Who Is Using The 988 Crisis Line?

Summary

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.

Transcript

[Amazon Pharmacy Ad]

This message comes from Amazon Pharmacy. Ever been so sick that thinking of going to the pharmacy made you more sick? With Amazon Pharmacy, meds are delivered fast right to your door. You just have to make it to your door. Amazon Healthcare just got less painful.

[Emily Kwong]

You're listening to Short Wave from npr. A few years ago, I started seeing these signs posted all over my city, in the metro, in public places, sharing this three digit phone number, 988. That is the national Suicide and Crisis Lifeline. And it was launched on this day exactly three years ago. When you call the line, you've reached.

[Jonathan Purtle]

The 988 suicide in crisis lifeline.

[Emily Kwong]

The first thing you hear is a pre recorded message. Par espanol marque el nue dos options to connect to specialized support for populations at high risk of suicide.

[Amazon Ad]

If you are a veteran or service.

[Emily Kwong]

Member or are calling about 1, press 1.

[Jonathan Purtle]

To connect to support for LGBTQI youth.

[Emily Kwong]

And young adults, press 3. Last month, the Trump administration announced it was canceling funding for a 988 LGBTQI+ service. That service alone has received over a million contacts. Otherwise, to talk with a counselor, stay.

[Jonathan Purtle]

On the line or press 0.

[Emily Kwong]

And then what happens is that using nearby cell phone towers, the system 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. That person picks up the phone and listens. Since launch, the line has been contacted millions of times through calls, texts and the 988 chat box. And a new study led by researchers at NYU and Johns Hopkins estimates that 1.6% of the US population used the line between July of 2022 and December of 2024.

[Jonathan Purtle]

Picture a room. 50 people. That's one of them.

[Emily Kwong]

This is lead author Jonathan Purtle, an associate professor at NYU who researches how mental health policies are implemented. And while 988 may look successful on paper, he says the percentage belies just how many Americans are are in need of mental health support.

[Jonathan Purtle]

It's still half the rate of emergency department use for mental health issues, which I think when we look at the data that way, it's an indicator of There still continues to be a lot of room for 988use to grow and meet. What is demand out there?

[Emily Kwong]

Today on the show, we talk about how 988 is going three years out, what it offers in addition to 911, and why portions of the country still don't know about it. I'm Emily Kwong and you're listening to Short Wave the science podcast from npr.

[Amazon Pharmacy Ad]

This message comes from Schwab. Everyone has moments when they could have done better. Same goes for where you invest. Level up and invest smarter with Schwab. Get market insights, education and human help when you need it.

[Amazon Ad]

This message comes from Amazon. When you're on hold with a doctor's office or pharmacy and the operator says your call is very important to us after the 10th time, well, suddenly your call doesn't seem very important to them at all. Amazon One Medical has 24. 7 Virtual Care and Amazon Pharmacy delivers meds right to you fast without any horrible hold music. Thanks to Amazon, Healthcare just got less painful support for npr. And the following message come from Indeed. Just realizing your business needed to hire someone yesterday, speed up your hiring right now with Indeed. Claim your $75 sponsored job credit now at indeed.com shortwave. Terms and conditions apply.

[Emily Kwong]

All right, Jonathan, so before we dig into your findings about who has and who has not been using 988, I want to talk about 911. A previous generation, you know, my parents, myself too, was taught to call 911 for any crisis, including a mental health crisis. How is a call to 988 for those crises different?

[Jonathan Purtle]

Yeah, 988 is part of a broader crisis continuum, right? So these are people who are trained specifically to deal with mental health crises. The 988 counselors will almost surely be familiar with those services and those teams they may be able to deploy those teams to and stay on the phone with you while those teams are on their way. So sure, in some places somebody would call 911. And perhaps that 911 center knows about a mobile crisis response team in that same region and they deploy that team as opposed to just deploying ambulance or police. I think in general, 988 centers have a much richer knowledge and better relationships with mobile crisis response teams and other kind of alternative response models, as they're called, that can be deployed. Whereas folks in 911 centers might have less knowledge about those services.

[Emily Kwong]

And you and your colleagues, you set out to determine a number of questions related to who was calling 988. And I want to talk to you about the piece you published in the journal JAMA Network Open, where during a 30 month period you found more than 16 million calls, texts and chats reached 988. And one finding that stood out to us was just the fact that 11% of the contacts came from veterans who were then transferred to the veterans crisis line. Do you have any further comment about the fact that 11% of the contacts were from veterans.

[Jonathan Purtle]

I think, you know, I think it can be perceived as a positive finding. You know, the veterans crisis line had existed for a while, but I think, you know, the public facing communication and marketing about the veterans crisis line probably not as intense as the communications about 988. So there are probably many veterans who didn't really know about the veterans crisis line and learned about 988 and felt in crisis and called and were very pleasantly surprised perhaps to hear that option for pressing 1.

