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Rural Health Information Hub

Crisis Call and Text Lines

Crisis lines, also called mental health helplines, are another essential component of a crisis response system. The 988 Suicide & Crisis Lifeline, formally known as the National Suicide Prevention Lifeline, is a 24/7 national crisis line that offers free support to individuals experiencing a mental health crisis. Individuals can call, text, or chat 988 to connect with trained crisis response professionals who are able to provide support and resources.

To provide immediate access to mental health support for those in need, rural programs can implement regional or statewide crisis call lines or promote existing helplines in local healthcare facilities. For more resources about talk and text lines, see our Rural Suicide Prevention Toolkit.

Examples of Rural Crisis Call and Text Lines

  • Native Crisis Line partners with Northwest Portland Area Indian Health Board and the Indian Health Service to be responsive to the unique mental health needs of American Indian and Alaska Native people. Individuals can text NATIVE to 741-741 to talk to a crisis counselor.
  • The Georgia Crisis and Access Line (GCAL) is an example of a state call center that effectively handles rural cases. Available 24/7, GCAL provides crisis intervention services via phone, dispatches mobile crisis teams, and connects individuals to urgent services. Georgia residents experiencing a mental health crisis have been encouraged to call GCAL directly to ensure immediate and localized support.
  • Be Well Indiana is a 24/7 crisis helpline for residents across the state. Residents are connected to a trained crisis counselor nearby.
  • Nebraska's Rural Response Hotline, NY FarmNet, and South Dakota's Farm and Rural Stress Hotline are free, confidential, and tailored statewide initiatives that aim to address mental health challenges among farmers and ranchers.

Implementation Considerations

The Substance Abuse and Mental Health Services Administration's (SAMHSA) national guidelines for crisis call centers can be challenging to implement in rural and under-resourced areas. Some rural areas may have few mental health providers available to answer crisis calls, leading to burnout. In addition, some rural residents may be reluctant to call centralized call lines like 988 due to beliefs that their concerns will not be understood by responders in urban areas. To enhance emergency call capabilities, rural mental health programs may consider partnering with other rural communities to develop regional or state-wide crisis call lines. This can ensure that callers receive immediate, localized support. Rural mental health programs may also consider implementing peer lines or warm lines where individuals with lived experience provide emotional support to those experiencing a mental health crisis.

Rural mental health programs should consider applying the implementation of 988 as a guide to ensure that local call centers are evidence-based and culturally appropriate. Call centers should be culturally relevant and meet the needs of all residents, including deaf and hard of hearing populations, LGBTQ+ youth, and other populations with unique considerations.

Program Clearinghouse Examples

Resources to Learn More

National Alliance on Mental Illness National Warmline Directory
A directory of peer-operated emotional support lines by state with phone numbers, hours of operation, and available communications modalities.
Organization(s): The National Alliance on Mental Illness
Date: 6/2023

Tribal Schools to get 24/7 Behavioral Health Crisis Line
Discusses the behavioral health crisis line implemented for students and staff at tribal schools nationwide by the Bureau of Indian Education.
Author(s): Silversmith, S.
Citation: Navaho-Hopi Observer
Date: 2/2024