As the National Suicide Prevention Lifeline prepared for the launch of a nationwide three-digit number on Saturday, local, state and federal government officials gathered in Philadelphia Friday to discuss the effort to get the new 988 calling code.
"There's been a lot of work to get to this day," Jessica Rosenworcel, chairwoman of the Federal Communications Commission, said. "But what we've done is we've made it easy. 988 is easy to remember. Now we have to make it clear to the entire country that it is a sign of strength to call it and use it, and not a sign of weakness."
The Lifeline has been in operation at a ten-digit number (1-800-273-TALK) since 2005, has taken over 20 million calls in that time, and that number will continue to route callers to the Lifeline following the launch of 988. However, the Substance Abuse and Mental Health Services Administration (a division of HHS) anticipates the increased ease of use for the three-digit number will dramatically increase calls to the service.
Tim Jansen, chief executive officer of Community Crisis Services Inc. in Hyattsville, Maryland, told ABC News that call volume at his facility has gone up over the last few years, and he expects the increase will continue amid the launch of 988.
"I think we're going to see a significant uptick in calls," Jansen said, adding that his facility has been working to increase their staff over the last six months in preparation. "I think the big thing is [988 will] make the number much easier to remember."
The Biden administration has put an unprecedented amount of funding toward launching the new number for the Lifeline. Following the addition of $150 million for the Lifeline as part of the recently passed gun safety legislation, the federal investment in 988 stands at $432 million.
Jansen says that funding, along with about $5 million in funding from Maryland that will be distributed across the state this fiscal year, has helped his facility increase the salary of existing staff and hire about 150 new employees. CCSI now has about 225 employees available to answer calls, chats and texts for the Lifeline in its capacity as both a local center and one of the national backup call centers.
Experts say that, ideally, Lifeline calls should be answered at the local level so callers can be more easily connected with follow-up resources in their area, but there are several national backup centers (such as CCSI) that can field calls from anywhere in the country if a particular center is unable to answer.
Jansen explained that local centers have about 30 seconds to answer a call before it is forwarded to the next nearest local or regional call center. If it is not answered by that center within about three minutes, he added, it then goes to the national backup network.
Nationwide, HHS officials say, the influx of federal funding for the Lifeline has enabled call centers to field 17,000 more calls, 37,000 more chats and 3,000 more texts in June of this year, compared to 2021.
While the federal funding has increased the ability of the Lifeline to respond nationwide, answer rates still vary from state to state, as much of the funding for these call centers happens at the state level.
When Congress designated 988 as the new number for the Lifeline in 2020, it gave states the authority to levy fees on cell phone bills to help sustainably fund the service, similar to how 911 call centers are funded.
So far, only four states have passed that legislation. Some others, like Maryland, have allocated some funding for the launch. Experts worry, however, that many states will not be able to accommodate the volume of calls anticipated after the new number launches.
HHS officials continue to emphasize the need for state-level investment for this system to be built out long-term and able to handle the volume of calls.
"Failure is not an option," HHS Secretary Xavier Becerra said at the launch news conference on Friday.
"988 is a three digit number, but it really is more." Becerra said. "It's a message -- when you need someone, we will be there."
The transition to a fully reimagined mental health crisis care system -- the ultimate goal of 988 -- will take time, officials say.
While most of the callers reaching out to the Lifeline during a mental health crisis can be deescalated over the phone, some require additional care, which can include a visit from a mobile crisis response team, a trip to a crisis stabilization unit or in some cases, inpatient hospitalization.
Those additional elements of what experts call the "crisis care continuum" are currently available in some cities across the country, but that portion of the crisis care system will take additional time to build out, they say.
"One of the challenges with 988 is it's going to expose the fact that there are not enough vendors, not enough therapists, not enough counselors," Jansen said.
Despite the expected hiccups in the overall nationwide rollout, he said, "To me, one life saved is success," adding, "But I think that the ultimate gauge of what makes  successful is if we ultimately see a reduction in the rates of suicide. That's going to take some time."
An employee for nearly 26 years at the center he now runs, Jansen said, "It's one call, one text, one chat at a time … [Every day] You can walk out of here knowing that I helped somebody with a safety plan. Somebody said that their only option was dying and now they have other options."
If you are experiencing suicidal, substance use or other mental health crises please call or text the new three digit code at 9-8-8. You will reach a trained crisis counselor for free, 24 hours a day, seven days a week. You can also go to 988lifeline.org or dial the current toll free number 800-273-8255 [TALK].