Introduction

The National Suicide Prevention Lifeline is a United States-based suicide prevention network of over 160 crisis centres that provides 24/7 service via a toll-free hotline with the number 1-800-273-8255 (TALK).

It is available to anyone in suicidal crisis or emotional distress. The caller is routed to their nearest crisis centre to receive immediate counselling and local mental health referrals. The lifeline supports people who call for themselves or someone they care about. In July 2020, the US Federal Communication Commission (FCC) finalised an order to direct telecommunication carriers to implement 9-8-8 as the new toll-free nationwide telephone number for the hotline by 16 July 2022.

Brief History

The National Suicide Prevention Lifeline grant is one component of the National Suicide Prevention Initiative (NSPI), a multi-project effort to reduce suicide, led by the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Centre for Mental Health Services.

In July 2004, SAMHSA released a notice of funding availability (NOFA) as part of its National Suicide Prevention Initiative (NSPI). In keeping with SAMHSA’s duty to advance the goals of the National Strategy for Suicide Prevention, the NOFA called for proposals from non-profit organisations to expand, enhance, and sustain a network of certified crisis centres providing suicide prevention and intervention services to those in need using a toll-free number and website.

In September 2004, the Mental Health Association of New York City (MHA-NYC) was selected to administer the federally funded network of crisis centres named the National Suicide Prevention Lifeline.

In December 2004, the National Suicide Prevention Lifeline was founded by the Substance Abuse and Mental Health Services Administration, a division of the Department of Health and Human Services.

Google, Bing, Yahoo and Ask.com all place the phone number and website details of the National Suicide Prevention Lifeline as the reserved first result for when one enters keywords related to suicide, such as “How to tie a noose” and “I want to die.”

In April 2017, Logic, an American musician and rapper released a song featuring Alessia Cara and Khalid for his third album Everybody titled “1-800-273-8255”, the number used for The National Suicide Prevention Hotline. On the day of the song release, the lifeline received one of its highest daily call volumes. It was made to bring awareness to the hotline and to the problems associated with suicide. After being featured on the 2017 MTV Video Music Awards, it increased the calls to the hotline by 50% that night. On the day of the song release, “Lifeline’s Facebook page saw 3 times its usual traffic” and Lifeline’s “website saw a 17% increase in users in May 2017 over the previous month.” Many of the callers to several crisis centres have mentioned Logic’s song, and a third of those callers were struggling with suicidal thoughts. The song was performed at the 60th Annual Grammy Awards as a tribute to Linkin Park vocalist Chester Bennington, who committed suicide in the previous year.

The National Suicide Hotline Improvement Act of 2018 required the Federal Communications Commission and other agencies to consider a three-digit number for the hotline. On 15 August 2019, FCC staff recommended that the Commission designate the number 988 for the hotline. On 12 December 2019, the Commission approved a proposed rule starting the process for public commenting and final rule making. The rule was adopted on 16 July 2020 in final form in a 5-0 vote by the FCC. The rule requires telecommunication carriers to implement the telephone number 988 to route calls to the existing service number by 16 July 2022. This provides sufficient time to expand staff and training to handle the anticipated call volume. As 988 is already assigned as a central office prefix in many area codes, the dialling procedures for these areas must prescribe ten-digit dialling, or the central office prefix 988 must be retired. Where necessary, ten-digit dialling will become mandatory on 24 October 2021.

On 17 October 2020, the National Suicide Hotline Designation Act (S.2661) was signed into law to support the implementation of the hotline. Disability advocates, calling for equity, petitioned the FCC to implement text-to-988 service for hard-of-hearing and speech-disabled people. The following month, on 20 November 2020, T-Mobile became the first wireless carrier to implement the 9-8-8 number for voice calls.

The Canadian Radio-television and Telecommunications Commission has recommended using a three-digit number, most likely 988, for a similar program in Canada. Should 988 be used, it would require the last four areas without ten-digit dialling currently in place or with a planned overlay, those being area codes 506, 709, 807 and 867, to convert to ten-digit dialling to implement, as 988 is an active prefix in all areas above.

Veterans Hotline

In June 2007, the Department of Veterans Affairs (VA) partnered with SAMHSA and the National Suicide Prevention Lifeline to provide a veterans hotline to help veterans in emotional crisis. Callers who identify themselves as a US military veteran are routed to a special veterans hotline. This service caters to VA-specific mental health care needs, and helps connect vets to the VA Healthcare system. In addition to the hotline, the veterans hotline also offers text messaging support by texting to 838255, as well as an online chat service for those who want to use the hotline.