States Doing Limited 988 Public Awareness Promotion for Now

“It's very, very frustrating," Matthew Shapiro, public affairs associate director for the New York chapter of the National Alliance on Mental Illness, told us: "This is lifesaving information we are talking about.”

Since 988 won't be available to everyone across the country until July 16, SAMHSA recommends not promoting the use of 988 to the public at least until July 2023, an agency spokesperson emailed.

The onus of promoting 988 is largely on states now, with a national, coordinated, public awareness campaign not happening at least until 2023 (see 2204070031). "We have been asking the states to step up for a long time now," emailed a Department of Health and Human Services spokesperson. "In fact, the Secretary routinely reaches out to states and stakeholders to highlight how critical their support is. The launch of 988 will require state investment to make it the successful lifesaving mental health crisis line that it can -- and should -- be."

Vibrant and SAMHSA don't want a big media campaign because of concerns about states whose crisis call centers are less prepared for an expected jump in traffic due to 988 calls and texts, Shapiro said. That stems from Congress not giving direction to states or funding for implementation, with states "left on their own to try to figure this out," he said. NAMI's New York chapter is working with the state's Office of Mental Health on marketing plans, and will be ready in July 2023 with an aggressive campaign, he said. But even then some states won't be ready for 988, he said.

Multiple states said their focus between now and July 2023 is reaching out to specific populations and stakeholders in targeted promotion of 988.

Simultaneous with 988 promotion is beefing up crisis response call centers and ensuring adequate staffing and appropriate technology to support the heavier traffic volumes, and making sure there's an adequate crisis response system, said Ashley Fielding, assistant commissioner-agency affairs, Georgia Department of Behavioral Health and Developmental Disabilities. "We're talking about a decade of building," she said. She said 988 awareness efforts are now focusing on parties such as county and local governments and at-risk populations such as immigrants, veterans and the LGBTQ community. She said meetings with representatives of those groups are ongoing, so they're aware of 988's existence and also to get input on how to design services. Even without widespread promotion of 988 to the public, Georgia is projecting crisis call center volume will double by July 2023, she said.

In its 988 implementation plan submitted to SAMHSA earlier this year, Texas said it "has numerous stakeholders who will likely engage in 988 messaging across the public and private sector." It said possible goals include targeted messaging to reach marginalized groups and outreach to organizations serving them, such as rural, older adult and Spanish-speaking populations, service members and tribal communities. It said it anticipates creating communications materials with customized messaging starting in early 2023.

Michigan is rolling out its Michigan Crisis and Access Line a region at a time, with it to be statewide by October, per the state Department of Health and Human Services. That line will also handle 988 call traffic, and the state is developing a plan for its text and chat coverage, an agency spokesperson emailed. It said it's doing "a soft rollout" of 988 per Vibrant's instructions. It said its initial public awareness approach is targeting people most at risk for behavioral health crisis through community groups, advocacy organizations and allied professionals. It said the state plans to develop a public awareness/marketing plan that will look for the existing channels like websites and conferences that could be used to promote 988. That plan also will provide 988 marketing materials to stakeholders who then can get them to people who might benefit from 988, it said.