• Posted November 2, 2023

Those Most in Need of the 988 Lifeline Are Aware of It, Survey Shows

More than a year after its launch, public awareness of the national 988 Suicide & Crisis Lifeline remains moderate, a new survey found.

However, awareness is highest among people who need it most -- those in serious psychological distress.

Survey participants with serious distress were 45% more likely to have heard of 988 than those with no distress. Further, those in moderate psychological distress were 27% more likely to have heard of 988 than those with no distress.

“When we looked across these different psychological distress categories, as you would expect to see and hope to see, the percentage of people using the lifeline was way higher among those with serious psychological distress,” said lead researcher Jonathan Purtle. He is director of policy research at New York University's Global Center for Implementation Science.

The 988 line launched in July 2022, transitioning from the 10-digit 1-800 number of the National Suicide Prevention Lifeline into a simpler three-digit number with a broader focus on crisis counseling.

To assess awareness of the line, researchers surveyed more than 5,000 U.S. adults in June 2023.

“The key innovation of what we did here is we assessed people's psychological distress,” Purtle said. “We were able to compare folks by their levels of distress and awareness of the lifeline.”

Overall, about 42% of poll respondents had heard of the 988 lifeline, a finding comparable to that of a National Alliance on Mental Illness poll conducted around the same time, said Dr. Eric Rafla-Yuan, a staff psychiatrist with the San Diego County Psychiatric Hospital and a 988 technical advisor for California.

“It's in that same ballpark as what this study has found,” Rafla-Yuan said.

However, more than 47% of people in serious psychological distress and 45% of those in moderate distress had heard of the lifeline, the new poll results showed.

Those in serious distress also were significantly more likely to have called 988 on their own behalf -- about 6%, compared with 1% of those in moderate distress and 0.2% of those with little to no distress.

The findings were published online Oct. 31 in JAMA Network Open.

“This study shows that the new 988 system demonstrates a moderate degree of awareness and appears to serve individuals most in need,” said Dr. Georges Benjamin, executive director of the American Public Health Association.

“This is an early study with a small sample size, but it is an exciting finding because it shows the value of distress and crisis lifelines to enhance access to mental health information,” Benjamin added.

Rafla-Yuan agreed that “the awareness that was found here is actually pretty good, considering that 988 has been in existence for about 14 to 15 months. Here, there is a significant number of folks who are aware of it.”

However, Rafla-Yuan said that more needs to be done to increase people's familiarity with the lifeline and understanding of how it works.

Part of the reason behind the low overall levels of awareness regarding the 988 lifeline is that states have been appropriately slow-rolling their messaging, Purtle said.

“Some states have been deliberately slow and cautious in their public communication and awareness-raising about the lifeline because they want to make sure that they have the services and the systems and the workforce capacity in place to meet a really big increase in demand,” Purtle said.

“If awareness was 100%, that might be too high, actually. It's still early on, we're still rolling this thing out,” he explained.

Younger people had greater awareness of the lifeline, and were more likely to use it, according to the poll.

People aged 18 to 29 were 78% more likely to know of 988 and nine times more likely to use it on their own behalf, compared to middle-aged folks 45 to 59, the findings showed.

“There's just more awareness around mental health resources for younger folks,” Rafla-Yuan said. “And then for people who have more serious mental illness, they're more likely to have been engaged with mental health treatment or resources in the past. And so because of that, they are more likely to have seen 988 advertised as a resource at a clinic or online or in a handout.”

Numbers tracked by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) have shown a substantial increase in call volume for 988 compared to the previous 10-digit suicide lifeline.

Nearly 160,000 more crisis calls, chats and texts came in during May 2023 compared to May 2022, two months before 988's activation on July 16, SAMHSA figures show.

More information

The Substance Abuse and Mental Health Services Administration has more on the 988 Suicide & Crisis Lifeline.

SOURCES: Jonathan Purtle, DrPH, director, policy research, New York University's Global Center for Implementation Science, New York City; Eric Rafla-Yuan, staff psychiatrist, San Diego County Psychiatric Hospital; Georges Benjamin, MD, executive director, American Public Health Association; JAMA Network Open, Oct. 31, 2023, online