A Small Price to Pay for Better Mental Health Crisis Care: Why States Should be Funding the New 988 Hotline Through Phone Fees

This comment argues that stable, long-term funding is needed at the state level in order to sustain and improve the 988 Hotline,specifically through a 988 fee, so that the United States can move to implementing steps two and three of SAMHSA’s framework. Part I discusses the issues with mental health emergency response in the United States—specifically, the dominant role that 911 and law enforcement play in the current system, why this is problematic, and its consequences. 

Part II details SAMHSA’s three-step “integrated crisis system” framework and the reasons why each state would benefit from adopting this three-step framework. Part III introduces the 988 Hotline; discusses how it was launched and how it operates; discusses the federal grants that have temporarily helped states fund the hotline; and examines how various states have funded their implementations of the hotline thus far.

Part IV then argues that the 988 Hotline is experiencing three interconnected problems that are threatening its capabilities: (1) a lack of long-term funding; (2) various operational issues; and (3) a lack of awareness and trust in the hotline and its resources. Finally, Part V proposes solutions to these issues, namely that all states who have not already done so should institute a 988 fee to fund the hotline; the proceeds of which can then be used to build the hotline’s infrastructure to improve its capabilities.

Katherine G. Menello *

* J.D. Candidate, 2025, University of Richmond School of Law; B.A., 2022, George Washington University. I want to thank all of the people who supported me while I was writing this comment, and throughout my law school career. First, to Professor Rachel Suddarth, thank you for all of your help with and feedback on this piece. Your teaching has made such a profound impact on my writing and given me a huge interest in health law, and I am forever grateful for your mentorship. Second, thank you to my friends and colleagues on University of Richmond Law Review, especially Online Editor Connor Johnson,
for your hard work in editing this piece. Third and finally, I want to thank my family and friends for your constant love and support. To Mom, Dad, and Eddie – thank you for being the best family anyone could ask for. And to Zach – thank you for being my rock and always lighting up my life.