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Untreated mental health symptoms are a pervasive and persistent public health problem. Around 39 million individuals in the United States identified as having a mental illness in 2019. Of this number, fewer than one-half (45 percent) received treatment in the past year. Left untreated, individuals' symptom profiles can worsen to the point of becoming a mental health emergency. This paper describes the result of a mixed methods study on preparedness for the launch of the new three-digit mental health emergency hotline number (988), and it is accompanied by a research tool summarizing the literature on mental health emergency hotlines. Researchers conducted a national survey of behavioral health program directors, which was complemented by semistructured interviews with a subset of directors. Overall, the study indicates that many agencies at state and local levels do not feel prepared to meet an increased need, and policymakers and administrators will need to work quickly if they wish to be ready before the number goes live in July 2022.

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This research was funded by the Sozosei Foundation and carried out within the Access and Delivery Program in RAND Health Care.

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