In July 2022, a new, nationwide 3-digit code to access crisis services - 988 - went live to support people experiencing a behavioral health crisis. This development was the follow up to a Federal Communications Commission (FCC) order designating 988 to replace the previous Suicide Prevention Lifeline phone number. Calling 988 provides rapid access to suicide prevention and mental health support services.

Now, people in crisis can call 988 from anywhere in the country to get services and support. In Massachusetts, calls are answered by staff of call centers specially trained to talk with people in emotional distress.

An opportunity for much-needed change

Implementation of 988 offers an opportunity to build and support a comprehensive system of crisis services and support in Massachusetts.

If implemented effectively – and in conjunction with other community-based solutions and investments – 988 call center providers will address callers' issues through support provided over the phone. In cases where such support is not enough, the call center might dispatch support such as mobile crisis intervention teams of behavioral health professionals and peer support. Only in instances where there is an imminent risk of harm to self or others will 988 call centers contact 911. These approaches minimize the need for police response and reduce risks associated with police interventions and potential arrests.

Importantly, in Massachusetts 988 will soon be assisted by the roll out of the Behavioral Health Helpline, part of the Commonwealth's Roadmap for Behavioral Health Reform. The helpline is a service staffed by clinicians that offers a robust crisis services system which also could provide real-time appointment scheduling, healthcare navigation, and social services navigation.

The helpline is supported by outside sections 22 and 65 of the state’s FY23 budget which created the Behavioral Health Access and Crisis Intervention Trust Fund. That fund supports not only the helpline but also behavioral health crisis intervention services available 24/7 in mobile and community settings. The fund is supported by a surcharge on payors.

The federal law establishing the 988 system also supports the establishment of local crisis centers and the development and implementation of wraparound crisis care services. A robust implementation of the 988 system will reduce emergency room boarding and divert individuals from police involvement and potential subsequent arrest.

Our current emergency response system, 911, works well for health emergencies, fires, and criminal activity. But behavioral health emergencies are not well-handled by an ambulance, a fire truck, or a police officer. The addition of 988 is one important step in creating an effective behavioral health emergency response system.

988 and Massachusetts

To better implement the 988 system in Massachusetts, the state Legislature passed provisions as part of Chapter 177 of the Acts of 2022, An Act addressing barriers to care for mental health, signed into law on August 10, 2022. The Act codifies the 988 crisis hotline into Massachusetts law and establishes a 988 Commission within the Massachusetts Executive Office of Health and Human Services to provide ongoing strategic oversight and guidance regarding 988 service. The Act permits the commission’s funding recommendations to include the establishment of user fees and require the commission to advise on promoting the 988 number, such as including 988 information on student ID cards and on signs in places where there have been known suicide attempts.

Key resources

988 Fact Sheet (MAMH): The basics on 988 in Massachusetts.

Crisis Now: Provides communities a roadmap to safe, effective crisis care that diverts people in distress from the emergency department and jail by developing a continuum of crisis care services that match people’s clinical needs.

"What is 988 and why should YOU care:" Guest blogger Monica Luke, Executive Director for The Living Assistance Fund, explains the importance of 988: a 24/7 line that will reimagine behavioral health crises response.

"A Once in a Lifetime Moment to Reimagine Crisis:" Guest blogger Monica Luke, Executive Director of The Living Assistance Fund, writes about the upcoming launch of 988 as a nationwide, 3-digit crisis line and how we can advocate for comprehensive crisis services in our communities.

988 Suicide and Crisis Lifeline [U.S. Substance Abuse and Mental Health Services Administration (SAMHSA)]: Resources and information to help states, territories, tribes, mental health and substance use disorder professionals, and others looking for information on understanding the background, history, funding opportunities, and implementation resources for strengthening suicide prevention and mental health crisis services.

Preparing for 988: Suicide Prevention and Mental Health Crisis Line: website detailing the background, benefits, and planning of 988; and frequently asked questions.

Technical resources

Criminal Legal System Diversion – Creating a Behavioral Health Emergency Response System (MAMH issue brief): Details on creating an effective and appropriate behavioral health emergency response system in Massachusetts.

National Guidelines for Behavioral Health Crisis Care - Best Practice Toolkit (SAMHSA): More guidance on best practices in behavioral health crisis care.

National Guidelines for Children and Youth Behavioral Health Crisis Care (SAMHSA): A framework that states and localities can consider as they develop or expand their crisis safety net for youth and families.

Taking the Lead to Invest in Community Crisis - International Declaration (IIMHL/Crisis Now Academy 2): A declaration to invest in community crisis.

Implementation of the 988 Hotline – A Framework for State and Local Systems Planning (Technical Assistance Collaborative): A framework for key stakeholders to use in organizing, planning, implementing, and sustaining an effective 988 crisis call system.

How to Use 988 to Respond to Behavioral Health Crisis Calls (The Council of State Governments & NAMI): Guidelines detailing how to use 988 to respond to behavioral health crisis calls.

Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System: Authored by the CEO Alliance on Mental Health who worked closely on the development of this shared vision to achieve a common goal - improving lives for people
with mental health and substance use disorders. This document provides a clear blueprint for building the continuum of care we need for a functioning crisis response system.


Find national crisis response system partners on the Crisis Now website.