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Most mental health crisis calls still answered by 911, not 988

SALT LAKE CITY — Even as the 988 Suicide & Crisis Lifeline gains visibility, most mental health crisis calls in the United States are still being directed to 911 dispatchers, according to the International Academies of Emergency Dispatch (IAED). In 2023, emergency communication centers handled at least 24 million such calls, compared with the 17 million contacts to 988 since its 2022 launch.

A recent IAED survey found 40% of dispatchers felt they lacked adequate tools for managing callers experiencing suicide risk or ideation. “The majority of people in a mental health crisis still call 911, and we need better tools and training to handle these calls and deliver better outcomes,” said Ty Wooten, IAED’s director of governmental affairs.

To address the gap, IAED released Protocol 41: Caller in Crisis in 2024. The tool guides dispatchers through structured questions to determine whether to send emergency responders or transfer a caller to 988. It also includes an Emotional Control Tool to help dispatchers coach callers through dangerous moments—such as moving away from a weapon or coming down from a rooftop—while responders are en route.

Three Great Lakes region agencies are among the early adopters. Illinois Valley Regional Dispatch (IVRD) in Peru, Illinois, has integrated Protocol 41 under state law, with Executive Director Brandon Miller noting it provides staff with confidence and structure. In Indiana, Hendricks County Communications Center credits the protocol with saving three lives so far. And in Minnesota, Allina Health EMS reports it gives dispatchers an “immediate ability to impact” outcomes for suicidal callers, according to training specialist Jonathan Flynn.

“By having this Protocol, you have given your telecommunicators a tool to alleviate somebody else’s trauma, to alleviate somebody else’s PTSD, to immediately intervene, and when they’re in their darkest place to literally give them hope, give them a way forward,” Flynn said.

Hundreds of ECCs nationwide have now adopted Protocol 41, with thousands of dispatchers trained to use it.

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