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Behavioral Health Crisis Response System and 988

Beginning July 16, 2022, a new three-digit phone number — 988 — will be available 24/7 for people to call when they are or someone else is having a behavioral health crisis or emergency. 988 is short and easy to remember, like 911, which people can call for all other emergencies.

Until then, people can call the 24/7 National Suicide Hotline number: 1-800-273-TALK (8255) or text the crisis text line by texting Oregon to 741741. Read more about the crisis text line here.

How 988 works

When someone calls 988, they will reach a compassionate, highly trained counselor who can help address their issue in the least intrusive way possible. The counselor is part of a call center that is linked to a network of services, so the caller will be connected quickly with the right kind of help, from the right type of helper.

According to the National Suicide Prevention Lifeline, more than 95% of current calls are resolved over the phone. When more help is needed, the counselor can connect the caller with mobile response providers or first responders, who will either help the person onsite or transport them to where they can receive the help and stabilization services they need.

​Mobile crisis response teams are prepared to visit the caller in their current location.

​A first responder is an Emergency Medical Technician or police officer who is trained to handle behavioral health crises or emergencies. If the 988 counselor determines a caller is in danger of harming themselves or others, they will send first responders with people trained in trauma-informed care.​

Why do we need 988?

In 2020, the National Suicide Prevention Lifeline received nearly 2.4 million calls. 988 will provide another resource for people who don’t know that number or are hesitant to call 911 during a behavioral health crisis. 988 is also another option for families and/or caregivers of children, youth, and young adults, who currently call a pediatrician’s office or go to the emergency department if they are having a behavioral health crisis.

The new 988 crisis response system will:

  • Ensure that someone experiencing a behavioral health crisis receives care in the appropriate setting.
  • Reduce the burden on hospital emergency departments and law enforcement.
  • Meet the unique needs of people most impacted by behavioral health crises, including youth and people who have a difficult time accessing appropriate health care.

A diverse array of stakeholders, crisis centers, telecommunications agencies, behavioral health providers, and people with lived experience are involved in the planning to ensure Oregon builds an inclusive crisis response system.

​The National Suicide Prevention Lifeline provides 24/7, free and confidential emotional support to people in suicidal crisis or emotional distress across the United States. The Lifeline is administered by the nonprofit Vibrant Emotional Health and funded by the Substance Abuse and Mental Health Services Administration (SAMHSA).

  • Evaluations and caller feedback show that Lifeline counselors are effective in reducing caller distress and suicidality. They help tens of thousands of people get through crises every day.
  • Crisis centers are local and connected to their community resources, community mental health, hospitals, social services and first responders.
  • All Lifeline centers are accredited, provide extensive training in crisis intervention, de-escalation and suicide prevention, and must apply Lifeline’s best practices on calls.
  • These same crisis centers continue to answer more than 12.1 million additional non-Lifeline crisis calls on their local, city, county and state crisis lines.
  • ​The suicide rate has climbed nearly 30% since 1999 – and the rate has increased in 49 out of 50 states over the last decade.
  • From 2008 to 2019, suicide was the 10th leading cause of death in the United States. Suicide claimed the lives of 47,511 Americans in 2019, resulting in about one death every 11 minutes. In 2020, COVID-19 bumped suicide to the 11th leading cause of death, at 44,834.
  • Oregon had the nation’s ninth-highest suicide rate across all ages in 2019 at 906. This marked a notable deterioration from 2018, when the state was 17th in suicide deaths. 
  • Suicide is the second leading cause of death among young people.
  • From 2016-2017, there was a 10% increase in suicides of young people between 15-24 years old in the U.S.
  • Approximately 20% of people over age 12 have a mental health condition in the U.S.

988 history

The ​Federal Communications Commission (FCC) recommended the use of 988 as the 3-digit code for the National Suicide Prevention Lifeline. FCC staff consulted with SAMHSA, the Department of Veterans Affairs, and the North American Numbering Council. 

​The FCC adopted rules designating this new phone number for people in crisis across the United States to connect with suicide prevention and behavioral health crisis counselors and set July 16, 2022, as the implementation date. ​

​Congress passed the 988 National Suicide Hotline Designation Act and called on states to establish a statewide coordinated crisis services system and provide the appropriate funding for its success.​

​The Oregon Legislature passed House Bill 2417, which:

  • Sets aside General Fund dollars for Oregon’s 988 implementation and infrastructure.
  • Outlines the requirements for the infrastructure and resources to implement the 988 emergency call system and a behavioral health crisis service system that can support 988. The bill:
  • Directs OHA to convene a work group to study and evaluate methods for continuing to fund mobile crisis intervention teams and other behavioral health supports. 
  • Expands crisis stabilization services, including crisis stabilization centers meeting criteria adopted by OHA by rule, short-term respite facilities, peer respite centers, behavioral health urgent care walk-in centers and crisis hotline centers. 
Plans for 988 services are based upon SAMHSA’s behavioral health crisis care implementation guidelines, using the best practices laid out in SAMHSA’s toolkit and guidelines​.

Who will pay for 988?

The legislature has set aside General Fund dollars to implement 988 call centers and infrastructure. As the 988 system expands, additional funding will be required and legislators will continue to explore the most sustainable funding source for 988 call centers, response units, and treatment centers.

Updates

988 Crisis System Advisory Workgroup Steering Committee:

Draft contracts for Oregon 988 call centers: Open for public comment June 13-20, 2022.

To submit public comment or questions, please email Brian Pitkin.

Resources

See the FCC’s 988 fact sheet.

Visit the FCC's web page about the National Suicide Prevention hotline.

Visit SAMHSA's 988 page.

Contact

Rusha Grinstead, MPH, OCPMP
Behavioral Health Crisis System and 988 Project Implementation Project Director
rusha.grinstead@dhsoha.state.or.us
503-602-9214