Download the executive summary of highlights from the report
The 988 Formative Research uncovered the attitudes, beliefs, perceptions, barriers, and motivations related to 988 and adopting help-seeking behaviors among populations with a higher risk for or disproportionately impacted by suicide, including:
- American Indian/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 have attempted suicide or experienced serious thoughts of suicide during their lifetime (ages 13+)
- LGBTQIA+ youth and adults (ages 13-49)
- People with disabilities (ages 13+)
- Rural older men (ages 49+)
These findings offer an important starting point for 988 messaging efforts, intended to produce insights that can be used by the field to make research-informed decisions about how to encourage use and/or access to 988. The research also generated evidence-based message frames that can be tested, validated, and enhanced through additional message testing and research.
988 Suicide & Crisis Lifeline: Messaging and Communications to People at Higher Risk for or Disproportionately Impacted by Suicide
The findings in this report provide a deeper look into how populations at higher risk for or disproportionately impacted by suicide view and/or access mental health resources and crisis services, and how to best develop messaging to encourage use and/or access to 988.
Key insights from the study include:
1. Mental Health: Participants ages 13-34, LGBTQIA+ participants, those who report experiencing suicidal ideation and participants with disabilities are more likely to report struggling with mental health, as compared to other cohorts.
- These groups of participants are also more likely to say their mental health has worsened over the past year, likely due to personal and economic setbacks or the loss of trusted resources.
- Three-quarters of general population participants said they’d be extremely/very (48%) or somewhat likely (30%) to seek out help or support of any type when they may be struggling with their mental health or they feel life is difficult. This was especially true among participants ages 13-34, LGBTQIA+ participants, and those with disabilities.
- Older participants—especially rural men (ages 49+)—are less likely to seek out help or support when struggling with their mental health.
2. Suicidal Ideation: Over a third of all participants in the study report experiencing suicidal ideation in their lifetime. Ideation is even more prevalent among those who reported struggling with their mental health.
- The majority of those who say they’d thought about suicide have done so more than once, and about half reported experiencing ideation in the past year.
- LGBTQIA+ participants report having experienced more suicidal thoughts than other cohorts in the study; Black and American Indian/Alaska Native participants ages 13-34 and LGBTQIA+ participants reported more suicide attempts.
3. 988: About a half of the sample have heard of 988, but most don’t know much about it.
- When struggling with mental health, participants are split on if they’d consider using 988 to get help or support. Participants ages 13-34 (especially those who are Black) and LGBTQIA+ participants are more likely to say they’d use 988; rural older men are least likely to say they’d use it.
- 24/7 availability has the strongest appeal to those who would consider using 988.
- Those who will not consider using 988 won’t do so because they are worried about opening up to a stranger, credibility, and privacy.
4. Messaging: Most found the foundational frame (the frame shown first to inform participants on what 988 is) extremely/very helpful in explaining 988, though less so for older rural men (ages 49+).
- Participants ages 13-34, LGBTQIA+ participants, those who have experienced suicidal ideation, and participants with disabilities were more likely to find the foundational frame relevant and said it would motivate them to use 988 when struggling.
- After reading the foundational frame, participants said they’re most likely to tell a friend or loved one about 988.
- All the conditional frames (shown after the foundational frame) improve the overall message, with “Health Equity/Access” slightly more relevant than the others.
- The frame most motivating for participants to consider contacting 988 is “Health Equity/Access,” followed by “Law Enforcement.”
5. Trusted Messengers + Resources: When struggling with mental health, participants are most likely to trust and get support from family and friends.
- Cohorts in general trust family and professional resources (mental health/healthcare providers and organizations) for information on 988.
- Participants overall would like 988 to provide additional information on who else to contact in a crisis that can offer support, dealing with a panic attack, and guidance for conversations.
988 Suicide & Crisis Lifeline Communication Toolkit
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 campaign messaging frames (key narratives and phrasing that best motivates people to use 988 when struggling with mental health), strategic information and trusted messengers specific to each of the participant groups included in the study.
This information can be used by communicators to craft and test more effective and personalized messages and campaigns to individual audiences. The messaging points and resources in this toolkit are based on the latest research gathered from specific cohorts within the general population as listed in the 988 Suicide & Crisis Lifeline: Messaging and Communications to People at Higher Risk for or Disproportionately Impacted by Suicide report.
Key messaging insights from the toolkit include:
- In general, if people have heard of 988, research found that they’re not always sure what situations warrant using it. This lack of knowledge breeds skepticism and uncertainty, or even fear, among people who are struggling with mental health for a variety of reasons: They’re concerned about opening up to a stranger, worried about privacy, are unsure of credibility and more.
- One of the biggest roadblocks to 988 interest and use is the perception that it’s solely an emergency crisis hotline (i.e., used only in emergent situations). Across all groups, our research found that certain words and phrases leave the impression that 988 is only for the most urgent situations. The words, phrases, and numbers that present challenges include “911,” and “Crisis.”
- Across participant groups, people were most likely to say they trust and get support from family and friends when they’re struggling with their mental health, as well as mental health professionals/organizations (for some). These same individuals/entities are generally also the messengers and resources participants say they’d trust for information on 988.
Use these materials to help disseminate findings.