The three numbers that could save your life

What our history with 911 can teach us about 988 and some actions to take

When did you learn the magic three numbers to call when there was an emergency? For me, 911 was the sticker on my rotary phone, refrigerator, and anywhere else my mom thought I might look in case there was some reason for me to call someone to help. From my earliest years, it was ingrained in me that all I needed to call 911 whenever there was a problem - and the right people would show up.

Of course, much of my source material for what this 911 experience would look like was largely pulled from what my parents and others told me, and of course, fiction. Comics, television, books, and movies, all created a vision for me of what happened when you actually called 911. I remember being at a sleepover when someone, likely based on a dare, called 911. We all were freaked out the rest of the night thinking the police were going to show up and arrest us for taking advantage of such an important service.

Reflecting on my childhood, I realize that even Public Enemy's call-out of 911 in their music was an early lesson for me. At the time, I didn't fully grasp the implications, but now I understand how these emergency systems have often failed many communities, particularly communities of color. And even now, still have problems, including outages and delayed wait times.

911 was something I grew up believing in—a number that was supposed to bring help whenever needed, a reliable presence in the background of my life that I thankfully never had to call upon. Yet, this perception was shaped by stories and assurances rather than personal experience.

The concept of 911 originated in 1957 when the National Association of Fire Chiefs recommended a single number for reporting fires. The fire chiefs were trying to find some mechanism, some way, to make it easier for people to know how to get access to them in case of a fire. This idea got a ton of traction in 1967 when the President's Commission on Law Enforcement and Administration of Justice advocated for a nationwide emergency number. While it’s pretty deep history now, this was a major push to get the public and private worlds to work together.

The Federal Communications Commission (FCC) collaborated with AT&T to select 911 as the number to call due to its simplicity and uniqueness. It launched, and the first 911 call was made in Haleyville, Alabama, on February 16, 1968. By the late 1970s, 911 was accessible to about 26 percent of the U.S. population, and its adoption continued to grow, with nearly 93 percent coverage by the end of the 20th century. Today, 911 is recognized internationally, with Canada even adopting it as their emergency number, solidifying its status as a critical component of modern emergency response infrastructure.

Without going into detail I have gone into here before, let’s just say that for most people, their 911 experience isn’t as consistent as one might hope even after 60+ years of it being in operation. In fact, in some brilliant work done by Code for America during their national day for civic hacking (yes, that’s a thing!), folks found several issues with the current 911 system, mainly focused on data. For example, 911 data is inconsistent across different jurisdictions, with cities and counties having various methods for classifying, sorting, and publishing their data. This means that without standardization, 911 datasets cannot be compared and analyzed because they are all different, a fact that likely frustrates most researchers. In addition, call types assigned by 911 operators are subjective and vary significantly, making it challenging to analyze and compare data accurately.

Now, remember that amazing new mental health and suicide prevention hotline that launched two years ago? That’s right, 988, a beacon of hope for those who needed a mental health intervention rather than a public safety intervention. As a brief reminder, the foundation of 988 is that you get someone to talk to, someone to respond, and a safe place that you can go, as needed. Yes, that same number, two years in is, unsurprisingly, having some of the same issues as 911. Are these just growing pains or are we at risk of creating a structure that is never able to fulfill its promise?

In a recent report put out by Inseparable entitled “A Better Response,” we learn a whole lot more about the differences between states on 988 implementation. Specifically, they point to five major policy areas and highlight how states, by adopting these policies, can better equip their communities with a more consistent and high quality 988 response. As you might expect, there are pretty significant gaps in what states have done, or not, to help advance their 988 work.

Inseparable’s report calls out these five policy areas to support 988.

The report is definitely worth your time, and will give you real ways to identify how your state can do more through policy to help support 988. Make no mistake, there is real work to be done. Data from 988 show massive disparities in answer rates, arguably the most important first step for a strong 988 system. At this moment, we can’t afford to have our systems let us down - for some this will cost them their life, for others, their belief that there are actually people there to help.

Just a snapshot at some of the recent 988 data and how widely things like answer times range between states.

We are two years into 988 implementation, but I can’t help worry that without dedicated attention to details, and addressing issues flagged in the Inseparable report, we may still have a patchwork quilt of well meaning but poorly executed 988 response systems. 911 has made major progress, but still has some issues, and remember, that’s a system that’s been around for decades! 988 is the new kid on the block, and has a big brother in 911 to look up to and learn from.

As we continue to navigate the complexities of emergency response systems, it's crucial to reflect on both the history and current state of 911 and 988. The 911 system, despite its long-standing presence, still faces significant challenges, particularly around data consistency and standardization. There are some things we can do.

First, we need to pay a ton of attention to the interoperability between 911 and 988. These systems need to be seamless in their integration to ensure that you get the most appropriate response for whatever is going on. We can’t have them exist in their silos and expect that all things will turn out for those in need.

Second, we must invest in our people. From 911/988 operators to the first responders, these jobs are often not paid a salary consistent with their importance. We should think about this a bit more as we develop our infrastructure.

Finally, we must stay steady and encourage our state leaders to take action to support these systems. Simply having 988 operational is not enough. We need high quality from beginning to end, and that’s just not possible without tackling some of the issues flagged in the Inseparable report like funding.

When we are in a crisis, whether it’s mental health or otherwise, we want to make sure there is a system there to help us. With the amount of money our country spends on health care, you would think that vital services like these get the resources they deserve - sadly, they do not.

As we look to the future of emergency response systems, it's clear that both 911 and 988 must evolve to meet modern challenges. Moreover, it is imperative that state leaders champion robust policies and adequate funding to address the disparities and inconsistencies identified in reports like Inseparable's "A Better Response." Our collective efforts can transform these emergency services into reliable lifelines for all, reaffirming the public’s faith in the system and, most importantly, saving lives when it matters most. At the end of the day, that’s what this is all about, isn’t it?