988 and 911: Similarities and Differences

The launch of the 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) in July 2022 was a historic moment in the story of mental health and substance use care services in our nation.

Now anyone, anywhere in the U.S. can call or text an easy-to-remember, three-digit number and be connected to a trained crisis counselor who will help them navigate challenging moments and situations.

The new line has made it easier for those most in need to reach critical care in a new and highly effective way — already with impressive results. Since implementation began in July, 988 has served tens of thousands of individuals through calls, texts and chat services.

988 is often compared to another three-digit number the nation knows well: 911. At the National Council for Mental Wellbeing, we often field questions about the differences between the two services. This blog post highlights some of the key differences and provides additional resources to help answer these and other key questions.

To summarize, 988 and 911 are each an easy to remember 3-digit number connecting people to crisis and other lifesaving services. But the similarities pretty much end there.

The Substance Abuse and Mental Health Services Administration (SAMHSA), the agency overseeing 988, has described their ultimate vision for 988 is to offer people experiencing a mental health or substance use crisis or emotional distress someone to talk to, someone to come to them and somewhere to go, as needed. Those second two offerings are perhaps familiar or comparable to 911, which dispatches first responders to callers’ locations.

Eventually, and with enough funding, workforce and infrastructure, 988 could facilitate dispatching mobile crisis responders to callers with much more regularity. This would help divert mental health and substance use calls from EMS, fire and police, and help get people treatment at community-based, non-emergency care settings, as appropriate. To this end, 988 is a key first step toward enhancing and expanding a full and comprehensive crisis continuum of care.

That first service, “someone to talk to,” is what makes 988 unique.

With 911, a dispatcher will send needed services (e.g., EMS, fire, police) to the caller and may provide support to the caller while they wait for the services to arrive. But 988 is itself a service. When an individual in need accesses 988 (via call, text or chat) they are connected to a trained crisis counselor who can provide help to reduce emotional distress.

More than 98% of 988 Suicide & Crisis Lifeline contacts are resolved at that first point of contact, with no need for any additional services to be dispatched. In fact, numerous studies show that most callers feel significantly less depressed, less suicidal, less overwhelmed and more hopeful after speaking to a Lifeline crisis counselor.

One key area of overlap between 911 and 988 occurs when there is an imminent risk to the 988 user’s life (an ongoing suicide attempt, for example). While the 988 coordinated response is intended to promote stabilization and care in the least restrictive manner, in the case of imminent danger, 988 calls are connected to emergency services like 911. Currently, fewer than 2% of Lifeline calls require this connection.

To learn more about the function and structure of 988, key comparisons to 911, other National Council work in this space or SAMHSA’s vision for the crisis continuum and 988, check out these resources from SAMHSA and the National Council.

From the National Council:

• 988 Implementation and Future Priorities
• 988 Fact Sheet
• 988: Reaching Its Full Potential

From SAMHSA:

• SAMHSA’s 988 Fact Sheet
• 988 Suicide & Crisis Lifeline