The U.S. surgeon general called mental health the “defining crisis of our time” – and the statistics paint a bleak picture to say the least. According to the CDC, more than 49,000 people died by suicide in 2022. That’s one death every 11 minutes. Additionally, over 13 million adults considered suicide.
Two years ago, the three-digit 988 number launched nationally in an attempt to provide an easy-to-remember, universal number like 911 that anyone could call if they or someone they know was experiencing a behavioral health crisis. We’ve made great strides over the last two years toward improving the behavioral health crisis response system in America. It’s evident, however, that we still have a long way to go.
It’s time for technology to deliver the tools that will help healthcare professionals respond to a mental health or substance misuse crisis with the same urgency we extend to patients experiencing a physical health emergency. My career has been focused on behavioral health crisis response for over a decade. I’ve seen first-hand how important it is to seamlessly and non-intrusively identify and connect individuals in need to the right services at the right time via technology that complements the crisis workflow.
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There is no doubt that when Congress provided states with $1 billion dollars to build out the 988 Suicide & Crisis Lifeline, it was a necessary step in the right direction. Prior to 988, we had a host of hard-to-remember 10-digit phone numbers for people needing live support or assistance. The 988 number was born out of the need to respond in real-time to crises, including suicide, overdoses and emotional distress.
Notable progress
In its first year, 988 answered nearly 5 million calls, texts and chats. In 2025, experts predict that 988 call centers will respond to 7.5 million contacts from individuals in distress, illustrating the critical role technology plays in our lives, helping us access the care we need seamlessly.
Now, we need to build on that success by continuing to expand access to care and securing the funding we need to ensure the sustainability of the 988 Lifeline network moving forward. For example, since its inception, 988 has launched additional specialized services for LGBTQ+ youth and young adults, as well as a Spanish-language text/chat service and video calls for deaf and hard-of-hearing ASL users. There is also a dedicated call and text line for military veterans, service members and their families.
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While 988 is a crucial win for behavioral health professionals, we still have work to do. As is the case across the entire healthcare industry, we still struggle to have the resources and systems in place to provide equitable access in urban and rural communities. Now is the time to move the needle. What if we could leverage data and technology solutions to create a truly effective, integrated crisis response ecosystem?
Case in point: Calls to 988 are routed to the nearest crisis contact center based on the caller’s area code, which makes it difficult to coordinate local care properly when and where it is needed for callers who no longer reside in, or may be temporarily outside of, the state their area code is assigned to. The work the Substance Abuse and Mental Health Service Administration (SAMHSA) and the Federal Communications Commission (FCC) are doing to georoute 988 calls is a positive step forward and considered a win for both the 988 network and the individuals accessing it.
Funding is an ongoing issue as states struggle to allocate long-term resources to operate these call centers and downstream services for higher levels of care. The need is only growing. There are over 200 centers answering 988 calls, texts and chats, but as the population grows, we’ll need to expand that number, especially if we want to provide access to care in rural communities across the country. This illustrates another problem—the growing workforce shortage— particularly in behavioral health. How can we expand these services if we don’t have enough people to staff them? Using technology as a force multiplier is one option, reducing time to search for, identify, and, if needed, connect to higher levels of care. Leveraging an interoperable system that cascades information throughout the crisis event, emerging technology solutions can eliminate manual processes and allow specialists to focus on meeting the needs of the individual.
The road ahead
Based on my experience working in the crisis space and the insights I’ve gained from collaborating with state partners, three key areas have emerged that impact the sustainability of the 988 Lifeline network.
1. Leveraging insights gained from real-time data to identify available resources
States and providers need to be able to translate raw data into actionable insights to better serve the needs of their communities. Regardless of the intake points, whether someone calls 988 or law enforcement encounters someone in crisis and requests assistance, call centers need the technology to intake whatever data is applicable about an individual, determine the best next step and ultimately, get this person to the best possible outcome.
Let’s say that out of 5,000 calls received, we know that 15% of the calls coming in required mobile crisis dispatch; or that 15% of the calls resulted in a referral to an outpatient provider. That information can be digested and analyzed, creating actionable insights that states can use to understand where the gaps are and how to fill them. Maybe a call center is sending too many people to a walk-in crisis center when they should have been diverting them to the mobile crisis team, or maybe the call center staff needs additional education about the local resources. If we are over-utilizing the emergency department, can we direct individuals to a crisis stabilization provider instead? Are there mobile crisis responders that could address the situation upstream and divert the individual from the ED?
Connecting the dots in this behavioral health care continuum depends on our ability to see and analyze the data coming in. If we don’t, we’re missing an opportunity to provide better care.
2. Creating a source of sustainable funding We need consistent funding for the 988 call centers and downstream providers. States and commercial insurers (who agreed to support behavioral health claims the same way they do physical health) are and should be the primary sources of funding in this area. The Biden-Harris Administration invested nearly $1 billion to support the 988 Lifeline in its infancy, and additional funding has been approved by Congress. Still, more investment at all levels is needed.
3. Using technology to reduce the strain on an overworked workforce Suppose we had an interoperable system that could cascade critical information throughout the care continuum regardless of where a patient enters the system. In that case, we eliminate time-consuming manual processes, allowing staff more time to focus on getting individuals the right care during critical health moments. This is especially crucial for call centers that still use Excel sheets or hand-written notes to track data or fax machines to coordinate care. In today’s booming age of technology, there are certainly more efficient ways of managing these processes and capturing necessary data.
If we don’t have the right technology in place, we are left with a puzzle that has missing pieces – we have all this data, but we can’t make sense of it. Interoperable technology solutions can immediately address gaps in pivotal care coordination moments by standardizing workflows, facilitating data sharing among states and their provider network and ultimately facilitating the most appropriate and least restrictive care journey for individuals in crisis.
What’s next?
The challenges we faced two years ago are still challenges today. Funding is still an issue. The need to pinpoint where someone is calling from as opposed to their phone’s area code isn’t new. Implementing a nationwide system isn’t easy. In fact, it took decades to get 911 where it is today, and 988 is still in its infancy. The real lesson is this: If we want 988 to be successful in helping those experiencing behavioral health crises, we need an integrated system capable of helping any individual in need, wherever they may enter the crisis continuum.
I’m proud of the work states have done to get 988 call centers up and running and, most importantly, to increase their in-state answer rates over the past two years. More people have access to life-saving care by simply picking up their phones. Imagine what we can accomplish when we implement real-time data sharing and care coordination between 988 call centers, states and service providers.
Now that would truly be a giant step forward for the entire healthcare system.
Photo: ipopba, Getty Images
Gina Gibson is the Senior Director of Behavioral Health Solutions and serves as the crisis operations and technology subject matter expert at Bamboo Health. In her role, she leverages her more than a decade of experience in the behavioral health crisis space to consult with states to determine their business needs, matching those needs to the most appropriate Bamboo Health solution to achieve their desired outcomes. Prior to Bamboo Health, Gina was the Chief Operating Officer overseeing the statewide Georgia Crisis and Access Line (GCAL) contact center hub and providing operational oversight for company-run mobile crisis response services covering two-thirds of the state.
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