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An update on 988: What is the future of behavioral health crisis care?

Kyle Thompson
Policy Associate
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July 24, 2023
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On July 7th, 2023, Governor Mike DeWine gave a press conference discussing the 988 Lifeline. His press conference outlined significant changes that have occurred since the Lifeline number was federally changed last July. Previous work by Community Solutions has tracked the implementation of the 988 Lifeline number. With the conclusion of the state budget, the Ohio Department of Mental Health and Addiction Services has dedicated $46 million to bolstering 988. Through this funding, Ohio can begin to chart a path for supporting the 988 Lifeline with programs and services that can help vulnerable groups. Let's look at the major developments and future plans for the Lifeline.

 The Ohio Department of Mental Health and Addiction Services has dedicated $46 million to bolstering 988.

What has changed nationally?

In May 2023, the U.S. Department of Health and Human Services (through the Substance Abuse and Mental Health Services Administration) announced that $200 million for 988 would be disbursed to build local capacity of the 988 Suicide and Crisis Lifeline service. Funding for this includes:

  • $17.8 million to federally recognized Indian Tribes, Urban Indian Organizations, and Tribal organizations. This is meant to grow, improve call response, and ensure access to culturally competent 988 crisis center support.
  • $177.35 million to states and U.S. territories to improve call response, workforce enhancement, security measures, and support for underrepresented populations.
  • $5 million for 988 Lifeline crisis follow up programs. This allows crisis centers to reconnect with at-risk people who have reached out to the 988 Lifeline. This has provided coordination of crisis stabilization, reduction of police engagement, and connections for high-risk populations.The Biden Administration has also made a significant investment of $1 billion to support the 988 Lifeline. This initial investment was meant to support the Lifeline transition in July 2022, as well as building up crisis center capacity. Part of this funding was also meant to support services for Spanish speaking individuals.  

Since the implementation of 988, the Lifeline has answered more than 665,000 texts nationally. This is an 1,135% increase compared to previous texts made to the old 10-digit Lifeline number. The previous 10-digit Lifeline number took 15 to 30 minutes to respond to texts, and about 40% of texts were left unanswered. With the current three-digit Lifeline number, the average speed to answer has decreased significantly from 2 minutes and 39 seconds to just 41 seconds.  

According to a network wide report released May 2023, total routed contacts call, chat, and text were 402,494. When accounting for calls to the Veteran Crisis Line (66,529), this rate increases to 469,023. This is a significant increase compared to the performance metrics released in May 2022. When contrasting performance metrics released last year to today, call answer rates have increased by 45%, chat answers have increased by 52%, and texts have increased by 938%.

What has changed in Ohio?

988 Workforce

Ohio is also currently focused on building out the workforce for frontline call specialists. In the past year, over 400 staff members have been trained to respond to 988 callers. Call specialists have a vast range of educational backgrounds, ranging from licensed social workers, college, and high school graduates.

988 Legislation

On June 29th, 2023, Representative Gail Pavliga introduced HB231 to the House floor. This legislation is meant to establish a 988-suicide prevention and mental health crisis telephone line. HB231 contains language that will also create a 988 administrator.

 This legislation is meant to establish a 988-suicide prevention and mental health crisis telephone line.

The 988 administrator will work within the department of mental health and addiction services to supervise the statewide implementation of the Lifeline. Other responsibilities of the 988 administrator will focus on building out infrastructure of the 988 Lifeline. The 988 administrator will work with mental health and drug addiction agencies to oversee the designation of crisis centers throughout the state. The crisis centers will have mobile crisis teams to dispatch to a person’s location, as well as coordination of technology to allow for real-time crisis care and treatment.

Post-Budget Priorities

One of the priorities of the DeWine Administration post budget is to develop crisis support systems and the infrastructure of 988. Currently, there are 19 Lifeline centers that respond to over 12,000 calls and texts a month. Over 90 percent of calls are answered in state, and just 2 percent of those calls are rolled over to a national backup center. When the Lifeline initially launched last year, 8,670 calls from July-December 2022.

 Currently, there are 19 Lifeline centers that respond to over 12,000 calls and texts a month.

In the past year, Ohio increased the number of Lifeline call centers from 12 to 19. Approximately 10,000 calls, chats, and texts to 988 are answered each month. This has successfully increased the percentage of Lifeline calls that are answered in-state. Ohio has one of the highest in-state connection rate, along with Indiana, West Virginia, Tennessee, Michigan, Kansas, Missouri, Oklahoma, Mississippi, and Montana. In Ohio, the in-state answer rate is high, with 88% of calls being routed to a provider.

What is next for 988? Only time will tell.

With the conclusion of the state budget, the 988 Lifeline is set to be an impactful service to all Ohioans. As time goes on, more legislation, advocacy, and community work will continue to build out the infrastructure of the Lifeline to support all Ohioans with their mental health needs. Be sure to follow Community Solutions as we continue to track developments in the Lifeline.

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