As most of you know, the National Suicide Prevention Lifeline became the 988 Crisis and Suicide Lifeline last year. This has expanded its reach and who it aims to serve. Millions of people have accessed 988 Lifeline through calls, texts and messages over the past year. This is extremely impressive. But how successful is the 988 Suicide and Crisis Lifeline in helping people? Would they call 988 again if they were in danger?
Is the 988 lifeline useful for suicide and crisis cases?
I’ve written about Lineline before, highlighting its positive and possibly negative aspects. That said, I have always viewed the National Suicide Prevention Lifeline, now the 988 Suicide Crisis Lifeline, as a positive. People absolutely need a place to go and people who will listen to them 24/7, and that’s what Lifeline offers. In fact, I highly recommend the 988 Suicide and Crisis Lifeline to people who are struggling. I do this because the people on the line are trained professionals. They also aim to be located for the caller (text message messenger, etc.) and have access to information about resources that could further help a person in distress. Otherwise, most people simply would not have access to that information. Lifeline workers are in a much better position to help a person in distress than any unprofessional person you may find online or anywhere else.
What do people who have called 988 Lifeline say?
But what do people who have called the 988 Suicide and Crisis Lifeline have to say about it?
Unfortunately, their reactions are not very positive, according to a new survey published in the Journal of the American Medical Association (JAMA). This survey estimates that only About 30 per cent of people with serious problems who called 988 are likely to call Lifeline again.which is slightly above the average of around a quarter of those who are likely to call again if in danger (from here). (I think at least part of this has to do with the growing pains of serving so many people; of course, I don’t know because we don’t have any information about because people didn’t call back.)
What would the success of the 988 Suicide and Crisis Lifeline look like?
Let’s dream about what the success of the 988 Lifeline would be like.
I believe 988 Lifeline would be 100 percent successful if everyone who called, texted or messaged 988 was directed to the appropriate resources and therefore never had to call 988 again. In other words In theory, 988 would actually receive fewer calls over time as callers were directed to the appropriate resources.
This, of course, is a pipe dream. 988 Lifeline may do everything right, but people still may not be accessing the right resources. Resources may not be available. Resources may be too expensive. The resources may not work for them. Etc. There are 1000 reasons why 988 Lifeline can do everything right and people still need to trust them.
Therefore, we need a more reasonable version of success. In simpler terms, these questions are important:
- Does the 988 Suicide and Crisis Lifeline help people when they call as judged by the caller?
- Would people who have called the 988 Suicide and Crisis Lifeline call again if they were in danger?
There are other success metrics for the 988 Lifeline as well, but I’d say those two are pretty important.
We have an answer to the second question, but let’s take a look at the first question.
Does the 988 Suicide and Crisis Lifeline help people when they call?
Because this incarnation is new, there is no research available over the past year. That being said, the National Suicide Prevention Lifeline has been around for years and has been studied. This is some of what we have learned from the research. (Thanks to The journalist’s resource for such an excellent investigative summary.)
In one study, 3,000 callers from a representative sample of crisis centers were interviewed. It was found that of the severely suicidal people who called suicide hotline services, eight percent were actually in the midst of a suicide attempt and 58 percent had made a previous suicide attempt. Callers reported significant reductions in self-reported crisis states and suicide at the end of the call. (from here).
In a 2017 study, it was found that almost 80 percent of clients interviewed who had used the National Suicide Prevention Lifeline reported that the intervention prevented them from committing suicide and 91 percent said it kept them safe.. People at higher risk for suicide at the time of their Lifeline calls perceived the follow-up intervention to be more valuable (from here).
In 2021, a study found that at the end of the chat with a Lifeline Crisis Chat responder, Two-thirds of those approached who were suicidal reported that the correspondence had been helpful.and 45 percent reported being less suicidal.while 30 percent said they felt the same as when they started the chat, and 12 percent said they were more suicidal (from here). These are incredible numbers. In a single conversation, almost half of the suicides were helped. That’s a number to shout about. (Of course, other services need to catch up to that level to sustain that benefit and take advantage of it. I suspect we’re slipping a lot in that regard; see next paragraph.)
A 2012 study, to no one’s surprise, highlighted the negative perceptions people have about mental health resources. Nearly 83 percent of callers reported receiving mental health treatment at some point in their lives, and 46 percent were in treatment at the time of their call. However, Only 35 percent of callers referred to mental health resources and followed through with the referral.. Barriers to accessing mental health services included denial of the severity of the mental health problem, financial problems, and not having health insurance. One-third of callers reported a lack of trust or a negative experience with mental health providers as a reason for not accessing mental health care after the call. (from here). (Note that negative perception is clearly different from stigma; the latter is widely cited as the main barrier to care, which is not confirmed in studies.)
However, not everything is so rosy. TO New York Times This year’s data analysis found that 18 percent of calls in the first half of the year went unanswered. (That’s about 180,000, which blows my mind; from here). Just to do the scary math, if other statistics here are correct, that means about 14,400 people were in the middle of a suicide attempt and didn’t get their call answered.
I think we can say that much of the data will be similar for calls answered by 988 Suicide and Crisis Lifeline as it was for the previous incarnation when taking into account the severity of the distress. Previously, more callers showed greater distress; Now, thanks to public awareness campaigns, 988 responds to many more calls and a greater proportion show less distress. (Which, by the way, isn’t a bad thing. It’s easier to address a problem before it becomes a catastrophe.)
Can the 988 Suicide and Crisis Lifeline Succeed?
Not everyone who calls the 988 Suicide and Crisis Lifeline will receive help. Not everyone will get their calls answered. That said, studies show that the National Suicide Prevention Lifeline was successful in saving lives, and there is no reason to think that the 988 Suicide and Crisis Line will be successful either, even if there are growing pains right now. There are definitely improvements that need to be made. I think that’s clear. And I’m a little biased, but I think the only person you save makes your effort a success.
But . . .
We need to do more. Skilled, empathetic and dedicated people are working as hard as they can to save lives, but at best they are a stopgap. To be honest, it should be the exception, not the rule, that a person who is in great distress needs to call a lifeguard. It should be the case that people in great distress, and certainly people who are suicidal, can have access to real resources that can really help them over time. A person talking on the phone or online will never be able to sew up a gunshot wound. All they can do is put a Band-Aid on you and point you in the direction of a surgeon. But if surgeons are not available, if surgeons ignore your gunshot wound, if surgeons hurt you in the past, no Band-Aid will save you.
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