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988 Messaging Framework

Introduction

988 Fast Facts

  • 988 is confidential, free, and available 24/7/365, connecting those experiencing a mental health, substance use, or suicidal crisis with trained crisis counselors.
  • Access is available through every land line, cell phone, and voice-over internet device in the United States and call services are available in Spanish, along with interpretation services in over 150 languages.
  • The 988 dialing code is available for call, text, and chat starting on July 16, 2022. The previous 1-800-273-8255 number will continue to function even after the transition.
  • The nationwide transition to 988 is just an initial step in reimagining crisis support in the U.S. 

In July 2022, our country entered a new era of more equitable and accessible crisis services, marked by the adoption of 988 as the easy to remember three-digit dialing, texting, and chat code for anyone experiencing a suicidal or mental health related crisis. As the U.S-based universal dialing code connecting to the existing National Suicide Prevention Lifeline (Lifeline)—a network of local crisis centers throughout the country—988 increases the accessibility and use of life-saving interventions and resources. In addition, a recent public percepction survey of U.S. adults conducted in late July 2022 found that over half of respondents (57%) had heard of 988 and 81% report being likely to reach out to 988 if they or someone they know needed help. 

This is an exciting development for the nation broadly—and for the mental health, substance use, and suicide prevention fields in particular—and will understandably be the topic of considerable attention and public communications. Given the critical, lifesaving nature of 988, it is essential that these public communications are accurate, effective, and safe. 

To help you as messengers—including state agencies, crisis centers, non-profit organizations, businesses, foundations, and others—in your ongoing and future efforts to communicate about 988 more effectively, the National Action Alliance for Suicide Prevention (Action Alliance) and its partners developed the 988 Messaging Framework. This resource provides general guidance about when and how to develop messaging about 988. It does not take the place of tailored and tested audience-specific messages. To learn about how this 988 Messaging Framework was informed and developed, please read this background one-pager. To view the ‘Aligning the Field Around a 988 Messaging Framework’ webinar launch for the 988 Messaging Framework, click here

Key Considerations

We know that aligned and coordinate messaging has a better chance of achieving impact and creating change. As you begin to develop messaging about 988, please consider these core elements to help guide your efforts in crafting timely, effective, and safe messaging.  

Determining When to Start Widescale Promotion of 988

Promoting 988 Widely 

  • Before promoting 988 widely post-launch, work with local implementers in your state or territory to confirm the infrastructure is in place to answer the anticipated increase in calls/texts/chats.
  • For key messages, frequently asked questions, branding tools, and other messaging resources, visit the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 988 Partner Toolkit.
  • While 988 is now available nationwide via call, text, and chat, it’s important to remember that it may take some time for 988 to be operating optimally in your area. Key factors should be considered before widely promoting 988 in your state or territory, such as:
    • Is there sufficient local 988 crisis contact center capacity to meet the anticipated increase in demand?
    • Has your local state or territory established connections and linkages between 988 crisis contact centers and mobile crisis or other rescue units to escalate care, if needed? Are your local 988 crisis contact centers interacting and coordinating with local 911 call centers?
    • Is there sufficient behavioral health provider and service work capacity in your state or territory that can respond to crisis episodes should they escalate beyond crisis contact centers and mobile response teams?
  • Finally, 988 represents a once-in-a-lifetime opportunity to change how crisis services are delivered in the U.S. The July 2022 transition was just the beginning. It’s important to continue messaging with key policymakers to ensure additional investments in the 988 system and support infrastructure are in place for your state or territory. To learn more, visit the National Alliance on Mental Illness’ (NAMI) Reimagine Crisis Response or the Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System

 

Understanding How 988 Works

More About 988

Interested in learning more about 988 and how it works? Visit our partners at SAMHSA and Vibrant Emotional Health for the latest information! 

