Someone to Call, Someone to Respond, and a Place to go: Two Years Since Launch, 988’s Promises are Coming True in Washington

From: Washington Governor Jay Inslee
July 2, 2024

This month marks the two-year anniversary of the launch of Washington’s 988 Suicide & Crisis Lifeline. For Washingtonians in need of support, professional counselors are just three digits away: 9–8–8.

Washington’s lifeline debut in 2022 was part of a national effort. Dialing or texting 9–8–8 from any state connects help-seekers to the national network of call centers for assistance during suicidal crises, mental health or substance use concerns, or emotional distress.

In implementing its part of the network, Washington state is taking additional steps to ensure 988 becomes more than a call center. At launch, the promise for the future of Washington’s lifeline was threefold: someone to call, someone to respond, and a place to go. Once the system is built out, 988 counselors will be able to schedule appointments or deploy mental health responders for someone in crisis.

People in crisis may not have someone to call, so they often contact 911. And they may have unmet medical needs, so they often visit hospital emergency rooms for care. The 988 system fills these voids, offering a lifeline to call or text, and intermediate care for mental health issues.

Since Washington’s lifeline launched in July 2022, calls are up 40%. Texts have increased by 670% and chats have increased by 124%. As many as 8,600 people a month called in their time of need last year.

Washington’s 988 counselors are quick to pick up and slow to hang up. The state’s 91% answer rate in May was sixth-best in the country and showed a 3% advantage over the national average. The average caller waited just 20 seconds to speak to somebody. Counselors took an average of 13 minutes and seven seconds to listen to each caller.

988 counselors also answer calls, texts and chat messages around the clock. The lifeline has already received over 2,100 text messages and 2,400 online chats in 2024. Counselors responded to 99% of all texts received and replied in just twenty seconds on average.

The lifeline is helping people, and Washington’s network is setting an example for the nation. Here’s a look at the progress made in the first two years, and the work coming up.

Personal circumstances, personal resources

Washington’s lifeline is responsive to the unique circumstances of its help-seekers. Upon dialing 9–8–8, veteran help-seekers can press “1” to reach the specialized Veterans Crisis Line. LGBTQ+ youth may dial “3” to reach the specialized LGBTQI+ Youth Line. Indigenous help-seekers may dial “4” for the specialized Native and Strong Lifeline. Pressing “2” connects help-seekers to Spanish-speaking counselors. Many of these subnetwork lines are also accessible by text and chat.

Suicide and mental health issues afflict different groups differently. Washington’s 988 system is responsive to these differences.

Compared to a national age-adjusted rate of 14.21 suicides per 100,000 people, America loses veterans to suicide at a 123% greater rate (31.7/100,000). A 2023 national survey by The Trevor Project found that 41% of LGBTQ+ young people seriously considered suicide in the past year. And American Indian or Alaska Native people die by suicide at higher rates than any other racial or ethnic group.

The 988 lifeline and its specialized units are each staffed by trained counselors. But the specialized lines offer culturally relevant care — counselors are representative of the people they help, and they understand the factors that increase mental health risks for these groups.

Help beyond the call

Efforts to build follow-up resources are underway, especially in mobile crisis response. Rep. Tina Orwall sponsored and Gov. Jay Inslee signed HB 1134 in 2023 to fund and train mobile crisis response teams statewide. Since 1134’s passage, 12 mobile crisis teams have been newly created or expanded with state funding. The bill also directed coordination between 988 and 911 so that mental health calls are diverted from 911 to 988, and responded to with mental health resources rather than law enforcement.

Before HB 1134, independent mobile crisis response teams operated by independent standards. Now, teams are trained to federal best practices. By early 2026, these teams will have a system to arrange a next-day appointment for someone in crisis, determine if they attended that visit, and follow up accordingly. Standardized training and personal attention like this will make crisis response teams more effective.

The third promise of 988, “a place to go,” is also coming to fruition. Orwall sponsored and Inslee signed HB 1477 in 2022 to expand investments in substance use disorder treatment, crisis stabilization centers, and other similar resources.

The state Department of Health is preparing funding models and policy guidance for walk-in relief centers where people can receive immediate services. Those might include medication refills, substance use disorder treatment, or even medical evaluation and treatment in some cases. DOH expects to begin licensing facilities like these by summer 2025. These may look similar to the new walk-in centers King County leaders are poised to launch.

“People who seek help are often traumatized when they do. They might sit for hours in an emergency room or maybe have a police interaction that’s not good,” said Orwall on TVW’s The Impact. “988 is a way to create a clinical response to people having a behavioral health crisis.”

A law enforcement response isn’t usually the best response for a mental health call. And emergency hospitalization isn’t usually the best treatment for mental health issues. By operating a responsive lifeline, expanding crisis response teams, and investing in stabilization centers and more treatment options for common mental health issues, Washington is setting a national example.

 

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