Introduction
988 Fast Facts
- 988 will be confidential, free, and available 24/7/365, connecting those experiencing a mental health, substance use, or suicidal crisis with trained crisis counselors.
- Access is available through every land line, cell phone, and voice-over internet device in the United States.
- 988 services will be available in Spanish, along with interpretation services in over 150 languages.
- The 988 dialing code will be available for call, text, and chat by July 16, 2022. Until then, those in crisis should continue to use 1-800-273-8255, which will continue to function even after the transition.
- The nationwide transition to 988 as a three-digit call, text, and chat line is just the first important step in reimagining crisis support in the U.S.
In July 2022, our country will enter a new era of more equitable and accessible crisis services, marked by the adoption of 988 as the easy to remember three-digit dialing, texting, and chat code for anyone experiencing a suicidal or mental health related crisis. As the U.S-based universal dialing code connecting to the existing National Suicide Prevention Lifeline (Lifeline)—a network of local crisis centers throughout the country—988 will increase the accessibility and use of life-saving interventions and resources.
This is an exciting development for the nation broadly—and for the mental health, substance use, and suicide prevention fields in particular—and will understandably be the topic of considerable attention and public communications. Given the critical, lifesaving nature of 988, it is essential that these public communications are accurate, effective, and safe.
To help you as messengers—including state agencies, crisis centers, non-profit organizations, businesses, foundations, and others—in your ongoing and future efforts to communicate about 988 more effectively, the National Action Alliance for Suicide Prevention (Action Alliance) and its partners have developed the 988 Messaging Framework. This resource provides general guidance about when and how to develop messaging about 988. It does not take the place of tailored and tested audience-specific messages. To learn about how this 988 Messaging Framework was informed and developed, please read this background one-pager.
Timing
Before the transition to 988 across the country (effective July 16, 2022), it is important that you as messengers closely review these guidelines to ensure timing of our collective 988-related messaging is appropriate, coordinated, and effective. While it’s necessary to educate key audiences about 988 prior to the transition—such as key implementation partners or policymakers—it’s critical that there is not widespread promotion encouraging the public to dial, text, or chat 988 until the nationwide transition takes place and staffing and technology capacity needs are met.
Before Transition | Present – July 2022
Navigating the Transition
- -Please continue promoting the National Suicide Prevention Lifeline (1-800-273-8255) leading up to transition in July 2022.
- Before promoting 988 widely post-launch, work with local implementers in your state or territory to confirm the infrastructure is in place to answer the anticipated increase in calls/texts/chats.
- Until 988 is available nationwide and systems are ready to handle potential increases in call, text, and chat volumes, we recommend that your communications to the broader public avoid encouraging use of 988. Instead, continue to direct people to the existing Lifeline number (1-800-273-8255) until the transition.
- Communication prior to the transition is best centered on sharing basic information about 988 and should be targeted towards implementation partners—or individuals who have a role to play in suicide prevention and/or crisis response—and policymakers, rather than the public at-large. Use the following key messaging points to help you craft pre-transition communications (for more messages, visit the Substance Abuse and Mental Health Services Administration’s [SAMHSA] Partner Toolkit):
- What is 988? In 2020, Congress designated 988 as the new dialing code to operate through the existing National Suicide Prevention Lifeline (Lifeline) network of local call centers, which are staffed by trained crisis counselors. 988 is more than just an easy-to-remember number—it is a direct connection to compassionate, accessible support for anyone experiencing mental health related distress, including thoughts of suicide, mental health or substance use crisis, or any other kind of emotional distress. People can also dial 988 if they are worried about a loved one who may need these types of crisis supports.
- Why do we need 988? There are urgent realities driving the need for crisis service transformation. Simply put, too many people living in the U.S. are experiencing suicidal cries or mental health related distress without the support and care they need. And, sadly, the COVID-19 pandemic has only made a bad situation worse when it comes to mental health and wellness in America. In 2020 alone, the U.S. had one death by suicide every 11 minutes—and for people aged 10-34 years, suicide is a leading cause of death. Additionally, from April 2020-April 2021, over 100,000 individuals died from drug overdoses in the U.S.
- What is the vision for 988? In the short-term, the goal is to strengthen and expand the current Lifeline call center infrastructure and capacity to ensure trained crisis counselors are available to quickly respond to 988 via call, text, or chat. In the longer term, the vision is to build a robust crisis response system across the country that links callers to community-based providers who can deliver a full range of crisis care services, if needed (like mobile crisis teams or stabilization centers). This more robust system will be essential to meeting crisis care needs across the nation.
- It’s important to keep in mind that 988 represents a once in a lifetime opportunity to change how crisis services are delivered—ensuring compassionate, accessible care and support for anyone experiencing a suicidal crisis or mental health related distress. The transition to 988 requires additional policy changes and funding support from federal and state governments. Even before the transition, messaging efforts should be cognizant of this and should focus on the need for further investment in the 988 system and support infrastructure nationwide. To learn more, visit the National Alliance on Mental Illness’ (NAMI) Reimagine Crisis Response or the Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System.
