3 years later, 988 Lifeline sees higher volume but special option for LGBTQ youth cut

Three years after the launch of the three-digit 988 Suicide & Crisis Lifeline, the service is seeing increases in call volume, state-level support and reported effectiveness, as well as reductions in specialized offerings, including one designed to help LGBTQ youth.

“This year, the 988 Lifeline continued to provide life-saving help to millions of people, with about a 20% higher volume of calls, texts and chats compared to the year prior,” Dr. John Palmieri, acting director of SAMHSA’s 988 Lifeline Office, told ABC News via email.

SAMHSA is the Substance Abuse and Mental Health Services Administration, the division of the Department of Health and Human Services which oversees 988.

“Recent evaluation work affirms the effectiveness of the 988 Lifeline, with studies showing that the vast majority of suicidal callers saying they thought their crisis call helped them and stopped them from killing themselves,” he added.

A network of more than 200 crisis call centers field calls, chats and texts on behalf of the Lifeline, offering support to callers experiencing suicidal crises and other forms of mental distress. This network has existed in some form for at least a couple of decades, beginning with the precursor to 988 — the 10-digit National Suicide Prevention Lifeline, which was started in 2005.

During his first term, President Donald Trump signed into law the National Suicide Hotline Improvement Act of 2018, which designated 988 as the new three-digit number to call in case of a mental health emergency. The new number, intended to be easier to remember and access in times of crisis, officially launched on July 16, 2022.

13 million contacts so far

Since that launch date, the Lifeline has answered over 13 million calls, chats and texts across the U.S. and its territories, according to SAMHSA.

“The transition to 988 three years ago sparked coordinated efforts across the country — inspiring local governments, states, Tribes and healthcare providers to improve crisis care response systems in communities nationwide,” Palmieri said.

Despite increasing state-level support for the Lifeline, recent downsizing efforts across the federal government have had an impact on the ability to “build out a crisis continuum of care across the country,” Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, told ABC News.

“Interestingly, the administration has proposed flat funding for 988 for fiscal year 2026, so that was really encouraging that they’re proposing keeping funding levels at [$519.6 million],” Wesolowski said. “But with a lot of the changes within HHS, we’ve seen a fair number of the staff within the 988 behavioral health crisis coordinating office depart the administration.”

The Trump administration has implemented significant workforce reductions for HHS and SAMHSA over the last few months. HHS also recently announced a major restructuring effort, which includes plans for additional staffing cuts and and the reorganization of some of the department’s agencies, including SAMHSA, under a new entity called Administration for a Healthy America.

Asked how these changes to SAMHSA’s place within the federal government may impact its oversight of 988, SAMHSA told ABC News via email that, “The 988 Suicide & Crisis Lifeline will continue daily, life-saving work, helping thousands of people every day and millions of people every year.”

In addition to the federal funding of 988, states offer varying levels of funding to support the Lifeline’s operation. Many states have chosen to either adopt fees or recurring state appropriations in order to maintain efficient service and availability of counselors.

Currently, twelve states charge a small tax on phone bills every month to fund 988 operations. This funding structure is modeled after the one used to fund 911 call centers. Those twelve states include Washington, Oregon, California, Nevada, New Mexico, Colorado, Minnesota, Illinois, Virginia, Maryland, Delaware and Vermont.

The permanent funding fees range from no cost in New York to $0.60 in Delaware.

An additional five states — Arizona, Utah, Kansas, Georgia, Florida — have implemented recurring state appropriations, meaning those states’ legislatures offer funding through their annual budget.

“We’ve seen an increased commitment by states to create sustainable funding mechanisms for the service and a growth in local response to people in crisis,” Palmieri said via email.

While states have been increasing resources to support 988, the Lifeline’s offerings nationwide are about to change.

Currently, callers to the Lifeline are prompted to press numbered options for certain specialized services — 1 for the Veterans’ Crisis Line, 2 for the Spanish-language subnetwork and 3 for LGBTQ-youth centered care.

‘Press 3’ option for LGBTQ youth

SAMHSA recently announced that the Press 3 option, which provides specialized care for LGBTQ youth, will no longer be a part of the Lifeline. That repeal was announced during LGBTQ Pride Month, just under three years after the subnetwork was first established as a pilot program in 2022.

The cut came as a surprise to those working on the specialized line, including The Trevor Project, which has been operating this type of service for ten years, according to Interim Vice President of Advocacy and Government Affairs Mark Henson.

Henson told ABC News that the federal funding for the service allowed The Trevor Project and other organizations to “double our capacity to serve youth.”

Since the launch of Press 3, Henson says the option has fielded over 1.3 million calls, chats and texts. Monthly calls have also increased from 1,752 at the option’s launch to 69,057 answered contacts in its last reported data from SAMHSA in May 2025.

In a letter to HHS Secretary Robert F. Kennedy, Jr., a bipartisan group of Congressional representatives responded to the cut announcement, noting that the subnetwork has averaged approximately 2,100 contacts per day.

“These numbers reflect the critical, ongoing demand for this targeted support,” the members said. “To a young person feeling alone and scared, 988 is truly a lifeline.”

In a statement announcing the discontinuation, SAMHSA said the move comes in response to significant operation costs and “to focus on serving all help seekers, including those previously served through the Press 3 option.”

“The Fiscal Year 2023 Omnibus included a Congressional directive for $29.7 million to fund the specialized services,” SAMHSA said. “Federal funding in FY24 for the Press 3 services increased to $33 million. As of June 2025, more than $33 million in funds have been spent to support the subnetworks, fully expending the monies allocated for 988 Lifeline LGB+ subnetwork services.”

Despite the evident utility of the specialized option, “Press 3 option has run out of Congressionally directed funding,” an HHS spokesperson wrote in a statement to ABC News, adding, “continued funding of the Press 3 threatened to put the entire 988 Suicide & Crisis Lifeline in danger of massive reductions in services.”

The Trevor Project remains adamant that the change to the program will do more harm than good because it neglects the specific challenges that people in the LGBTQ community face.

“I think there’s a fundamental lack of understanding that suicide prevention is about risk and not about identity,” Henson told ABC News. “It’s because of the life experiences and the stigma and the bullying associated with LGBTQ+ young people that make them more than four times as likely to attempt suicide.”

“It’s their life experiences and the unique drivers that have increased their risk of suicidality and therefore, have tailored care,” he added.

For NAMI’s part, Wesolowski said the organization is, “continuing to advocate with Congress,” to reverse the decision to remove press 3, saying that, “members of Congress on both sides of the aisle express some concern around this.”

Despite the federal shifts, Wesolowski says she hopes the foundation of 988 is strong enough to withstand political changes, both now and in the future.

“The goal has always been that anyone who’s in a mental health crisis or emotional distress gets appropriate mental health care response,” she said. “And I think right now, the [political] uncertainty is creating a lot of concern. [But] I think there’s still strong bipartisan support and cross systems support.”

If you are experiencing suicidal, substance use or other mental health crises, or are worried about a friend or loved one, please call or text the 988 Suicide & Crisis Lifeline. You will reach a trained crisis counselor for free, 24 hours a day, seven days a week. You can also go to 988lifeline.org.