(NEW YORK) -- Two years after the launch of the 988 Suicide & Crisis Lifeline, 10 million contacts have been answered, according to the Substance Abuse and Mental Health Services Administration.
"That's 10 million people who, often on the worst day of their life, had a resource to reach out to," Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, told ABC News.
Prior to the launch of the three-digit number, the services provided by 988 were available through the 10-digit National Suicide Prevention Lifeline, which had been active since 2005.
"In its first year, [the 10-digit Lifeline] served about 45,000 people, and to think that we serve that many people in less than a week now is sort of mind-boggling," Dr. Tia Dole, chief 988 Suicide & Crisis Lifeline officer for the lifeline's administrator, Vibrant Emotional Health, told ABC News.
In the months leading up to the launch of the new number in 2022, advocates were concerned that funding and staffing issues would hamper the lifeline's ability to serve what was expected to be a dramatic increase in call volume.
The latest available data from SAMHSA shows nationwide answer rates of 88% for calls, 83% of chats and 97% of texts for the month of May.
"The average call is 14 minutes. To me, that type of impact is so significant," Dole said. "[With 988,] you don't need insurance, you don't need to say who you are -- and the person on the other end of the line instantly has empathy for you."
Funding helps meet demands
Despite still imperfect answer rates, some advocates tell ABC News that robust levels of federal and state funding have helped increase capacity to largely meet demand.
"We're two years into a system that needed massive infrastructure investment, new ways of thinking, new ways of partnering with other systems," Wesolowski said. "We always knew that [building out crisis care] was going to take many years, and if we waited for it to be perfect, we never would have gotten it off the ground."
The Biden administration funneled $1.5 billion into standing up the 988 Lifeline network, much of that ahead of the launch in 2022, to help address capacity concerns.
"It's been just such a priority for the administration to really invest heavily in the [988] Suicide & Crisis Lifeline," SAMHSA Administrator Dr. Miriam Delphin-Rittmon told ABC News. "There's been $1.5 billion that has been invested into 988, as part of this comprehensive strategy to address the nation's overall behavioral health."
Building a sustainable funding future
In the midst of a contentious political cycle, Wesolowski said she's "hopeful" that the outcome of the presidential election won't substantially impact federal investment in the service -- noting that former President Donald Trump was the one who signed the bill that designated 988 as the lifeline in 2020.
"We have seen even in the change of control of the House, [a] split Congress, that there's still a pretty strong interest in funding this resource. We saw a modest increase [in funding] this past fiscal year, about $18 million more to 988, but in an environment where a lot of programs are being cut, that's pretty good," she said. "There's strong bipartisan support."
Delphin-Rittmon said that many states have been working with the federal government on building out the crisis care system, making state-level investments to help fund 988 and related services.
So far, nine states have enacted a 988 lifeline cell phone tax, similar to the tax in place to fund 911 call centers, according to the National Alliance on Mental Illness, or NAMI, and several others have allocated appropriations to fund the service.
In Washington, one of the states with a 988 tax, Levi Van Dyke is the chief behavioral health officer for Volunteers of America Western Washington, which fields 988 calls, chats and texts across the state.
"Sustainable funding for 988 in Washington state is, maybe, different from other states. We are seemingly in a really good place with having that 988 fee and support," Van Dyke told ABC News. "In talking with colleagues at centers around the country, I always feel very fortunate because we are in a good position as far as those resources."
Subnetworks providing specialized services
Amid the buildout of the 988 system, the lifeline has also bolstered specialized services for veterans, Spanish speakers, LGBTQ youth, and people who are deaf and hard of hearing.
Dole said there aren't currently plans to add another national subnetwork, saying that extending the interactive voice response at the beginning of a 988 call poses a challenge.
"The challenging part is extending the IVR [Interactive Voice Response] -- press one, press two, press three, press four," she said. "When you add additional wording to the message, you delay access to care. And what that does is increase the chance of abandonment, which is people clicking out."
Back in Washington, the Native and Strong Lifeline enables callers to speak with Indigenous counselors who can offer culturally specific care to Indigenous people. The state-specific line was created in response to disproportionate rates of suicide among Native American communities.
Delphin-Rittmon told ABC News that SAMHSA has received interest from other states about creating a similar line and that those conversations are ongoing.
Van Dyke said the process to create the line in Washington was years long, requiring specialized staff and training, but that he would love to see it offered in other states.
"We've seen how impactful and how important it is to have this dedicated service, and we would love to see that service grow and expand outside of Washington state," Van Dyke said.
Building awareness -- and when to call
Dole said that while the service is called the 988 Suicide & Crisis Lifeline, "I actually think of 988 as preventative," noting that you don't have to be in active crisis to call.
"If you're in a mental health emergency, absolutely call us," Dole said. "But if you are really struggling, if you call us -- the earlier you call us, the more likely that you can be connected to services that will prevent something that is an emergency."
She said that 988 staff can connect callers to resources to help them deal with nonemergency mental health issues, and that they hope to help prevent crises, as well as respond to them.
"988 is certainly for people in crisis, and it is certainly for people before they get into crisis, and their loved ones and their family," she said.
Delphin-Rittmon echoed the sentiment, telling ABC News, "If people are struggling, it's important for them to know that they're not alone, that we are here to help. There's compassionate, trained counselors available, 24 hours a day, seven days a week, to help them with any type of mental health, substance use or suicide-related crisis."
Looking ahead, the advocates say they want 988 to be widely known as the number to call for people struggling with mental health issues.
"I want 988 to be as ubiquitous in our culture as 911," Wesolowski said. "I want every young person to not even hesitate, to not even think -- if they are struggling, if their friend is struggling, if their parent or sibling is struggling -- to feel like 988 is a natural place for them to reach out to and to know what they're going to get when they reach out."
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.