- During the pre-transition phase, you should also develop an overall strategy for communicating about 988, including determining key goals, audiences, and messaging channels. These key planning steps can help you as you develop your strategy.
- As you begin preparing to message more broadly about 988, it’s important that messages are research-based and data-informed to ensure accuracy and safety. This is especially important when messaging to certain audiences that are at higher risk of suicide or mental health conditions, such as youth, older adults, Black Americans, American Indians/Alaskan Natives, and LGBTQ+ individuals, among others.
- Finally, during the pre-transition phase, it’s important to speak with individuals from diverse backgrounds and perspectives (e.g., gender, age, race, ethnicity, and lived experiences) that represent your key audiences to better understand their awareness, perceptions, and behaviors around mental health, suicide prevention, and crisis supports.
- For example, the state of Utah—through the Utah Division of Substance Abuse and Mental Health Services—conducted a series of focus groups to better understand crisis needs, barriers, and solutions from a variety of perspectives to help inform its 988 strategy.
After Transition | July 2022
- Once the transition to 988 has taken place, communication can shift from educational messaging to implementation partners, policymakers, and others, to more promotional messaging to your key audiences outlined in your strategy.
- While messaging can begin promoting use of 988 via call, text, and chat once it’s available nationwide, it’s important to remember that it may take some time for 988 to be operating optimally in your area. Key factors should be considered before widely promoting 988 in your state or territory, such as:
- Is there sufficient local 988 crisis contact center capacity to meet the anticipated demand?
- Has your state or territory established connections and linkages between 988 crisis contact centers and mobile crisis or other rescue units to escalate care as needed? Are your local 988 crisis contact centers interacting or coordinating with local 911 call centers?
- Is there sufficient behavioral health provider and service worker capacity in your state or territory that can respond to crisis episodes should they escalate beyond crisis contact centers and mobile response?
- Finally, as mentioned above, 988 represents a once-in-a-lifetime opportunity to change how crisis services are delivered in the U.S. The July 2022 transition is just the beginning. After the transition it’s important to continue messaging with key policymakers to ensure additional investments in the 988 system and support infrastructure are in place for your state or territory.
Key Considerations
As you begin to develop messaging about 988, please consider these core elements to help guide your efforts in crafting timely, effective, and safe messaging.
Understanding How 988 Works
More About 988
Interested in learning more about 988 and how it will work? Visit our partners at SAMHSA and Vibrant Emotional Health for the latest information!
- Before you develop public-facing messaging about 988, it is critical to understand how it works—both generally and more specifically in your state or territory. While dialing, texting, or chatting 988 will look the same across the country, rollout and implementation may vary from region to region—such as the availability of mobile crisis response teams and crisis stabilization services—so make sure your planning is built on a foundation of solid, accurate information. We encourage you to work with local crisis centers and state suicide prevention coordinators to better understand the 988 infrastructure in your state or territory.
- Make sure you are familiar with how calls, texts, and chats into 988 are handled so you can share an accurate picture with your audiences. To learn more about how calls are currently routed, check out this Lifeline infographic. Communicating details such as who operates the line, what qualifications or training the crisis counselors answering the line have, and what callers should expect when they call, text or chat, will help address potential barriers that may keep someone from using 988.
- 988 will be built with accessibility and inclusion in mind to ensure the service is available to all individuals, regardless of communications needs. As such, 988 will be available via text and chat to anyone interested in using those services, as well as Spanish support via the press 2 option and interpretation service in over 150 languages.
- The transition to 988 will not impact the availability of crisis services for our nation’s Veterans and military Service Members. Once the nationwide transition takes place, the Veterans Crisis Line (VCL) can be accessed by dialing 988 then pressing 1. VCL chat and text options can be accessed online or by texting 838255.
Knowing What 988 Is… And What It Isn’t
- With the adoption of any new system it is essential that the field has an accurate and consistent understanding of 988 services and how it fits into the broader ecosystem of other crisis support services—such as 911, 211, warmlines, and other local crisis call centers. This will look different in each community, which is why it’s important you work alongside local implementers of 988 to better understand how these services work together at the local level.
- 988 services are distinct and separate from the emergency medical and public safety response associated with 911. 988 crisis counselors are trained to use the least invasive interventions, when possible, and oftentimes the call, text, or chat itself is the only intervention needed. However, ongoing coordination—at the federal, state, and local levels—between 988 and 911 will help individuals in crisis get the appropriate support they need, such as deploying mobile crisis teams or social workers in place of police or EMS responders, when needed and where available.
- Concerns about a potential law enforcement response may be a prominent consideration and potential barrier that prevents some communities (such as Black, Latino, or immigrant communities—among others) from utilizing 988. This is why understanding the needs of the audiences you are messaging to and whether your state or territory has mobile crisis teams (as opposed to police or EMS) available to respond if a crisis warrants follow-up care, will be key.
