988 Suicide & Crisis Lifeline Formative Research
Beginning July 2022, 988 has been the national 3-digit hotline for mental health resources and suicide prevention. Though 988 responded to 5 million contacts in its first year, we must increase awareness and use of this valuable resource.
Since July 2022, 988 has been the national 3-digit hotline for mental health resources and suicide prevention. Though 988 responded to 5 million contacts in its first year, we must increase awareness and use of this valuable resource to address the current and growing need: 15 people per 100,000 died by intentional self-harm in 2022, more than any other year on record in the United States.
Suicide is rarely caused by a single event or circumstance. Many individual, relationship, community, and societal conditions or factors contribute to suicide risk. Some groups experience more negative social conditions and factors related to suicide, such as racism and discrimination, economic hardship, poverty, limited affordable housing, lack of education opportunities, and barriers to physical and mental healthcare access. In addition, some groups may have higher or recently increased rates of suicide, suicide attempt or suicidal ideation than the general U.S. population. These groups may be considered higher risk or disproportionately impacted by suicide.
With the nationwide transition to 988, a need arose for 988-specific formative research among groups at higher risk for or disproportionately impacted by suicide to help support culturally sensitive, responsive, effective, and successful 988 communications: First, to make more people aware of 988 across the country, then to promote overall help seeking, and instill trust and confidence in the service.
In summer 2022, the 988 Formative Research Project began, a collaborative effort led by the National Action Alliance for Suicide Prevention (Action Alliance), the Suicide Prevention Resource Center (SPRC), and the Ad Council Research Institute (ACRI), and the Substance Abuse and Mental Health Services Administration (SAMHSA). The project fills a critical research gap and supports more informed 988 messaging and implementation efforts.
Key Findings
- On Their State of Mental Health:
- 14% of participants ages 13-34 said their mental health is somewhat or much worse compared to a year ago, though it was slightly higher among 13-34-year-old American Indian/Alaska Native participants (17%) and Asian American, Native Hawaiian, and Pacific Islanders (19%). For LGBTQIA+ participants and participants who have experienced suicidal ideation, this increased to 23% each.
- On 988 Awareness:
- Roughly half of participants were aware of 988, but most said they don’t know much about it.
- On 988 Usage:
- Young adults ages 13-34 (especially those who are Black) and LGBTQIA+ participants (ages 13-49) were more likely than other populations in the study to say they would use 988, whereas rural older men (ages 49+) were least likely to say they would use it.
- On Why They Would/Would Not Consider 988:
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Those who would consider using 988 when struggling with their mental health found its 24/7 availability most helpful, as well as factors like anonymity, no cost, and being able to communicate with a real person who’s trained to help.
Those who would not consider using 988 wouldn’t do so due to concerns of credibility and privacy (especially for rural older men ages 49+), opening up to a stranger (particularly among young adults ages 13-34), or someone being called as a result of their contacting 988—like their parents (among teens), law enforcement, or a hospital. This was especially noted among those who have experienced suicidal ideation. - On Trusted Messengers:
- Young adults ages 13-34 (especially those who are Black) and LGBTQIA+ participants (ages 13-49) were more likely than other populations in the study to say they would use 988, whereas rural older men (ages 49+) were least likely to say they would use it.