The Numbers are Staggering

According to the "Volume Projections" in SAMHSA's December 2021, 988 Appropriations Report,

"The potential addressable population for 988 is an estimated 150 million people (about 53 percent of the U.S. population age12 and older), which reflects the following estimates of the prevalence of mental and/or substance use disorders and exposure to potentially traumatic events:

About 70 million individuals with mental health and/or substance use disorders, or about 25 percent of the U.S. population age 12 and older. This 25 percent of the U.S. population includes 17 percent with a mental disorder(s) only, 4 percent with a substance use disorder(s) only, and 4 percent with a co-occurring mental and substance use disorder(s).

About 80 million individuals with potential lifetime exposure to a potentially traumatic event(s) but no mental or substance use disorder, or about 29 percent of the U.S. population age 12 and older. Examples of potentially traumatic events include experiencing, witnessing, or being confronted with event(s) involving actual or threatened death or serious injury or threats to the physical integrity of self or others (e.g., violence).

The potential serviceable population for 988 is a subset of the potential addressable population that may be vulnerable to a mental health or suicide-related crisis at a given time and is estimated at 39 million (about 14 percent of the U.S. population age 12 and older).

The potential serviceable population excludes an estimated 7 million individuals who may not be able to access 988 because they may be overseas (e.g., active military duty personnel stationed abroad), lack telephone services (e.g., households lacking landlines and wireless phone service, unsheltered individuals lacking cell phones), or in institutions (e.g., nursing homes, correctional system).

The potential serviceable population also excludes an estimated 104 million people who may have a mental and/or substance use disorder(s) and/or may have exposure to a traumatic event, but may not be in crisis at a given time (defined as not experiencing suicidal ideation or serious psychological distress).

A subset of the serviceable population is currently served by the Lifeline, the national network of crisis centers, 911, and other potential sources of support and services; in contrast, a share of the potential serviceable population for 988 may not be supported by any services today.

The subset of the potential serviceable population served by existing crisis hotlines includes about 2 million currently served by Lifeline, about 4 million served by the broader local/regional crisis center network, and about 6 million served via 911.

The remaining subset of the serviceable population is assumed to potentially be receiving support from providers, community services, family/friends, or other support systems. They also may not be receiving support.

Being able to serve this many people will require significant investments in education and marketing to ensure that every American knows what 988 is and when and how to contact 988; initiatives to change the public’s attitudes about seeking help for mental health issues; and systems changes like standardized training for public safety professionals to ensure that contacts to 911 are diverted to 988 when appropriate.