ACTION NEEDED: 

Urge your members of Congress to appropriate Fiscal Year (FY) 2024 funding for the National Suicide Prevention Lifeline that is at or above the level of $501.6 million appropriated in FY 2023. Additionally, urge your members of Congress to support the passage of authorizing legislation that will support and strengthen county crisis response infrastructures.

BACKGROUND:

In 2020, Congress unanimously passed the National Suicide Hotline Designation Act, which established a three-digit dialing code (9-8-8) for the National Suicide Prevention Lifeline (Lifeline), a national hotline that would facilitate local mental health crisis service coordination. The FCC officially designated 988 as the three-digit dialing code for the Lifeline in July of 2020, which became nationally available in July 2022. Since the launch of 988, there have been over 154,000 calls answered nationally by the lifeline, in as fast as 36 seconds per call.

In 2021, 47,646 individuals died by suicide in the United States, and evidence suggests that the COVID-19 public health emergency has only exacerbated stress on the mental health and well-being of many Americans. SAMHSA’s 2021 National Survey on Drug Use and Health (NSDUH) data show 4.8 percent of adults aged 18 or older had serious thoughts of suicide, 1.4 percent made a suicide plan, and 0.7 percent attempted suicide in the past year. Among adolescents 12 to 17, 12.7 percent had serious thoughts of suicide, 5.9 percent made a suicide plan, and 3.4 percent attempted suicide in the past year. The findings vary by race and ethnicity, with people of mixed ethnicity reporting higher rates of serious thoughts of suicide.

The implementation of the 988 National Suicide Prevention Lifeline is a critical step in building a stronger crisis care system by establishing a universal entry point to access needed crisis services that mirror other emergency medical services, such as 911. Lifeline crisis call centers are primarily financed by state and local level governments, who also fiscally contribute to the provision of behavioral and mental health services, with
support from federal funds through the Medicaid program.

The FY 2023 omnibus appropriations bill provided $501.6 million for the 988 Lifeline, a nearly $400 million increase from FY22. Additionally, the 2022 Bipartisan Safer Communities Act appropriated $150 million to SAMHSA to support the implementation of the lifeline. These investments, alongside future federal investment, will aid 988 efforts across the country to scale up local crisis call center operations and hire adequate staffing as the demand for crisis services continues to grow.

Counties urge federal policymakers should enact legislation that would support these efforts by mandating crisis services be covered by all health insurers; create 24/7 crisis call centers that serve as centralized hubs for answering calls and connecting individuals to services, assist in building the crisis response workforce that both staffs call centers and respond to calls via mobile crisis teams, and support the development of crisis stabilization programs that provide an alternative to treatment in a jail or emergency department.

KEY TALKING POINTS:

• Suicide is the tenth leading cause of death in the United States and the second leading cause of death among individuals between the ages of 10 and 34.

• Counties are an integral part of the local behavioral health crisis care continuum and are key implementers of the 988 National Suicide Prevention Lifeline.

• Lifeline crisis call centers are primarily financed by state and local governments, who also fiscally contribute to the provision of behavioral and mental health services, with support from federal funds.

• Congress should appropriate FY 2024 funding for the National Suicide Prevention Lifeline that is at or above the FY 2023 level of $501.6 million.

• Congress should support the passage of legislation that will further support and strengthen county crisis response infrastructures.