988 telecom fees tied to higher crisis funding

State allocations rose over 6 fiscal years but did not vary significantly by suicide death rate.

To analyze the impact of 988 telecom fees on state funding for suicide prevention and crisis services from fiscal years 2021 to 2026.

Study Design: Conducted a repeated cross-sectional state-year panel study of 306 enacted budgets from all 50 states and the District of Columbia.
Funding Review: Systematically reviewed budgets for funding explicitly dedicated to suicide prevention or mental health crisis programs.
Outcome Measures: Primary outcome was annual per-capita state funding; secondary outcome was the percentage of each state's total annual budget for these services.

Cumulative $7.25 billion allocated for suicide prevention and crisis services across 306 budgets.
Mean annual funding increased from $1.05 in 2021 to $6.55 in 2025, then $4.51 in 2026.
States with enacted 988 telecom fees allocated a mean of $7.73 per capita, more than twice that of states without such fees ($3.13).
12 states enacted 988 telecom-fee legislation by July 2026.

Only captured funding explicitly allocated in state budgets, excluding city, county, and general mental health funding.
Differences in state budget categories limited comparisons.
Analyzed budgeted amounts rather than actual expenditures.
Could not assess the impact of funding on suicide mortality due to timing of data.