A strategic framework for effectively measuring the success of California’s 988 system
In 2022, the Steinberg Institute sponsored Assembly Bill 988, which launched the 988 Crisis Lifeline in California—a simple, nationwide number that individuals experiencing mental health or substance use crises can call, text, or chat to access immediate support. The bill also:
- Established a statewide framework for operating and integrating 988 crisis call centers into the broader crisis response system.
- Created a small surcharge on telephone lines to provide ongoing funding.
The goals of AB 988 go beyond a crisis line. It aims to create a system where there is someone to call, someone to come, and somewhere to go. That means:
- Provide rapid access to trained professionals
- Connect individuals in crisis with the right services at the right time
Measuring the success of AB 988
As California continues to invest in strengthening its crisis care continuum, it must assess whether the 988 system is achieving these goals. To date, measures of the 988 Crisis Lifeline focus on operational indicators such as call volume and answer rates. While these measures provide some understanding of performance, they provide a limited picture of whether the system is actually improving outcomes for people in crisis.
Measuring the success of AB 988 requires a broader view—one that evaluates not only how quickly calls are answered, but whether people are connected to appropriate services and experience meaningful improvements in their lives. Fiscal measures, like commercial insurance reimbursement rates,are also necessary to assess whether the 988 system is funded appropriately.
Developing a framework for evaluating AB 988 is particularly important given the major reforms underway to improve the behavioral health system. Initiatives such as California Advancing and Innovating Medi-Cal (CalAIM), the Behavioral Health Transformation (BHT), and Behavioral Health Community-Based Organized Networks of Equitable Care and Treatment (BH-CONNECT) are intended to strengthen coordination across care systems, expand community-based crisis response, and improve accountability for outcomes. Currently, 988-specific measures are not built into these reforms.
The 988 Crisis Lifeline serves as a critical entry point into the broader system of care. The above initiatives provide an opportunity to integrate 988-specific measures into the overall strategy for measuring performance in the behavioral health system. This larger perspective is essential to fully understand how well AB 988 is working.
New policy brief: A strategic blueprint for setting proper 988 outcome measures
Building on recommendations from the state’s 988-Crisis Policy Advisory Group (PAG), this policy brief provides a strategic blueprint for effectively measuring the success of 988. The measures outlined in this brief move beyond operational call center metrics and measures people-focused outcomes, efficiencies in connecting individuals to care, and more.