- Finally, once again it is important to remember that the adoption of 988 is an important first step in reimagining crisis support in our country, but it is not the final step. Transition to 988 is an opportunity for states and territories to reimagine their crisis service provision, and to ensure adequate financing for key services, such as crisis call centers, mobile crisis response teams, and crisis stabilization services.
Following Best Practices
- Use Messaging Guidance: Visit the Action Alliance’s Framework for Successful Messaging for best practices for communicating about suicide and suicide prevention strategically, effectively, and safely. In addition, the National Federation for Families’ Reframing Language resource outlines how to talk about mental illness.
- Be Strategic: Ensure that there is a strategy behind your messaging about 988. This upfront thinking and planning will help your message(s) succeed by determining the goal of your message, who you plan to message to, and what delivery channel you will need to use (e.g., web content, blog, social media posts, etc.). This strategy piece should be considered before any messaging takes place.
- Use Safe Messaging: Research tells us that messages that present simplistic explanations for suicide, glamorize or romanticize suicide, or portray suicide as a common or acceptable response to adversity may spur imitation of suicidal behavior among marginalized individuals. Increase safety by focusing your messages on the importance of help-seeking and the solutions and services that exist for those who may be struggling. Many safety issues occur when messages focus on the problem of suicide, rather than on what can be done about it.
- Avoid reinforcing negative stereotypes, myths, or stigma. Rather than just talking about how mental health stigma is a problem, messaging should also focus on solutions to stigma. For example, share stories of effective interventions or help-seeking.
- Follow a Positive Narrative by Reinforcing Solutions: Highlight that effective programs and services exist, prevention works, and help is available. Focus on messages that highlight those who have sought and received help and are now living full and active lives.
- Go beyond cursory mentions of positive themes. Avoid using a slogan like “suicide is often preventable” without including specific actions people can take, such as reaching out to 988 for help.
- Use Data Strategically: Make sure if you use data in your messaging that you do so in a strategic, and prevention-focused manner. Do not assume all messages should include statistics—part of developing your messaging strategy is determining what content is most likely to lead to the intended action, given limited time and space to get your message across. Often, statistics aren’t the best information to help your audience to act without the appropriate context around them.
- Illustrate the problem of suicide in terms of effective solutions. Rather than emphasizing data about the extent and severity of suicide or mental health in the U.S., instead use data that speaks to effective solutions. For example, “Research shows that suicide hotlines save lives and can contribute to reducing the estimated $34.6 billion in annual medical and work loss costs of suicide in the U.S.”
Tailoring 988 Messaging for Your Audience
- Each audience you are messaging to has its own unique makeup, and with that, its own unique considerations you need to account for when developing your messages. Suicide prevention and mental health are not one-size-fits-all issues and our messaging about them shouldn’t be either. Consider who makes up your key audience(s) and what actions you want them to take as you develop messaging to make sure that your messages speak to their unique perspectives, experiences, and communications or language needs.
- Use resources such as the Center for Disease Control and Prevention’s (CDC) Health Equity Guiding Principles for Inclusive Communication to learn more about crafting communications that are respectful and equitable to all audiences.
- When considering the experiences of certain audiences—such as tribal communities, Black or Latino communities, LGBTQ populations, youth, and Veterans—it is important to collaborate with organizations that have extensive expertise working with these groups. The organizations and agencies that comprise the 988 Messaging Task Force, among others, have invaluable perspectives, access to subject matter experts, and can be essential resources when planning any communications efforts that will engage these communities.
Amplifying Your Message
- Be sure to engage a broad range of local champions to help get the word out about 988 in your communities. Consider reaching out to local media, government, individuals with lived experience, and education organizations that have extensive reach and who are already recognized as authoritative sources of information in your communities.
- Engage storytellers with diverse perspectives (e.g., gender, age, race, ethnicity, etc.) and lived experiences who can speak to the value of support and promote help-seeking. Encourage those with lived experience to utilize the Lifeline’s Storytelling for Suicide Prevention Checklist, the American Foundation for Suicide Prevention’s Speaking Out About Suicide guidance, or NAMI’s Present Your Story resources.
- Social media is a powerful tool to amplify your message and understanding best practices for communicating through those channels is critical. Review the Lifeline’s Support on Social Media toolkit for more information.
- Some messengers may be contacted by news media to field inquiries about the implementation of 988. Should you receive a media inquiry about 988 implementation at the national level that you don’t feel equipped to answer, you are encouraged to connect reporters directly with the Action Alliance (info@TheActionAlliance.org) so they can be routed to an appropriate contact.
- Finally, as you engage with members of the news media regarding 988, please share with them our 988 Media Toolkit and encourage them to continue following the Recommendations for Reporting on Suicide and the American Psychiatric Association’s Words Matter: Reporting on Mental Health Conditions guidance.