New York University School of Global Public Health, 708 Broadway, New York, NY 10003, USA,
J Ment Health Policy Econ. 2023 Jun 1;26(2):85-95.
Per federal law, "988" became the new three-digit dialing code for the National Suicide & Crisis Lifeline on July 16, 2022 (previously reached by dialing "1-800-283-TALK").
This study aimed to produce state-level estimates of: (i) annual increases in 988 Lifeline call volume following 988 implementation, (ii) the cost of these increases, and (iii) the extent to which state and federal funding earmarked for increases in 988 Lifeline call volume are sufficient to meet call demand.
A 50 state pre-post policy implementation design was used. State-level Lifeline call volume data were obtained. For each state, we calculated the absolute difference in number of Lifeline calls in the four-month periods between August-November 2021 (pre-988 implementation) and August-November 2022 (post-988 implementation), and also expressed this difference as percent change and rate per 100,000 population. The difference call volume was multiplied by a published estimate of the cost of a single 988 Lifeline call (USD 82), and then by multiplied by three to produce annual, 12-month state-level cost increase estimates. These figures were then divided by each state's population size to generate cost estimates per state resident. State-level information on the amount of state (FY 2023) and federal SAMHSA (FY 2022) funding earmarked for 988 Lifeline centers in response to 988 implementation were obtained from legal databases and government websites and expressed as dollars per state resident. State-level differences between per state resident estimates of increased cost and funding were calculated to assess the extent to which state and federal funding earmarked for increases in 988 Lifeline call volume were sufficient to meet call demand.
988 Lifeline call volume increased in all states post-988 implementation (within-state mean percent change = +32.8%, SD = +20.5%). The total estimated cost needed annually to accommodate increases in 988 Lifeline call volume nationally was approximately USD 46 million. The within-state mean estimate of additional cost per state resident was +USD 0.16 (SD = +USD 0.11). The additional annual cost per state resident exceeded USD 0.40 in three states, was between USD 0.40- USD 0.30 in three states, and between USD 0.30 - USD 0.20 in seven states. Twenty-two states earmarked FY 2023 appropriations for 988 Lifeline centers in response to 988 (within-state mean per state resident = USD 1.51, SD = USD 1.52) and 49 states received SAMHSA 988 capacity building grants (within-state mean per state resident = USD 0.36, SD = USD 0.39). State funding increases exceeded the estimated cost increases in about half of states.
The Lifeline's transition to 988 increased 988 Lifeline call volume in all states, but the magnitude of the increase and associated cost was heterogenous across states. State funding earmarked for increases in 988 Lifeline center costs is sufficient in about half of states. Sustained federal funding, and/or increases in state funding, earmarked for 988 Lifeline centers is likely important to ensuring that 988 Lifeline centers have the capacity to meet call demand in the post-988 implementation environment.
根据联邦法律，“988”于 2022 年 7 月 16 日成为国家自杀和危机生命线的新的三位数拨号码（之前通过拨打“1-800-283-TALK”拨打）。
本研究旨在提供以下州级估计数：（i）988 实施后 988 生命线呼叫量的年增长率，（ii）这些增长的成本，以及（iii）指定用于增加 988 生命线呼叫量的州和联邦资金在多大程度上足以满足呼叫需求。
采用 50 个州的前后政策实施设计。获得州一级生命线呼叫量数据。对于每个州，我们计算了 2021 年 8 月至 11 月（988 实施前）和 2022 年 8 月至 11 月（988 实施后）四个月期间生命线呼叫量的绝对差异，并表示为百分比变化和每 100,000 人口的变化率。将差异呼叫量乘以公布的单个 988 生命线呼叫成本估计值（82 美元），然后乘以三，得出每年 12 个月的州级成本增加估计值。然后，将这些数字除以每个州的人口规模，以生成每个州居民的成本估计值。从法律数据库和政府网站获得了有关州（2023 财年）和联邦 SAMHSA（2022 财年）为应对 988 实施而指定用于 988 生命线中心的资金的州级信息，并以每个州居民的美元表示。计算了每个州的估计增加成本和资金之间的差异，以评估为满足呼叫需求而指定用于增加 988 生命线呼叫量的州和联邦资金在多大程度上充足。
988 生命线呼叫量在所有州都增加了（州内平均百分比变化=+32.8%，SD=+20.5%）。全国范围内，为适应 988 生命线呼叫量的增加而每年所需的估计费用约为 4600 万美元。每个州居民的额外成本估计值为+0.16 美元（SD=+0.11 美元）。每个州居民的年度额外成本超过 3 个州的 0.40 美元，在 3 个州之间在 0.40-0.30 美元之间，在 7 个州之间在 0.30-0.20 美元之间。22 个州在回应 988 时指定了 2023 财年的专款用于 988 生命线中心（州内人均=1.51 美元，SD=1.52 美元），49 个州获得了 SAMHSA 988 能力建设赠款（州内人均=0.36 美元，SD=0.39 美元）。州级资金增加在大约一半的州超过了估计的成本增加。
生命线过渡到 988 增加了所有州的 988 生命线呼叫量，但增加的幅度和相关成本在各州之间存在差异。为增加 988 生命线中心成本而指定的州级资金在大约一半的州是充足的。联邦持续资金，和/或为 988 生命线中心指定的增加州级资金，对于确保 988 生命线中心在 988 实施后的环境中具备满足呼叫需求的能力可能很重要。
