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There's a new national hotline for mental health. How will we pay for it?

Fewer than half of states have enacted legislation to pay for the 988 suicide prevention number, set to launch in July.
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GREENVILLE, S.C. — The mental health version of 911 is set to launch nationwide next month with hopes it will be a game changer for suicide prevention and other emergencies, but some mental health professionals worry they will not be ready to handle the anticipated flood of calls.

“We have all of the technology,” said Jennifer Piver, the executive director of Mental Health America of Greenville County in South Carolina. “We do not have the funding for staff, for salaries.”

The new national three-digit number — 988 — is meant to connect people in mental health crises with those who are specially trained to respond to such situations. The easy-to-remember number launches July 16.

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

But most states, including South Carolina, have not allocated money for the service. Even partial legislation to implement 988 is pending in only 20 states, according to the National Alliance on Mental Illness. Just four states, Colorado, Nevada, Virginia and Washington, have enacted comprehensive funding plans.

According to a Rand Corp. report published last week, more than half of public health officials charged with launching the 988 line said they felt unprepared and without necessary financing for staffing or infrastructure to handle the rollout. 

The lack of support from legislators has flummoxed mental health professionals like Piver. South Carolina, for example, last year passed the Student Identification Card Suicide Prevention Act, which required the National Suicide Prevention Lifeline to be printed on the student identification cards of students from grade seven through the university level.

The program has been a success, Piver said. “Within the first 24 hours of the first day of school, we saved the life of a young person.”

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

Every moment counts when a person in crisis or a family member calls for help. Piver and other mental health professionals nationwide worry that states without the designated funds or staffing will struggle to meet the expected demand when the line launches next month.

According to the Centers for Disease Control and Prevention, about 20 percent of Americans will have a mental illness in any given year. And reports of mental health problems have been growing in recent years, even before the Covid pandemic.

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

“We have the seats. We have an infinite amount of resources to have people work remotely,” Piver said. 

But there is no new support, she said, to hire enough qualified people to staff the lines. Calls that come into call centers without appropriate staffing are put into a queue and routed elsewhere, often to the National Suicide Hotline or to other states.

“If we don’t have the folks to answer the phone, time is an issue,” she said. People in mental health emergencies who are strong enough to call for help need help quickly, she said.

“Are they going to stay on the phone that long to make sure they get routed to someone?

“The minutes do matter.”

The director of the Suicide Prevention and Exposure Lab at the University of Kentucky, Julie Cerel, a licensed psychologist, agreed.

Waiting for help makes callers in crisis “less likely to call next time they’re having a problem,” Cerel said. “If they are in a crisis where they’re suicidal or thinking of ending their life, it could lead them to hang up the phone and attempt suicide or die by suicide.”

What is 988?

The new number is expected to be easier to remember than the 800 number handled by the National Suicide Prevention Lifeline. It is meant to streamline mental health responses so people can get the urgent help they need much faster than by calling 911, which generally connects callers to law enforcement agencies rather than mental health professionals.

Bob Gebbia, the chief executive of the American Foundation for Suicide Prevention, said the 988 program is promising, but he called for additional federal and state money to implement it appropriately. 

“It’s still better that we have this than not,” he said, “but matching demand is a concern.”

The call center in Greenville — the only such center certified to handle mental health calls for the more than 5 million people living in South Carolina — is able to answer more than 80 percent of the approximately 100 mental health crisis calls that come in every day. 

Piver expects the percentage to plunge if the state does not step in with additional financing — and the number of calls will only increase after the rollout of 988. 

South Carolina has no legislation on the table to increase money for 988. Piver said she is frustrated about the dearth of funds, saying calls into her center have helped de-escalate life-threatening situations in which people otherwise might have had to call the police, sit in emergency rooms or otherwise ultimately die by suicide.

“These phone calls do save lives.”

The new hotline does not go into effect until mid-July. If you or someone you know is in immediate crisis, call the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit for additional resources.

CORRECTION: (June 13, 12:15 p.m. ET) A previous version of this article misstated Bob Gebbia’s position at the American Foundation for Suicide Prevention. He is the chief executive, not the chief operating officer.

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