    • Before you develop public-facing messaging about 988, it is critical to understand how it works—both generally and more specifically in your state or territory. While dialing, texting, or chatting 988 will look the same across the country, rollout and implementation may vary from region to region—such as the availability of mobile crisis response teams and crisis stabilization services—so make sure your planning is built on a foundation of solid, accurate information. We encourage you to work with local crisis centers and state suicide prevention coordinators to better understand the 988 infrastructure in your state or territory. 
    • Make sure you are familiar with how calls, texts, and chats into 988 are handled so you can share an accurate picture with your audiences. To learn more about how calls are currently routed, check out this Lifeline infographic. Communicating details such as who operates the line, what qualifications or training the crisis counselors answering the line have, and what callers should expect when they call, text or chat, will help address potential barriers that may keep someone from using 988.
    • 988 is built with accessibility and inclusion in mind to ensure the service is available to all individuals, regardless of communications needs. As such, 988 is available via text and chat to anyone interested in using those services, as well as Spanish support via the press 2 option and interpretation service in over 150 languages. 
    • The transition to 988 does not impact the availability of crisis services for our nation’s Veterans and military Service Members. The same dedicated service Veterans know and trust in the VCL remains fully in place and ready. The Veterans Crisis Line (VCL) can be accessed by dialing 988 then pressing 1. Chat and text options can be accessed by visiting https://www.veteranscrisisline.net/get-help-now/chat/ or by texting 838255.

     

    Developing Strategic and Informed Messaging

    • Before widescale public messaging takes place, you should also develop an overeall strategy for communicating about 988, including determining key goals, audiences, and messaging channels. These key planning steps can  help you as you develop your strategy.
    • As you begin preparing to message more broadly about 988, it’s important that messages are research-based and data-informed to ensure accuracy and safety. This is especially important when messaging to certain audiences that are at higher risk of suicide or mental health conditions due to racism, homophobia/transphobia, historical traumas, and access to lethal means—such as youth, older adults, Black Americans, American Indians/Alaska Natives, and LGBTQ+ individuals, among others.
    • Finally, it’s important to speak with individuals from diverse backgrounds and perspectives (e.g., gender, age, race, ethnicity, and lived experience) that represent your key audiences to better understand their awareness, perceptions, and behaviors around mental health, suicide prevention, and crisis supports. 

       

    Knowing What 988 Is… And What It Isn’t

    • With the adoption of any new system it is essential that the field has an accurate and consistent understanding of 988 services and how it fits into the broader ecosystem of other crisis support services—such as 911, 211, warmlines, and other local crisis call centers. This looks different in each community, which is why it’s important you work alongside local implementers of 988 to better understand how these services work together at the local level. 
    • 988 services are distinct and separate from the emergency medical and public safety response associated with 911. 988 crisis counselors are trained to use the least invasive interventions, when possible, and oftentimes the call, text, or chat itself is the only intervention needed. However, ongoing coordination—at the federal, state, and local levels—between 988 and 911 will help individuals in crisis get the appropriate support they need, such as deploying mobile crisis teams or social workers in place of police or EMS responders, when needed and where available. 
      • Concerns about a potential law enforcement response may be a prominent consideration and potential barrier that prevents some communities (such as Black, Latino, or immigrant communities—among others) from utilizing 988. This is why understanding the needs of the audiences you are messaging to and whether your state or territory has mobile crisis teams (as opposed to police or EMS) available to respond if a crisis warrants follow-up care, will be key. 
    • Finally, once again it is important to remember that the adoption of 988 is an important first step in reimagining crisis support in our country, but it is not the final step. Transition to 988 is an opportunity for states and territories to reimagine their crisis service provision, and to ensure adequate financing for key services, such as crisis call centers, mobile crisis response teams, and crisis stabilization services.

     

