988 hotline can't help rural Americans as much without more state funding; only 13 states have allocated money to it

The new 988 hotline is meant to help all Americans better access mental-health support, but access is still far from universal, especially since only 13 states have appropriated money for it.

"In particular, rural Americans, who die by suicide at a far higher rate than residents of urban areas, often have trouble accessing mental-health services. While 988 can connect them to a call center close to home, they could end up being directed to faraway resources," Christina Saint Louis reports for Kaiser Health News and The Daily Yonder. "The new system is supposed to give people an alternative to 911, yet callers from rural areas who are experiencing a mental health crisis may still be met by law enforcement personnel, rather than mental-health specialists."

More than 150 million Americans, most of them rural, don't have enough mental-health professionals in their communities. And though the Biden administration allocated $105 million to help states beef up crisis call-center staffing, "states are responsible for filling any gaps in the continuum of care that callers rely on if they need more than a phone conversation," Saint Louis reports. "States also shoulder most of the responsibility for staffing and funding their 988 call centers once the federal funding runs dry."

That continuum of care is critical to effective mental-health treatment. States with successful 988 programs will "will ensure callers have a mental health professional to talk to, a mobile crisis team to respond to them, and a place to go — such as a short-term residential crisis stabilization facility — that offers diagnosis and treatment," Saint Louis reports. That's according to the federal Substance Abuse and Mental Health Services Administration, which runs the original National Suicide Prevention Lifeline that 988 expands upon. Without a nearby crisis team and/or treatment program, callers may not have their needs met.