A Counselor’s Reflection on the 988 Crisis Response

The response to the mental health crisis in the U.S. is changing. For many counselors, the rollout of the 988 Suicide & Crisis Lifeline represents an overdue shift: When someone is in crisis, they should receive care not punishment. 

The 988 system was designed to reduce reliance on law enforcement and connect people to trained mental health professionals through call centers and mobile crisis teams. Maryland has passed legislation to reinforce this approach by building infrastructure meant to support a coordinated, health-centered response.

For the counseling profession, this reflects years of advocacy finally taking shape. We have long recognized the harm that occurs when mental health crises are treated as criminal issues rather than clinical concerns. My perspective is shaped by nearly three decades of experience in addiction treatment, behavioral health and counseling-related services. I’ve also worked alongside individuals and families navigating complex clinical and systemic barriers. 

Policy Intention and Reality Misalignment

Sometimes policy does not match what is experienced in practice. Across systems, gaps can exist between intention and reality. A system can be well-designed, well-funded and widely promoted yet fall short for the people it is meant to serve. Access does not always mean availability, availability does not always mean quality, and quality does not always mean cultural understanding.

Maryland’s Behavioral Health Administration reported that although crisis response and stabilization services were available statewide in fiscal year 2025, round-the-clock mobile crisis team coverage was available in only 19 of its 24 jurisdictions. Additionally, Maryland’s 988 system received over 157,000 contacts, a 27% increase from 2024. These figures illustrate a practical implementation challenge: A person may be able to reach 988, but access to the next level of local, in-person crisis response can still depend on where that person lives.

This does not mean the 988 system is not needed. The demand for crisis support is real, and the system has already connected millions of people to care. However, the existence of a system is only the beginning, and we need to ask whether people can benefit from it and trust its effectiveness.

Utilizing the Experience to Improve 988

Counselors sit at the intersection of policy and practice. We see what works, what does not and where people can fall through the gaps. That places us in a unique position not only to support individuals in crisis but also to advocate for systems that are accountable to the communities we serve. The development of the 988 system has increased awareness, expanded access points and created new opportunities for counselors to engage in systemic change.

A practical place to start is locally. Counselors can learn how 988 and mobile crisis response operate in their own communities, review available crisis-response data and identify where clients encounter recurring barriers. From there, they can bring one documented concern to a local behavioral health authority, professional counseling association, advisory board or public-comment opportunity and ask what is being done to address it. Advocacy does not always begin with sweeping reform; sometimes it begins by identifying one recurring gap and refusing to let it remain invisible.

Counselors are participants and witnesses to how these systems function in real time, and these positions carry responsibility. It requires us to move beyond awareness to advocacy, ensuring that what is designed at the policy level is actually experienced as care at the human level. Ultimately, the success of 988 will not be determined by how well it is written but by how well it is lived.

Note: Opinions expressed and statements made in this blog do not necessarily represent the policies or opinions of ACA and its editors.