New data shows the program has been heavily utilized over the past year, though the root causes of mental illness in the US still prove problematic to mental health experts.
"It's the million dollar question, and I think there's been a million words put towards it. I don't think anyone truly understands," said Dr. Patrick Sullivan, director of UNC's Suicide Prevention Institute.
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Sullivan said the overwhelming demand for services like 988, while obviously problematic, shows the service is serving its purpose for many people who need it. Sullivan said it can expand with even more support.
"It's encouraging to see over 60% of Americans have actually heard of it, over half support it and even more than that want Congress to make this be -- mental health funding be a major interest of Congress in the coming year," Sullivan said.
In its first full year, the lifeline had nearly 5 million total contacts and roughly 665,000 text message contacts. One million of the total contacts came from veterans, and specialized services for other at-risk groups like the LGBTQ+ community have also come online recently.
"When it comes to a mental health crisis for one of these people, they may not be able to turn to a parent. They may not be able to turn to a sibling or family member. We have to be there," said Cayden Blaylock, a board member with Fayetteville Pride.
Cayden and his wife Catrina both say they know what it feels like to try to find mental health support in communities where they didn't feel accepted.
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"It was really hard to be able to find help, especially in a small town, even if you were able to get an appointment, it was an 'I don't know if they either agree or accept us'," Catrina said.
She says a rapid-response service like 988 has never been more necessary.
"With all the anti-LGBTQ laws coming out, having someone to reach out to and know, 'we're here to listen, we're here to help you regardless' is very important," Blaylock said.
A Spanish language text and chat service has recently come online as well.
If you are experiencing suicidal, substance use, or other mental health crises please call or text the new three-digit code at 988. You will reach a trained crisis counselor for free, 24 hours a day, seven days a week. You can also go to 988lifeline.org or dial the current toll free number 800-273-8255 (TALK).