Suicide prevention funding in American state budgets has climbed sharply over the past six years, yet the amount any resident can expect their state to spend on crisis care still depends heavily on where they live, according to a new analysis published in JAMA Network Open.

The study, led by researchers at New York University alongside colleagues from RAND and Johns Hopkins University, examined every enacted state budget across the United States and the District of Columbia between fiscal years 2021 and 2026. It represents one of the most detailed efforts yet to track how much money states actually set aside for suicide prevention and crisis response, rather than mental health spending in general.

A Sharp Rise in Crisis Service Investment

Across 306 enacted budgets, researchers found that states allocated a combined total of just over 7.2 billion dollars explicitly for suicide prevention and crisis services. The average per person allocation more than tripled during the study period, moving from around one dollar per resident in 2021 to over six dollars per resident by 2025.

The percentage of total state budgets dedicated to this area also grew, albeit from a small base. The researchers attribute part of this rise to expanding federal investment in crisis infrastructure and to growing public and legislative concern about suicide and mental health emergencies. Earlier work cited in the study found a steady increase in state legislation and public commentary referencing suicide in recent years, suggesting the funding trend reflects a broader shift in policy attention rather than a one off spike.

Where the Money Goes, and Where It Does Not

Not every state moved at the same pace. Western states recorded the highest average crisis funding per resident, while Southern and Midwestern states consistently trailed behind. In more than one in five of the budget years studied, researchers found that a state had allocated nothing at all explicitly for suicide prevention or crisis services, relying instead on broader mental health appropriations that made no specific mention of the issue.

Notably, the study found no meaningful link between a state’s suicide death rate and how much it spent on prevention and crisis infrastructure. States facing the highest suicide rates were not consistently spending more than those with lower rates, a pattern the authors describe as a missed opportunity to align funding with actual need.

The 988 Telecom Fee Effect

One of the clearest findings concerns the 988 Suicide and Crisis Lifeline, the three digit hotline launched nationally in 2022. States that introduced a dedicated telecom fee, a small flat charge added to phone bills to fund 988 operations and related crisis services, spent more than twice as much per resident on suicide prevention as states without such a fee.

As of mid 2026, twelve states had enacted this type of legislation. The researchers argue that a dedicated funding stream, rather than reliance on general budget appropriations that can shift year to year, offers a more stable foundation for crisis infrastructure. Prior research cited in the study has repeatedly flagged inconsistent funding as one of the biggest obstacles facing 988 call centres and their staff.

Still Falling Short of Other Public Investments

Even at its highest point, state level spending on suicide prevention remains modest when set against other public health investments. The study notes that the strongest annual figure recorded, just over six dollars per resident in 2025, is a fraction of the roughly 177 dollars per veteran the Department of Veterans Affairs allocated for suicide prevention that same year, despite veterans facing a suicide rate more than double that of the general population.

The authors suggest this gap points to considerable room for states to expand and stabilise their commitment to prevention and crisis infrastructure, particularly as demand for these services continues to grow nationwide.

A Foundation for Future Policy

The researchers note several limitations, including that their figures cover only state level budget line items and do not capture city, county or Medicaid funding for crisis services, meaning the true scale of investment is likely underestimated. Even so, the dataset offers a rare state by state benchmark that policymakers and advocates can use to evaluate whether funding commitments are keeping pace with need.

As more states weigh whether to introduce dedicated funding mechanisms of their own, the findings offer a timely reminder that consistent, needs based investment in prevention infrastructure remains uneven across much of the country, even as the conversation around mental health crises continues to grow louder.

Source: jamanetwork