Suicide Prevention: Capacity and Federal Assessment of the 988 Lifeline

What GAO Found The 988 Suicide & Crisis Lifeline (988 Lifeline) is a network of independent crisis contact centers that answer calls, texts, and chats from people in suicidal crisis or emotional distress. The U.S. Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) set up the 988 Lifeline to connect individuals with local crisis contact centers in states and minimize the time they wait, according to officials. As of March 2026, calls are generally routed to local crisis contact centers based on callers’ approximate location. In contrast, texts and chats are routed based on individuals’ area codes or zip codes. SAMHSA plans to begin routing texts based on approximate location by April 2027, in accordance with a Federal Communications Commission rule. SAMHSA primarily measures the 988 Lifeline’s capacity through contact volume, answer rates (i.e., the percentage of contacts that are responded to), and the average time to answer. About 19.1 million calls, texts, and chats were routed to crisis contact centers from July 2022 through September 2025. During that time, call volume increased by about 87 percent, text volume by about 260 percent, and chat volume by about 23 percent (see figure). Call answer rates increased; text and chat answer rates fluctuated over time, as did average time to answer. 988 Lifeline Contact Volume By Method, July 2022 through September 2025 SAMHSA incorporated selected key performance management practices in assessing the 988 Lifeline’s routing and capacity. Specifically, SAMHSA set long- and near-term goals for the 988 Lifeline, collected information related to those goals, and used that information to assess progress and communicate information about performance. For example, to promote answer rate improvement, SAMHSA set a goal for local crisis contact centers, by September 2026, to answer more than 90 percent of the texts and chats they receive. SAMHSA also reviewed performance data and published them on its website. Why GAO Did This Study Suicide is one of the leading causes of death in the United States, resulting in over 49,000 deaths in 2023 (the latest data available from the Centers for Disease Control and Prevention as of June 2026)—or about one death every 11 minutes. Overall, suicide rates increased about 31 percent from 2003 through 2023. SAMHSA provides federal funding for and oversees the 988 Lifeline. Local crisis contact centers within states may also receive funding through state appropriations, state-enacted 988 telecommunications fees, or other sources. In consultation with SAMHSA, a nonprofit network administrator is responsible for administering the 988 Lifeline. Congress included a provision in the Consolidated Appropriations Act, 2023, for GAO to review the 988 Lifeline. This report, among other things, (1) describes how calls, texts, and chats are routed to the 988 Lifeline; (2) describes how SAMHSA measures capacity of the 988 Lifeline and what those measures showed; and (3) examines how SAMHSA assesses routing and capacity of the 988 Lifeline. GAO analyzed 988 Lifeline performance data reported by SAMHSA for the period beginning July 2022, the month the 988 Lifeline number went into effect, through September 2025. GAO also reviewed documentation from and interviewed officials from SAMHSA, the Federal Communications Commission, and a nongeneralizable sample of nine states and two territories. States and territories were selected to obtain variation in geographic location, percentage of the total population living in rural areas, and other factors. Additionally, GAO examined SAMHSA’s efforts related to assessing routing and capacity of the 988 Lifeline against selected key performance management practices. For more information, contact Alyssa M. Hundrup at HundrupA@gao.gov.

Suicide Prevention: Capacity and Federal Assessment of the 988 Lifeline

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