If you or someone you know is struggling, call or text 988. The 988 Suicide and Crisis Lifeline is free, confidential and available 24 hours a day, seven days a week.
Merrilee Logue, Executive Director of the Blue Cross Blue Shield Association National Labor Office and Catherine Raley, consultant with the National Labor Office, joined the America's Work Force Union Podcast during Suicide Prevention Month to discuss the 988 Suicide and Crisis Lifeline, the 988 Coin Campaign and what Blue Cross Blue Shield is doing to expand behavioral health access for union members and youth.
Logue, who serves on the North American Building Trades Unions (NABTU) Opioid and Suicide Task Force, has personal connections to suicide loss. She described how the construction trades' use of poker chips bearing the 988 number became the model for a coin-based awareness campaign that has grown from 50,000 to 150,000 units distributed across the construction industry. It is also being piloted nationwide in public schools. Raley discussed the history of the 988 Lifeline, which launched nationwide in 2022 as a three-digit replacement for the original 1-800 crisis number, and how the NLO is partnering with Blue Cross Blue Shield plans to expand the coin campaign into middle and high schools.
Logue also addressed the growth of BCBS behavioral health provider networks, the mental health parity laws that require insurers to cover mental health the same as physical health and why she said the country must address this crisis.
Merrilee Logue has spent 30 years working with unions through the Blue Cross Blue Shield National Labor Office. She has also lost people close to her to suicide. When she took over the NLO, addressing mental health and suicide prevention was part of the mission she brought with her from the start. She serves on the North American Building Trades Opioid and Suicide Task Force, which has been one of the most active organized efforts to address suicide in the construction industry. Catherine Raley joined the NLO nearly four years ago and has led the development of the NLO’s 988 awareness program since its inception.
The 988 Suicide and Crisis Lifeline was launched nationwide in 2022. It is a federally funded, free and confidential resource connecting anyone in the United States experiencing mental health challenges, emotional distress, substance use concerns or thoughts of suicide with trained crisis counselors. It is available by phone call, text or chat, 24 hours a day, in all 50 states and U.S. territories. In its first four years, the 988 Lifeline has handled 26 million contacts.
The 988 number was shortened from the original 1-800 crisis line. The concept of a dedicated suicide crisis line was not new, but the three-digit format made it as accessible as 911 and far easier to remember and share. Raley described 988 as the mental health equivalent of 911, designed to reduce the barrier between a person in crisis and the help that is available to them.
The construction trades pioneered a simple and powerful idea: a poker chip bearing the 988 number, with each trade using a different color. Any union construction worker could carry the chip and hand it to a colleague they were worried about. The act of handing someone the chip carried a clear message: I see you, I'm concerned and here is the number to call. The physical object made it easier to start the conversation.
The NLO observed that campaign and decided to build on it. The first adaptation was practical, since poker chips are not appropriate for youth mental health campaigns. Instead of poker chips, the NLO worked with BCBS clinical staff to develop a coin. The clinical team specifically validated the coin format, noting that the physical act of holding and handling the coin carries a therapeutic dimension that reinforces the message on its surface. The coin reads "someone cares about you" and carries the 988 number, with a prompt to call or text.
The campaign began in the construction industry and has grown from an initial distribution of 50,000 coins to 150,000 now in circulation. Police officers and firefighters have also expressed interest in the program, and it has spread beyond the original construction audience. Logue noted that the NLO does not consider the idea proprietary. In the same way they adapted the trades' poker chip concept, they actively welcome others to do the same with the coin.
The next phase is public schools. The NLO is piloting its 988 Coin Campaign in middle and high schools nationwide through BCBS plans, designed to put the resource directly in the hands of young people and the adults who care about them. Logue said the goal is for the coin to be in every public school in the country.
Logue was explicit about one point: no one needs a coin, a chip or any program to access the 988 Lifeline. The number works for anyone, anywhere, at any age, in multiple languages, around the clock. The coin is a tool for community awareness and for making it easier to start a conversation. The lifeline itself is already there.
Logue addressed a striking finding: more than 70 percent of employers believe offering mental health benefits is too costly. She said that perception conflicts with both the law and the data. Mental health parity laws in the U.S. require insurers to cover mental health treatment the same as physical health treatment. According to the Substance Abuse and Mental Health Services Administration, 1 in 4 American adults experiences a mental health challenge, which means the workforce is deeply affected, regardless of what employers choose to acknowledge.
Between 2020 and 2023, Blue Cross Blue Shield companies increased the number of in-network behavioral health providers by 55 percent, bringing the total to more than 450,000 across all 50 states. BCBS has the industry's largest behavioral health network: 11 percent more providers in metro areas than the average of the top three competitors and 16 percent more in non-metro areas. She noted that Project Labor Agreements are increasingly including behavioral health clauses and that union health and welfare funds are adding in-house mental health resources for members.
She said the country must address this issue. The cost of inaction — in lives, in productivity and in long-term health outcomes — is far greater than the cost of coverage.
Logue closed with a note on language. The shift from saying committed suicide to died by suicide is not cosmetic. It reflects a change in how mental health and suicide are understood. Suicide is a health crisis, not a moral failing. Eliminating the stigma attached to mental health conditions is, she said, a crucial step, and it begins with how people talk about it.
She encouraged every listener, whether a leader or a member, to make the outreach that matters. Whether the person struggling is someone nearby or the listener themselves, it only takes one call to 988.
If you or someone you know is struggling with thoughts of suicide or a mental health crisis, call or text 988. The 988 Suicide and Crisis Lifeline is free, confidential and available 24 hours a day, seven days a week, across all 50 states and US territories.
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