USA launches 988, a suicide prevention hotline. But the states don't have the funds to keep it

By Erika Edwards, Emily R. Siegel and Kate Snow -

GREENVILLE, South Carolina — The mental health version of 911 is set to roll out across the country next month in hopes it will mark a turning point for suicide prevention and other emergencies, but some mental health professionals are They worry that they are not prepared to handle the expected avalanche of calls.

“We have all the technology,” says Jennifer Piver, executive director of Mental Health America of Greenville County, South Carolina.

"But we don't have the funds for staff and salaries."

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The new three-digit national number, 988, is intended to connect people in the midst of a mental health crisis with personnel trained to respond to such situations.

The easy-to-remember number will go live on July 16.

In 2020, bipartisan legislation in Congress mandated the launch of the 988 emergency number, but left financial support for staff, phone lines, computer systems, and other infrastructure to states.

But most states, including South Carolina, have not appropriated money for the service.

Even partial legislation to implement 988 is pending in just 20 states, according to the National Alliance on Mental Illness.

Only four states, Colorado, Nevada, Virginia, and Washington, have enacted full funding plans.

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According to a Rand Corp. report released last week, more than half of the public health officials tasked with launching the 988 line said they felt unprepared and did not have the necessary funding to staff or the infrastructure to handle the deployment. 

The lack of support from lawmakers has baffled mental health professionals like Piver.

South Carolina, for example, passed the Student ID Suicide Prevention Act last year, requiring the National Suicide Prevention Lifeline to be printed on student ID cards in seventh grade through college level.

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The program has been a success, Piver said.

“In the first 24 hours of the first day of school, we have saved the life of a young man.”

Some states have enacted laws to add a fee to mobile phone lines to pay for 988, but similar proposals in many states have failed.

Every moment counts when a person in crisis or a member of their family asks for help.

Piver and other mental health professionals across the country are concerned that states without the necessary funds or staff will struggle to meet anticipated demand when the line goes live next month.

Sue-Ann Siegel attends to a Montgomery County hotline caller, where they take calls from the National Suicide Prevention Lifeline, on March 18, 2020 in Chevy Chase, Maryland. Katherine Frey / The Washington Post via Getty Images

According to the Centers for Disease Control and Prevention (CDC), about 20% of Americans experience a mental illness in any given year.

And reports of mental health problems have been on the rise in recent years, even before the COVID-19 pandemic.

A previous state grant allowed Piver's team in Greenville County, in northwestern South Carolina, to build the infrastructure for a new call center.

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“We have the seats.

We have an endless amount of resources for people to work remotely,” Piver said. 

But there is no new aid to hire enough qualified people to attend the lines.

Calls that arrive without proper staffing are queued and diverted elsewhere, often to the National Suicide Hotline or to other states.

"If we don't have staff to answer the phone, time is a problem," he lamented.

People in a mental health emergency who are strong enough to ask for help need it quickly.

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“Are they going to be on the phone that long to make sure someone is referred to them?

Minutes do matter,” she added.

Director of the Suicide Exposure and Prevention Laboratory at the University of Kentucky, Julie Cerel, a licensed psychologist, agrees.

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Waiting for help makes people in crisis "less likely to call the next time they have a problem," Cerel said.

"If they're in a crisis where they're suicidal or thinking about ending their life, that could lead them to hang up the phone and attempt suicide or die by suicide," she said.

What is 988?

The new number is expected to be easier to remember than the 800 number handled by the National Suicide Prevention Lifeline.

Its goal is to streamline mental health responses so people can get the urgent help they need much faster than calling 911, which typically connects callers to law enforcement rather than mental health professionals.

Bob Gebbia, director of operations for the American Foundation for Suicide Prevention, believes the 988 program has promise, but called for more federal and state money to properly implement it. 

"It's still better that we have it than we don't," he said, "but matching demand is a concern."

The Greenville call center - the only one certified to handle mental health calls for the more than 5 million people who live in South Carolina - is able to respond to more than 80% of the approximately 100 health crisis calls mental they enter each day. 

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Piver expects that percentage to plummet if the state doesn't step in with additional funding, and the number of calls will only increase after the 988 rollout. 

South Carolina doesn't have any legislation on the table to raise money for 988. Piver is frustrated by the funding shortfall.

Calls to her center have helped de-escalate life-threatening situations where people might otherwise have had to call the police, sit in emergency rooms, or ultimately kill themselves.

"These phone calls save lives," he concluded.

The new hotline will not go into effect until mid-July.

If you or someone you know is in an immediate crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741, or visit