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Public Health Communication Still Needed for 988 Mental Health Line

Public health communication, plus a better look at how the 988 mental health line misses patient needs, will be key to increasing access.

The 988 helpline’s effectiveness is seriously stymied by limited public awareness of the service, prompting researchers to call for better public health communication and messaging about the number.

In a pair of studies recently published in JAMA Network Open, researchers from New York University found that public health leadership still needs to work to get the word out about the 988 mental health helpline.

Launched in July 2022, 988 was launched as something akin to 911 for mental health emergencies. The number was put in place as a new access point for the National Suicide and Crisis Lifeline and could service callers by telephone call, text, or chat.

Although the experts behind the 988 rebrand intended the short, three-digit number to be easy to remember and therefore easily accessible, data has shown there’s limited public awareness about it. A May 2023 report from Pew showed that only 13 percent of US adults have heard of the 988 Suicide and Crisis Lifeline and know its purpose.

This latest data from NYU adds some caveats to those findings, particularly that those with the highest levels of mental distress—and potentially most in need of accessing the 988 helpline—are the most likely to have heard of it.

Just under half (47.4 percent) of folks with serious psychological distress have heard of the 988 hotline, the survey of 5,058 US adults revealed, while 45 percent with moderate psychological distress had heard of it. That’s compared to 40.4 percent of those with no psychological distress who have heard of the 988 crisis number.

What’s more, folks with greater mental distress were also more likely to have used the 988 number in the past (6 percent), compared to 1 percent of those with moderate distress and 0.2 percent of those with no distress who have done the same.

But despite more knowledge of and experience with 988, people with serious psychological distress weren’t likely to use the number in the future.

The researchers said that only 30 percent of those reporting serious distress who’d used 988 in the past said they were very likely to use 988 again. Among all patients reporting serious psychological distress, only 22 percent said they’d use it again.

The NYU researchers said it’d be fruitful to look into any issues with 988, which previous reports said can have some access problems, that could discourage those who need it from accessing it.

“Launching the 988 hotline has been a critical step for addressing America’s expanding need for mental health services, but we have to get to the bottom of why so many users who were in serious distress wouldn’t use it again—whether that means better training is needed, more resources or other solutions,” Michael A. Lindsey, Dean and Paulette Goddard professor of social work at the NYU Silver School of Social Work, said in a statement about the study.

According to Jonathan Purtle, an associated professor in the NYU School of Global Public Health who led the JAMA study, it could be a matter of how well 988 meets patient needs.

“Our findings signal a need for research about satisfaction with the 988 Lifeline among people with serious psychological distress and the extent to which 988—and the resources it connects users to—sufficiently meets their needs,” Purtle said in the press release.

Additionally, it may be beneficial to investigate strategies for increasing awareness about the crisis line. Although more folks with serious psychological distress know about the number than the general public, it’s still less than half.

Purtle has looked into how elected officials spread the word about 988, publishing in a second JAMA Network Open study that discourse about the number was high in June 2022 when it was launched but then tapered off.

“We found that many state legislators actively communicated about 988 when it was launched in July 2022, but that communication was not sustained over time,” Purtle explained of the second study. “Robust public awareness of the 988 Lifeline and willingness to use in crisis situations is critical to realizing its public health impact.”

Elected officials represent one subset of public health messengers. Purtle’s study didn’t look into how effective elected officials are in spreading the word about 988 or the potential for other messengers to take part in spreading public awareness, but it may be beneficial to gain understanding.

If you or someone you may know are considering suicide, contact the Suicide and Crisis Helpline at 988 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: dial 711 then 1-800-273-8255) or the Crisis Text Line by texting HOME to 741741.

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