Why It Matters

More than 49,000 deaths resulted from suicide in 2023, part of a broader crisis that has seen suicide deaths increase by 31% over the past two decades. This year, an estimated 14.3 million adults and 2.6 million adolescents reported serious thoughts of suicide. The 988 Suicide & Crisis Lifeline was launched in July 2022 as the nation's primary suicide prevention infrastructure, a free, 24/7 service available via call, text, and chat. Since its launch, it has fielded approximately 19.1 million contacts.

Now, a Government Accountability Office (GAO) report examines whether this critical mental health support system is actually reaching people in crisis and whether the government is managing it effectively.

The Big Picture

An estimated 4.6 million adults reported making plans for or attempting suicide in 2024, alongside 1.1 million adolescents aged 12 to 17.

A provision in the 2023 Consolidated Appropriations Act mandated that the Government Accountability Office examine the 988 Lifeline's operations and performance. The investigation was directed at four key congressional committee leaders: Sen. Bill Cassidy, Chair of the Senate Committee on Health, Education, Labor and Pensions; Sen. Bernie Sanders, Ranking Member of that same committee; Rep. Brett Guthrie, Chairman of the House Committee on Energy and Commerce; and Representative Frank Pallone, Jr., Ranking Member of the House committee.

The mandate reflected concern that despite the infrastructure investment and the universal 988 number established by the National Suicide Hotline Designation Act of 2020, the nation lacked clear visibility into whether the system was actually working.

Scale and Reach

The 988 Lifeline comprises a network of more than 200 independent crisis contact centers across the U.S. and its territories. Vibrant Emotional Health serves as the nonprofit network administrator as of April 2026. The service is available 24/7, free and confidential, via call, text, and chat.

Call volume increased by approximately 87% from July 2022 to September 2025, rising from 245,905 to 460,264 calls monthly. Text volume surged by approximately 260%, climbing from 33,279 to 119,747 texts. Chat volume grew more modestly, increasing by approximately 23%, from 75,441 to 92,936 chats. Overall contact volume increased by approximately 90% over the three years.

Answer Rates and Response Times

The 988 Lifeline call answer rate increased from approximately 83% in July 2022 to approximately 90% in September 2025. Text answer rates ranged from approximately 82% to approximately 100% over the same period. Chat answer rates ranged from approximately 70% to approximately 99%.

Calls not answered within 2 minutes at local centers are rerouted to national backup centers. Texts and chats not answered within 5 minutes face the same rerouting.

Specialized Services and Language Access

The LGBTQ+ Youth and Young Adult Service was launched in Sept. 2022 and grew rapidly, reaching 69,571 contacts by June 2025, when it accounted for approximately 8% of all 988 Lifeline contacts. However, the service was discontinued on July 17, 2025, due to federal funding being fully expended. Congress restored funding via the Consolidated Appropriations Act, 2026, and as of March 2026, the Substance Abuse and Mental Health Services Administration (SAMHSA) was working through requirements to implement the restored funding.

Spanish Language Service for calls has been available since July 2022, with texts and chats added in June 2023. Spanish Language Service call volume increased approximately 19% from July 2022 to September 2025. Text volume increased approximately 152% from July 2023 to September 2025, and chat volume increased approximately 399% over the same period. In September 2025, the Spanish Language Service accounted for approximately 1% of all 988 Lifeline contacts.

The Videophone Service for deaf and hard-of-hearing individuals was launched in September 2023. Monthly volume ranged from 496 to 7,086 calls, with answer rates ranging from approximately 90% to approximately 99%, improving from approximately 95% to approximately 98% over the monitoring period. Average time to answer ranged from 12 to 22 seconds. Interpretation support is available in more than 240 languages as of March 2026.

Routing Technology and Geographic Challenges

As of March 2026, calls are routed based on callers' approximate location using georouting data. Texts are routed based on area code. Chats are routed based on the zip code entered in a pre-chat survey.

SAMHSA plans to begin routing texts based on approximate location by April 2027, per an FCC rule published in September 2025. Nationwide wireless providers, AT&T, T-Mobile, and Verizon, are now transmitting georouting data with calls to 988 as required by an FCC rule published in November 2024, with a January 13, 2025 compliance deadline. Non-nationwide wireless providers must comply by December 14, 2026.

The report documents significant operational challenges facing the network. Officials in 5 of 11 selected states cited staffing,x recruitment and retention challenges. Funding limitations were cited by officials in 4 of 11 selected states as preventing hiring to meet rising demand. Coordination challenges with the 988 Lifeline network administrator were cited by officials in 5 of 11 selected states, who reported slow responses to questions and concerns. Coordination challenges with SAMHSA were cited by officials in 2 of 11 selected states, citing reduced meetings due to SAMHSA workforce changes. Abusive contacts to the 988 Lifeline were cited as a challenge by officials in 2 of 11 selected states.

Funding and Federal Support

Officials from all but one of the 11 selected states noted the importance of federal funding for maintaining or expanding local 988 Lifeline access.

SAMHSA issued a cooperative agreement for fiscal year 2021 to manage, enhance, and strengthen the 988 Lifeline network, with a single nonprofit as the awardee, covering the period September 30, 2021 to September 29, 2026, for $635.7 million.

As of March, approximately half of the states had enacted appropriations or established dedicated funding mechanisms for their local 988 Lifeline services.

The Bottom Line

SAMHSA published the "Saving Lives in America: 988 Quality and Services Plan" in April 2024. The long-term goal for the 988 Lifeline is to save lives by serving anyone, at any time, from anywhere across the nation, and in a manner that promotes linkages to ongoing local supports.

The near-term goals are more specific. SAMHSA's near-term goal is for local 988 Lifeline crisis contact centers to answer more than 90% of texts and chats they receive by September 29, 2026. The goal to begin routing calls from nationwide wireless providers using georouting data by January 2025 was achieved. Another near-term goal is to begin routing texts using georouting data by April 16, 2027.

The GAO report concludes that SAMHSA incorporated selected key performance management practices for the 988 Lifeline. The report made no recommendations. SAMHSA reviews and publishes 988 Lifeline performance data on its website, and the network administrator publishes monthly state-level statistics.

HHS announced in March 2025 a planned restructuring to consolidate SAMHSA into a new "Administration for a Healthy America," but as of March 2026 the transition had not occurred.

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