    Following Best Practices

    • Use Messaging Guidance: Visit the Action Alliance’s Framework for Successful Messaging for best practices for communicating about suicide and suicide prevention strategically, effectively, and safely. In addition, the National Federation for Families’ Reframing Language resource outlines how to talk about mental illness. 
    • Be Strategic: As mentioned previously, it’s important to ensure that there is a strategy behind your messaging about 988. This upfront thinking and planning will help your message(s) succeed by determining the goal of your message, who you plan to message to, and what delivery channel you will need to use (e.g., web content, blog, social media posts, etc.). This strategy piece should be considered before any messaging takes place.
    • Use Safe Messaging: Research tells us that messages that present simplistic explanations for suicide, glamorize or romanticize suicide, or portray suicide as a common or acceptable response to adversity may spur imitation of suicidal behavior among marginalized individuals. Increase safety by focusing your messages on the importance of help-seeking and the solutions and services that exist for those who may be struggling. Many safety issues occur when messages focus on the problem of suicide, rather than on what can be done about it.
      • Avoid reinforcing negative stereotypes, myths, or stigma. Rather than just talking about how mental health stigma is a problem, messaging should also focus on solutions to stigma. For example, share stories of effective interventions or help-seeking.
    • Follow a Positive Narrative by Reinforcing Solutions: Highlight that effective programs and services exist, prevention works, and help is available. Focus on messages that highlight those who have sought and received help and are now living full and active lives. 
      • Go beyond cursory mentions of positive themes. Avoid using a slogan like “suicide is often preventable” without including specific actions people can take, such as reaching out to 988 for help.
    • Use Data Strategically: Make sure if you use data in your messaging that you do so in a strategic, and prevention-focused manner. Do not assume all messages should include statistics—part of developing your messaging strategy is determining what content is most likely to lead to the intended action, given limited time and space to get your message across. Often, statistics aren’t the best information to help your audience to act without the appropriate context around them. 
      • Illustrate the problem of suicide in terms of effective solutions. Rather than emphasizing data about the extent and severity of suicide or mental health in the U.S., instead use data that speaks to effective solutions. For example, “Research shows that suicide hotlines save lives and can contribute to reducing the estimated $34.6 billion in annual medical and work loss costs of suicide in the U.S.”

       

    Tailoring 988 Messaging for Your Audience

    • Each audience you are messaging to has its own unique makeup, and with that, its own unique considerations you need to account for when developing your messages. Suicide prevention and mental health are not one-size-fits-all issues and our messaging about them shouldn’t be either. Consider who makes up your key audience(s) and what actions you want them to take as you develop messaging to make sure that your messages speak to their unique perspectives, experiences, and communications or language needs. 
    • Use resources such as the Center for Disease Control and Prevention’s (CDC) Health Equity Guiding Principles for Inclusive Communication to learn more about crafting communications that are respectful and equitable to all audiences.
    • When considering the experiences of certain audiences—such as tribal communities, Black or Latino communities, LGBTQ populations, youth, and Veterans—it is important to collaborate with organizations that have extensive expertise working with these groups. The organizations and agencies that comprise the 988 Messaging Task Force, among others, have invaluable perspectives, access to subject matter experts, and can be essential resources when planning any communications efforts that will engage these communities.

     

    Amplifying Your Message

    988 Media Toolkit

    Download our 988 Media Toolkit for reporters and journalists covering the rollout and implementation of 988.

    • Be sure to engage a broad range of local champions to help get the word out about 988 in your communities. Consider reaching out to local media, government, individuals with lived experience, and education organizations that have extensive reach and who are already recognized as authoritative sources of information in your communities. 
    • Engage storytellers with diverse perspectives (e.g., gender, age, race, ethnicity, etc.) and lived experiences who can speak to the value of support and promote help-seeking. Encourage those with lived experience to utilize the Lifeline’s Storytelling for Suicide Prevention Checklist, the American Foundation for Suicide Prevention’s Speaking Out About Suicide guidance, or NAMI’s Present Your Story resources. 
    • Social media is a powerful tool to amplify your message and understanding best practices for communicating through those channels is critical. Review the Lifeline’s Support on Social Media toolkit for more information.
    • Some messengers may be contacted by news media to field inquiries about the implementation of 988. Should you receive a media inquiry about 988 implementation at the national level that you don’t feel equipped to answer, you are encouraged to connect reporters directly with the Action Alliance (info@TheActionAlliance.org) so they can be routed to an appropriate contact.
    • Finally, as you engage with members of the news media regarding 988, please share with them our 988 Media Toolkit and encourage them to continue following the Recommendations for Reporting on Suicide and the American Psychiatric Association’s Words Matter: Reporting on Mental Health Conditions guidance.