Title: Who Is Using The 988 Crisis Line?
Podcast: Short Wave
Host: Emily Kwong
Guest: Jonathan Purtle, Associate Professor at NYU
Release Date: July 16, 2025

Introduction

In the July 16, 2025 episode of NPR’s Short Wave, host Emily Kwong delves into the utilization of the 988 Suicide and Crisis Lifeline, marking its three-year anniversary. Alongside guest Jonathan Purtle, an expert in mental health policy, the episode explores who is reaching out to 988, the differences between 988 and the traditional 911 emergency number, and the challenges faced in expanding its reach across the United States.

Understanding the 988 Crisis Line

The 988 Suicide and Crisis Lifeline was launched three years prior to the episode's release, aiming to provide immediate support to individuals in crisis. Emily Kwong recounts noticing numerous signs promoting the three-digit number in various public spaces, signaling a significant shift in how mental health crises are addressed.

Emily Kwong explains, “when you call the line, you've reached... a system that routes your call through an existing network of 200 local and state-funded crisis centers and connects you to a trained crisis counselor who works in your area” (00:24).

Since its inception, 988 has been contacted millions of times via calls, texts, and chat options. A study led by researchers at NYU and Johns Hopkins estimates that approximately 1.6% of the US population utilized the service between July 2022 and December 2024.

Differentiating 988 from 911

A significant portion of the episode contrasts 988 with the traditional emergency number, 911. Emily Kwong questions how 988 differs for those experiencing a mental health crisis:

Jonathan Purtle responds, “988 is part of a broader crisis continuum... these are people who are trained specifically to deal with mental health crises” (04:21). He emphasizes that 988 counselors have specialized training and established relationships with mobile crisis response teams, enabling more tailored and effective interventions compared to 911 centers, which might default to deploying ambulances or police.

Research Findings on 988 Usage

Study by Jonathan Purtle et al. in JAMA Network Open

Jonathan Purtle discusses a comprehensive study that analyzed over 16 million interactions with 988 through calls, texts, and chats over 30 months. One notable finding was that 11% of these contacts were from veterans, who were subsequently transferred to the Veterans Crisis Line.

Jonathan Purtle notes, “the veterans crisis line had existed for a while, but... many veterans... learned about 988 and felt in crisis and called and were very pleasantly surprised... to have this option” (05:55).

Geographic Disparities in 988 Usage

The study revealed significant geographic differences in the utilization of 988. Usage rates were notably lower in the southern United States, with large states like Florida and Texas at the bottom of the usage rankings. Purtle attributes this disparity to regional attitudes towards mental health:

Jonathan Purtle: “...in more conservative parts of the US there might be more skepticism towards mental health treatment and counselors in general” (06:36).

Survey Study Published in Health Affairs

In a separate study published in Health Affairs, Purtle and his team surveyed 5,000 adults to understand preferences for mental health support sources. Participants were asked to rate their likelihood of turning to five different sources, including 988, friends and family, mental health professionals, and religious networks.

The survey identified five distinct groups based on their support-seeking behaviors:

1. Seek Help Nowhere
2. Definitely Not 988, but Yes Friends and Family Distressed
3. Seek Help Everywhere
4. Seek Help Most Places, but Not Religious Network
5. Relatively Indifferent, Not Distressed

Among these, the “Definitely Not 988, but Yes Friends and Family Distressed” group stood out. This segment, despite having the highest levels of recent psychological distress, 0% indicated a likelihood of using 988 in a crisis. Moreover, 95% of this group expressed a strong reluctance to use 988, highlighting a critical gap in outreach and awareness.

Jonathan Purtle: “We saw the opposite here... which I think has implications for how we disseminate messages and the content of those messages that we craft” (10:58).

Impact of Funding Cuts on LGBTQI+ Support

A pressing concern addressed in the episode is the Trump administration's decision to cancel funding for the LGBTQI+ Youth Service on 988, set to cease on July 17. This service had handled about half of the contacts from LGBTQI+ callers.

Emily Kwong: “Once that option goes away, what kind of specialized mental health support will still exist for LGBTQI+ young people?” (10:58).

Jonathan Purtle responds positively, pointing to the continued existence of the Trevor Project, which offers 24/7 support and receives funding from other sources, ensuring that LGBTQI+ youth still have access to specialized services.

Conclusions and Implications

As the episode wraps up, Purtle underscores the importance of 988 in normalizing mental health crises and the act of seeking help:

Jonathan Purtle: “It normalizes the fact that humans experience feelings of crisis and suicidality... and ideally normalizing help seeking as well” (11:54).

However, he cautions that 988 is necessary but not sufficient as a standalone solution. A robust mental health system requires a well-supported workforce and the capacity to provide ongoing care beyond immediate crisis intervention.

Notable Quotes

• Jonathan Purtle (02:07): “It's still half the rate of emergency department use for mental health issues... there still continues to be a lot of room for 988 use to grow and meet out demand.”

• Jonathan Purtle (04:21): “988... trained specifically to deal with mental health crises... have a much richer knowledge and better relationships with mobile crisis response teams.”

• Jonathan Purtle (10:58): “We did find this group also had significantly less awareness of 988... implications for how we disseminate messages and the content of those messages that we craft.”

• Jonathan Purtle (11:54): “We need a mental health system more broadly beyond just call, text and chat. We need a workforce which is, you know, paid well enough to stay in their jobs.”

Conclusion

This episode of Short Wave provides a comprehensive examination of the 988 Crisis Line’s impact and reach over its first three years. Through in-depth discussions and research findings, Emily Kwong and Jonathan Purtle shed light on the critical role of 988 in mental health support, the disparities in its utilization, and the ongoing challenges in ensuring that all individuals in need have access to the necessary resources.