By Cindy Rivera
In the summer of 2023, my daughter experienced a behavioral health crisis. Like many parents in that situation, I wasn’t sure what to do. Even though I worked in mental health and systems development, I found myself in unfamiliar territory when it came to my own child.
988 had just launched as the new national mental health crisis line, but I didn’t fully understand its purpose or scope. So, we did what many families still do … we went to the emergency room. That decision led to a five-day inpatient stay that didn’t provide the support my daughter truly needed. It was a horrible experience, and when it was over, we were left with the sense that not much had changed.
The following summer, in 2024, my daughter experienced another crisis. This time, we decided to call 988.
The experience was very different. We were quickly connected to someone who listened, asked the right questions, and dispatched a mobile response team to our home. The team included a licensed clinician and a peer support specialist. The peer’s presence made a real difference. They helped my daughter feel understood and gave her a new perspective on the value of accepting help. From that point forward, we were connected to a case manager and local community supports. This level of follow-up made a big difference in her recovery and helped set a more stable path forward.
From my personal experience, it’s clear the 988 system has grown. In 2023, it was still relatively unknown, and the infrastructure was not fully in place in many communities. By 2024, we saw a more coordinated response, with trained professionals, timely follow-up, and meaningful support. This shift didn’t happen by chance, it happened because systems are beginning to align with the 2025 National Guidelines for a Behavioral Health Coordinated System of Crisis Care and the 2022 National Guidelines for Child and Youth Behavioral Health Crisis Care.
These guidelines give states and local providers a roadmap for delivering consistent, effective, and youth-centered crisis care. When followed, they help prevent unnecessary hospital stays, reduce trauma, and connect families to services that actually make a difference.
Now, in my role providing technical assistance to states, organizations, and communities, with the Crisis System Response Training and Techincal Assistance Center I see how much progress is being made and how much more is needed. Many providers, schools, and community partners still don’t fully understand the role of 988 or the importance of aligning with these national guidelines.
If we want crisis systems to work better, especially for children and youth, we need to make sure everyone involved in their care understands how 988 works, what it offers, and how to build local systems that support it.
We also need to keep listening to families. Lived experience is a critical part of improving crisis response. Families often know what their children need, and when that insight is combined with best practices, the results are stronger and more sustainable.
The 988 system is not perfect, but it is evolving. With continued investment, community education, and a focus on doing what works, we can build crisis systems that respond effectively, reduce harm, and truly support youth and families in need.
