s 988 initiative in partnership with the Department of Children and Families.

Preparing for full 988 implementation and operational readiness requires a shared national and statewide vision for crisis care systems that provide direct, life-saving services to all in need. 988 will connect people experiencing mental and emotional health distress and/or suicidal crisis to compassionate, accessible care and support in their own state. Ideally, as early as possible.

Since the late 1960s, 911 has been both a number and an access point for emergency services such as police, fire, and ambulance. 988 will similarly be both a number and an access point for mental and emotional health distress and/or suicidal crisis services. The 988 number is scheduled to launch in July 2022, but it will take time to get the system up and running efficiently.

Fortunately, those implementing the 988 crisis service system have learned a great deal from the 911 system, and although Connecticut has a robust crisis service system to build off of, enhancements are occurring in preparation for the 988 system.

Connecticut will ensure that residents have someone to talk to, someone to respond and somewhere to go when needed. The enhancements and new services include: expansion of Mobile Crisis to 24 hours 7 days per week, adding mental health crisis care centers for all ages (similar to urgent care centers for medical needs), adult peer respite, peer support resources, and rapid access to treatment beds for youth.

• United Way of Connecticut’s Contact Center will handle Connecticut 988 calls and will provide the following for all ages:
  • Support over the phone is available 24 hours, 7 days a week, 365 days a year.
  • Mental health screening and suicide risk assessment based on national best practices
  • Access to home and/or community-based services, and peer support resources
  • Collaborative safety planning
  • Follow-up contacts
  • Warm transfer to local youth or adult mobile crisis services for in-person services
  • Coordination with 911 rescue services

• Youth Mobile Crisis Intervention Services for children and youth under 18 provides:
  • Rapid, urgent, face-to-face crisis response for children and their families expanding hours to 24 hours, 7 days a week, 365 days a year.
  • Mental health screening and suicide risk assessment based on national best practices
  • Collaborative safety planning
  • Access to various home and/or community-based services, treatment services, and peer support resources
  • Short-term follow-up care
  • Discharge collaboration with treatment locations
  • Information & Materials: https://www.mobilecrisisempsct.org

• Adult Mobile Crisis Services for adults age 18 and over provides:
  • Person-centered, telephonic support, or face-to-face response expanding hours to 24 hours, 7 days a week, 365 days a year.
  • Mental health screening and suicide risk assessment based on national best practices
  • Collaborative safety planning
  • Access to various community-based and/or treatment-based services, and peer support resources
  • Follow-up contacts
  • Information & Materials: https://uwc.211ct.org/actionline/

Call when:

• You are considering going to or sending a person to the Emergency Department for a mental health evaluation.
• You can’t reach the person’s mental health service provider during a crisis.
• You have already called the police, but need mental health support as well. Calling the police does not exclude a Mobile Crisis response.
• Mobile crisis can respond to a situation with police assistance or after police have stabilized a situation.

Call when any age person:

• Threatens or is at risk for suicide
• Threatens or is at risk for violence
• Has been victimized/traumatized
• Is in harms way without immediate assistance
• Is behaviorally “acting out” or out of control.
• Is in emotional or mental distress and/or uncommunicative
• Is depressed and you are worried
• Is having any other behavioral health crisis

Access Methods

• Statewide Text and Chat

Youth Services

• Mobile Crisis Intervention Services – 24 hours a day, 7 days a week, 365 days a year
• Rapid Crisis Bed Access
• Increased Short-term Crisis Stabilization Beds
• Care Transition support from EDs
• Community-Based Crisis Care Sites
• Increased Peer Support Resources and Service Integration

Adult Services

• Mobile Crisis Services – 24 hours a day, 7 days a week, 365 days a year
• Increased Short-term Crisis Stabilization Beds
• Community-Based Crisis Care Sites
• Increased Peer Support Resources and Service Integration

Promotion – Statewide Campaign

988/911 PSAP Intersection

988 necessitates consideration and clear documentation on how 988 will work cooperatively with public safety entities and Emergency Communications Centers (ECCs) to effectively address mental health caller needs and response resource allocation.

The National Emergency Number Association (NENA) 911/988 Interactions Work Group seeks to provide call and information sharing solutions to ECCs and 988 call centers.

WG’s goal is to provide uniform best practices to stakeholders in the ECC environment and the new 988 system.

• Address each entity’s roles and responsibilities
• Identify the processes and training needed to properly handle mental health crises.
• Define how the 988 system can interconnect and utilize the 911 system for accurate 988 call routing and support for text messaging to 988.

On July 16, 2022 the National Suicide Prevention Lifeline (1-800-273-TALK (8255) became the 988 Suicide & Crisis Lifeline. In Connecticut, the United Way of Connecticut/211 (UWC) Health and Human Services Contact Center is the only provider answering calls for the NSPL/988 Suicide & Crisis Lifeline. The 800 line and 211 will not go away in the event people need to call and aren’t familiar yet with 988. It will take time for people to learn about 988, and using a “no wrong door” approach is imperative to support timely crisis response. The CT 988 Contact Center services a person receives are the same at the call center level regardless of which number they use as the access point.

United Way of Connecticut has built its contact center capacity, and is ready to receive 988 calls. It is well staffed and has a high answer rate. Text and chat services have not yet been initiated for 988, so any 988 texters/chatters will be served by a national text or chat center.

Please help us share these primary messages:

• There is “no wrong door” in CT. To reach the CT crisis contact center for telephonic support or mobile crisis services, people can call 211 and press 1 for crisis and then 1 for children or 2 for adults, or they can call 988 to be routed to the CT contact center. They will not have to press any other numbers when they call 988 to get services, and call, text and chat services are all functioning. Veterans are still guided to press 1 for the Veterans Crisis Line when they call 988, just as the 800 NSPL line did.
• Youth in crisis? In CT, call 211 (press 1 for crisis, 1 for youth), Call/Text – 988 or Chat www.988lifeline.org
• Adults in crisis? In CT, call 800-HOPE-135 or 211 (press 1 for crisis, 2 for adults), Call/Text – 988 or Chat www.988lifeline.org

Call when:

• The person needs immediate police intervention (weapons involved, serious assault, etc.)
• The person needs immediate medical attention (overdosed, currently intoxicated, seriously injured, or at immediate risk of suicide attempt, etc.)
• Mobile crisis can respond to a situation with police assistance or after police have stabilized a situation. Calling the police does not exclude a mobile crisis response.