988 Suicide and Crisis Lifeline: A Guide for US Healthcare Staff

988 is the three-digit number for the 988 Suicide and Crisis Lifeline in the United States. It replaced the older 10-digit national suicide prevention number in July 2022, and healthcare staff are now regularly asked about it by patients, families and colleagues. This guide explains how 988 works, what recent federal data shows and how it fits alongside your own organisation’s suicide-risk protocols. It is general education and not a replacement for employer, state or accreditor requirements.

What is 988?

988 connects people in crisis with trained crisis counselors by call, text or chat, 24 hours a day, seven days a week, across the United States. Help is free and confidential and is delivered through a network of more than 200 local crisis centers. The service is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). The earlier Lifeline number, 1-800-273-8255, still works.

Callers can press 1 to reach the Veterans Crisis Line or press 2 for Spanish. Options can change over time, so check the official 988 Lifeline site for the current menu rather than relying on older posters or handouts.

What does the data show?

A 2026 report from the US Government Accountability Office reviewed the first years of the service. It found roughly 19.1 million contacts between July 2022 and September 2025. Over that period call volume rose by about 87 percent, text volume by about 260 percent and chat volume by about 23 percent. Answer rates for calls improved, while answer rates for texts and chats fluctuated. SAMHSA has set a goal for crisis centers to answer more than 90 percent of the texts and chats they receive by September 2026. The same report notes that suicide caused more than 49,000 deaths in 2023, a rise of 31 percent since 2003.

The takeaway for staff is that demand is growing, particularly for text and chat, and that people increasingly expect to be pointed to 988.

988 versus 911

988 is for emotional distress and suicidal thoughts. It is not the same as 911. If someone is in immediate physical danger, has taken an overdose or has a medical emergency, call 911 or follow your facility’s emergency procedure. If you are unsure, treat it as an emergency first.

How can healthcare staff use 988 well?

1. Know the number and the channels. Many patients prefer text or chat, so make sure you can explain all three.
2. Offer it as part of safety planning. A written safety plan is more useful when it lists 988 along with family, clinicians and local services.
3. Do not use it as a substitute for assessment. A patient with suicidal thoughts still needs screening and escalation under your own protocols. See our guide to suicide risk reduction for US healthcare staff for the Joint Commission requirements.
4. Stay with the person where appropriate. Handing over a number is not the same as ensuring safety. Follow supervision and observation rules.
5. Look after yourself. Supporting people in crisis takes a toll. Our guide to compassion fatigue explains how to spot the signs.

Talking about suicide

Asking directly about suicide does not plant the idea. Use plain, non-judgemental language, listen, and avoid promising confidentiality you cannot keep. Our UK-focused article on suicide and self-harm awareness for care staff covers conversation skills that apply well beyond the UK, though contact numbers differ by country.

Is there required 988 training?

We are not aware of a single federal rule requiring all healthcare staff to complete 988-specific training. Requirements vary by state, employer and accreditation body, so check what applies to your role. Suicide-risk and crisis-response training is widely expected in behavioural health settings, so building general skills is sensible.

Frequently asked questions

Is 988 free?

Yes. 988 is free and confidential.

Can people text 988?

Yes. People can call, text or chat.

Does 988 replace the old number?

The old Lifeline number still works.

Supporting families and carers

Relatives often ask what to do when they are worried about someone. Explain that they can contact 988 themselves for advice on how to support a loved one, as well as calling for the person in crisis. Encourage them to remove or secure means of harm where they can, to stay with the person, and to call 911 if there is immediate danger. Give them written information that they can keep at home, and tell them that the person’s care team will keep working with them.

Recording and follow-up

If a patient tells you they have used 988, or you gave them the number, record it in line with your facility’s policy and make sure the treating team knows. Follow-up matters because the period after a crisis, and after discharge, is when people need continuing contact. Check that the patient has appointments, a named contact and a written safety plan before they leave.

Key takeaways

• 988 offers free, confidential support by call, text or chat, every day.
• Use 911 for immediate danger.
• 988 supports, but does not replace, your own screening and safety planning.

Ready to build skills in this area? Browse our healthcare CPD courses.

If you or someone you know is in crisis in the US, call or text 988, or use emergency services.

Sources

• 988 Suicide & Crisis Lifeline: The Lifeline and 988
• US Government Accountability Office: GAO-26-108114 on the 988 Lifeline