Among those at Higher Risk for Suicide, Study Finds Key Factors that Drive 988 Lifeline Usage: Someone to Talk to 24/7 and Free Access

The Ad Council Research Institute, in partnership with the National Action Alliance for Suicide Prevention (Action Alliance) and the Suicide Prevention Resource Center (SPRC), and supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), have released crucial findings about the public’s awareness, perspectives, and current and potential usage of the 988 Suicide & Crisis Lifeline. As part of the collaborative 988 Formative Research Project, the partners are publishing insights and an actionable toolkit that can be used by individuals and organizations in their outreach and messaging efforts about mental health to make research-informed decisions about how to encourage use of and access to 988.

A number of participants ages 13-34 (14%) 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 nearly a quarter (23% each).

The mixed-methods formative research study focused on key populations at higher risk for or disproportionately impacted by suicide, found that:

  • Roughly half of the respondents were aware of 988, but most said they don’t know much about it.
  • 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’d use 988, whereas rural older men (ages 49+) were least likely to say they’d use it.
  • Those who would consider using 988 when struggling with their mental health found its 24/7 availability most helpful. Other top reasons included:
    • The ability to communicate with someone who’s trained to help.
    • It’s anonymous.
    • The ability to communicate with a real person.
    • It’s free.
  • Those who would not consider using 988 would not 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).
    • 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.
  • For receiving information on 988, the majority of study participants would most trust and turn to family and friends, followed by professional healthcare resources.

A toolkit for supporting culturally sensitive, responsive, and successful communications is also available at www.988messaging.org/research. This toolkit is designed to help organizations that reach the public―including nonprofits, state and local government entities and others—build awareness and trust in 988. The toolkit provides strategic insights that can be used by communicators to craft and test more effective and personalized messages and campaigns tailored for each of the study cohorts, which included:

  • American Indian and Alaska Native youth and young adults (ages 13-34)
  • Asian American, Native Hawaiian, and Pacific Islander youth and young adults (ages 13-34)
  • Black youth and young adults (ages 13-34)
  • Hispanic youth and young adults (ages 13-34)
  • Individuals who had attempted suicide or had serious thoughts of suicide during their lifetime (age 13+)
  • LGBTQIA+ individuals (ages 13-49)
  • People with disabilities (13+)
  • Rural older men (ages 49+)

“This research strengthens our ability to effectively message about 988, and is an important step in understanding how to better support populations that are more impacted by suicide,” said Colleen Carr, MPH, Director of the Action Alliance. “The Action Alliance and SPRC are eager to share these findings with partners across the country working to raise awareness of 988 among their communities. This research is a valuable foundation, though we know more work is needed to develop, test, and enhance 988 communications and campaigns, and better understand additional populations at high risk of suicide.”

“We are immensely grateful for the unwavering support and dedication of our partners in this vital research initiative. Through collaborative efforts like these, we can not only raise awareness about 988 but ensure that it truly serves as a lifeline for people most at risk and/or disproportionally impacted by suicide. Together, we can make strides to ensure everyone knows they have someone who is skilled, compassionate and will listen 24/7, without cost when they are struggling with their mental health,” said Derrick Feldmann, Lead Researcher and Managing Director of the Ad Council Research Institute. This study is an extension of the Ad Council’s large scale national Mental Health Initiative.

The research also uncovered important findings about trusted messengers from the study’s population groups. Additional formative research is currently underway among trusted messengers identified by this study’s cohorts. Those research findings are expected to be available in 2024.

Learn more about the 988 Formative Research at www.988messaging.org/research or download the report here.

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