The preliminary memo, dated April 10, previews the administration’s possible plans to slash discretionary federal health spending and rework health agencies as President Donald Trump and HHS Secretary Robert F. Kennedy Jr. consolidate many functions of the US Department of Health and Human Services into the Administration for a Healthy America, or AHA.
If the leaked budget draft is enacted, the 988 Suicide & Crisis Lifeline’s LGBTQ+ youth specialized services could be defunded beginning in October, according to the nonprofit The Trevor Project, a suicide prevention organization for LGBTQ+ youth that has been a subcontractor to the specialized service since 2022, serving as one of seven call centers within the subnetwork that provides specialized services for LGBTQ+ youth.
In October 2020, Trump signed a bipartisan bill making 988 the universal telephone number to reach the national suicide prevention hotline.
In July 2022, the 988 Suicide and Crisis Lifeline launched under the Biden administration, transitioning what was a 10-digit number to an easier-to-remember three-digit number. People seeking emotional and mental health support can dial 988 for help in the same way they might dial 911 for medical emergencies.
Soon after its launch, the 988 Lifeline included a subnetwork for LGBTQ+ individuals to connect with specialized services. Now, when people dial 988, they are given the option to press 3 to reach crisis counselors trained to work with LGBTQ+ youth.
There have been some discussions within the Trump administration around ending the 988 Lifeline’s LGBTQ+ subnetwork, according to a person in HHS who has worked closely with the 988 Lifeline team and who asked for anonymity because they were recently given a Reduction in Force notice but hope to keep their job.
“From what I gathered, and just talking to others, these decisions are made without input from anyone involved with the 988 team or project,” the source said, adding that if leadership on the 988 team was consulted, they probably would recommend against removing the LGBTQ+ subnetwork.
“Suicide rates are four times higher among LGBTQ youth than others,” the person said. “There is data to show that rates of suicide among the LGBTQ community are higher, which is why there is a dedicated number to press if you are from that community, because there is such a critical need.”
As of mid-March, more than 14.5 million people have called, texted or sent chats to the 988 Lifeline and been transferred to a crisis contact center since July 2022, according to data from the US Substance Abuse and Mental Health Services Administration. About 1.2 million of those were routed to the LGBTQ+ specialized service.
“Suicide prevention is about risk, not identity. Ending the 988 Suicide & Crisis Lifeline’s LGBTQ+ youth specialized services will not just strip away access from millions of LGBTQ+ kids and teens – it will put their lives at risk,” Jaymes Black, CEO of The Trevor Project, said in a news release.
“These programs were implemented to address a proven, unprecedented, and ongoing mental health crisis among our nation’s young people with strong bipartisan support in Congress and signed into law by President Trump himself,” he said. “We urge the Administration to maintain its long-standing commitment to ending suicide among high-risk populations, especially our nation’s young people.”
Miriam Delphin-Rittmon, who served as HHS’s assistant secretary for mental health and substance use in the Biden administration, said she worries about how the agency’s restructuring may affect 988 as a public health resource as well as other services and programs that fall under the Substance Abuse and Mental Health Services Administration.
“There’s been some discussion and questions about whether the LGBTQ+ line will remain, and so I am concerned about that part of 988,” she said. She’s also concerned about the 988 Veterans sub-lifeline, which is accessed by dialing 988 and pressing 1, and the Spanish subnetwork, which is accessed by dialing 988 and pressing 2.
Since 2022, the federal government has invested some $1.5 billion in the 988 project, including expanding access to services for Spanish speakers, LGBTQI+ youth and young adults, and people who are deaf or hard of hearing by creating sub-lifelines or subnetworks for those groups.
Delphin-Rittmon said she worries about how certain staffing and funding support for 988 could shift or be eliminated under the HHS restructuring.
The leaked memo notes that the budget would maintain the $10 million for specialized services for Spanish speakers seeking access to 988 services and eliminate the set-aside for specialized services for LGBTQ+ youth.
According to the document, the budget does not include funding for the LGB Center of Excellence, the African American Behavioral Health Center of Excellence, the Asian American, Native Hawaiian and Pacific Islander Behavioral Health Center of Excellence, the Hispanic/Latino Behavioral Health Center of Excellence and the LGBTQ Youth Family Support Program.
“I’m concerned about SAMHSA overall,” Delphin-Rittmon said. “Certainly, there have been a lot of questions.”