The 988 Lifeline’s Integration Into the Broader Crisis Care Continuum

Objective

To understand how 988 Lifeline centers are connected to the broader crisis care continuum—including 911, mobile crisis response, and community-based services.

Methods

The authors conducted a cross-sectional survey of 988 Lifeline centers in the U.S. between May and July 2025. A total of 159 centers (78%) completed the survey, which assessed transfer to/from 911, coordination with mobile crisis teams, capacity for referrals, and tracking dispositions and outcomes. Exploratory bivariate analyses were conducted to understand the factors associated with transfers to/from 911 and mobile crisis response team dispatch capability.

Results

Approximately 45% of centers reported bidirectional interoperability with 911. Among the 153 centers with a mobile crisis response team in their service region, 61% could dispatch the team directly. Exploratory bivariate analysis indicated that centers had higher odds of interoperating with 911 when mobile crisis services were present throughout their jurisdiction (OR = 2.10 [1.06, 4.20]) and could schedule appointments on callers’ behalf (OR = 2.88 [1.39, 6.23]).

Conclusions

Variation remains in centers’ ability to interoperate with 911 and dispatch mobile crisis teams. Centers with these capabilities were associated with having multiple referral, dispatch, and coordination capacities. Improving integration between 988 and other crisis services requires strengthened partnerships, sustainable funding, and investments in technology and data-sharing infrastructure.