Experiences Using and Intentions to Use the 988 Suicide & Crisis Lifeline Among Distressed Adults - PROJECT SUMMARY In July 2022 “988” became the new national dialing code for the Suicide & Crisis Lifeline. Lifeline call volume increased significantly following 988’s launch and it now receives about 8 million contacts per year. However, there are critical knowledge gaps relating to the quality of callers’ experiences using 988 and knowledge, expectations, and intentions related to 988 among populations at elevated risk of suicide. Pilot work by the project team found that only 29% of adults with serious psychological distress who used 988 would be very likely to use it in the future and that attitudes towards 988 and crisis help seeking vary across demographic groups. Further, 83% of adults who experienced and sought help for a crisis in the past year did not reach out to 988. To generate knowledge to inform 988 quality improvement and marketing activities, this four-year R01’s Specific Aims are to: 1) Identify factors associated with positive/negative experiences using 988 among a population-based probability sample of 500 adults who used 988 on behalf of themselves in the past year; 2) Identify segments of adults who vary in their knowledge, expectations, and intentions related to 988 among a population-based probability sample of 1,200 adults with serious/moderate past 30-day psychological distress, and 3) Explore associations between state-level factors and positive/negative experiences using 988 (Aim 1) and knowledge/expectations/intentions related to 988 (Aim 2). Aim 1 will be achieved by screening approximately 50,000 participants of two major address-based probability panels of U.S adults (Ipsos KnowledgePanel and NORC AmeriSpeak Panel) to create a weighted, nationally representative sample of 500 adults who have used 988 in the past year. Aim 2 will be achieved by screening approximately 4,000 AmeriSpeak Panel participants to create a nationally representative sample of 1,200 adults with past 30-day serious/moderate psychological distress. Sub-samples of Aim 1 and 2 survey participants will also participate in qualitative interviews to explore quantitative findings in greater depth. Aim 3 will be achieved by creating a longitudinal a state-level dataset of 988 financing, call wait time, and in-state answer rate variables, linking these variables to survey respondents, and conducting multi-level analyses. The project team has expertise on 988 implementation (Purtle), evaluation of crisis lines (Gould), suicide epidemiology (Keyes, Lindsey), latent class analysis (Dahlen), and qualitative patient experience research (Murray, LaForge). Ten practice partners representing call center and crisis system leaders and patients will help disseminate of study findings. The project is innovative because it will use large population-based probability surveys to collect information from people who have used, or should potentially use, 988 and will link these data to metrics of state financing and system context. The project is significant and will have impact because it focuses on a major federal initiative (i.e., 988) fairly early in implementation. The project is aligned with NIMH’s Strategic Plan, SAMHSA’s 988 Quality and Services Plan, and the HHS 2024 National Strategy for Suicide Prevention.
