Fund Local Crisis Response Efforts

ACTION NEEDED: 

Urge your members of Congress to appropriate Fiscal Year (FY) 2027 funding for the National Suicide Prevention Lifeline that is at or above the level of $535 million appropriated in FY 2026. 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 2020, which became nationally available in July 2022. In 2024, the FCC introduced new geo-routing requirements for the Lifeline program, ensuring that calls are routed based on a caller's general physical location rather than their phone number's area code; this change enabled callers to connect directly to local services, improving access and response. Since the launch of 988 in 2022, there have been over 16.5 million calls, texts and chats received nationally by the lifeline.

In 2023, 49,246 individuals died by suicide in the United States, a slight decrease from 2022 but an increase from 2018-2021. SAMHSA’s 2024 National Survey on Drug Use and Health (NSDUH) data show 5.5 percent of adults aged 18 or older (14.3 million adults) had serious thoughts of suicide in the past year; in addition, 1.8 percent (4.6 million) made a suicide plan and 0.8 (2.2 million) percent attempted suicide in the past year. Among adolescents 12 to 17, 10.1 percent (2.6 million adolescents) had serious thoughts of suicide, 4.6 percent (1.2 million) made a suicide plan and 2.7 percent (700,000) attempted suicide in the past year.

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, which also fiscally contribute to the provision of behavioral and mental health services, with support from federal funds through the Medicaid program.

The FY 2026 appropriations bill provided $535 million for the 988 Lifeline, a $15 million increase from FY 2025.  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 partners to support these efforts by mandating crisis services be covered by all health insurers; creating 24/7 crisis call centers that serve as centralized hubs for answering calls and connecting individuals to services; bolstering the crisis response workforce; and supporting the development of crisis stabilization programs that provide an alternative to treatment in a jail or emergency department.

KEY TALKING POINTS:

• Suicide is the eleventh leading cause of death in the United States. It is the second leading cause of death among individuals age 10-34 and is in the top eight causes of death for individuals age 10-64.
• 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, which also fiscally contribute to the provision of behavioral and mental health services, with support from federal funds.
• Congress should appropriate FY 2027 funding for the National Suicide Prevention Lifeline that is at or above the FY 2026 level of $535 million.