[Emily Kwong]

In looking at the data, you found geographic differences too, that some places in the US were using 988 more than others. What did you find?

[Jonathan Purtle]

Yeah, healthcare in general, but I would say especially mental health care and policy is very state driven in the United States. And within some states there is also a lot it's county driven. Right. So then we have county variation within states. So we found that rates of 988 use were much lower in the southern parts of the United States. So when we ranked, you know, all the states in terms of their, their rate of 98 use, really big states like Florida and Texas were down there like at the very bottom, which I think is kind of troubling because these are major population centers in the US where a ton of people live. And we don't really know the why from our data, but we can speculate in prior work and work of others. We found that more conservative folks generally report in survey based work being less likely to use something like 988 and being less supportive of it. It might be a matter of, of values and a matter of experience that in more conservative parts of the US there might be more skepticism towards mental health treatment and counselors in general. Yeah.

[Emily Kwong]

Now you did a really interesting second study that was published in Health Affairs. You and a team surveyed 5,000 adults about mental health support. How did you go about collecting data about the types of support people are more likely to use, which includes 988 for some, but for others does not.

[Jonathan Purtle]

So what we did, we asked these 5,000 U.S. adults. So we fielded this survey back in 2023. So it was pretty much exactly one year after 988 launched. And we presented people with the question of if you or a loved one were experiencing suicidality or a mental health crisis, how likely would you be to turn to each one of these sources? And we listed five sources, 988, which we defined for them briefly in the survey a crisis line other than 988, a mental health Professional, like a psych psychologist or social worker or psychiatrist. A friend or a family member or someone in your religious network. Right. So we asked them this question and we had them rate these things on a seven point Likert scale. So you say one or two. You probably have, like, strong feelings that, like, no, I'm not going to turn there. And then on the other side, we'd economize if people said six or seven. So if you said six or seven on the scale, you probably might actually turn there in a crisis. Right. We found these five different groups that varied in terms of where they would turn or where they say that they would turn in a crisis.

[Emily Kwong]

And what were those five types of groups?

[Jonathan Purtle]

So we had this group that we called Seek help Nowhere. We had this group we called definitely not 988. Yes. Friends and family Distressed. A group we called Seek Help Everywhere. A group we called Seek Help Most places, but not Religious Network. And finally, a group we called Relatively Indifferent, Not Distressed.

[Emily Kwong]

I found it interesting that The Definitely not 988, but yes, friends and family distress group had the highest levels of recent psychological distress. Why is that?

[Jonathan Purtle]

Yeah, so I think that's one of the. One of the most important findings of the study. So people in this group, definitely not 988. Yes. Friends and family distressed, they had the highest proportion of folks that had serious psychological distress in the past 30 days. And just kind of bring this back to 988. Zero percent of the people in this group said that they would be very likely to turn to 988 in a crisis. And 95% said, no, I definitely would not, which is one or two on this scale. We did find this group also had significantly less awareness of 988, which also has. Has implications. So I think this raises, you know, thinking about marketing communication about 988. You know, arguably, one may say these folks who are experiencing, you know, poor mental health in the past 30 days, this is a group we. We really want to know about 988 and feel comfortable potentially contacting 988. And we're kind of seeing the opposite here in, in these data, which I think has implications for how we disseminate messages and the content of those messages that we craft.

[Emily Kwong]

Well, let's talk also about the fact that the Trump administration has cut funding to the LGBTQI + Youth Service of the line that is set to go away on Thursday, July 17. Once that option goes away, what kind of specialized mental health support will still exist for LGBTQI plus young people?

[Jonathan Purtle]

I think the silver lining is, you know, pre 988, the Trevor project has existed and will continue to exist. And they, you know, have funding from other sources as well. That will remain an option.

[Emily Kwong]

Right. And for anyone who doesn't know, the Trevor Project was one of the groups providing 24. 7 support for 988's LGBTQI plus callers. They handled about half of the contacts from this group of people. So, zooming back out, just as we close, what message do you think it sends that 988 does exist? What does it do?

[Jonathan Purtle]

Yeah, no, I think it does a few things. I mean, one, I think it normalizes the fact that humans experience feelings of crisis and suicidality and that the federal government supports this lifeline or the safety net. Sends a positive message of normalizing that and ideally normalizing help seeking as well, which I think is. Which I think is really, really powerful and very positive. I think it's really important to keep in mind, though, it is, I would say, the category of necessary but not sufficient. Right. 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 to have a public mental health system with capacity to see people who need care.

[Emily Kwong]

Well, thank you so much for talking to me about 988 and what it means to people around the country.

[Jonathan Purtle]

Yeah, thank you for having me.

[Emily Kwong]

This episode was produced by Rachel Carlson, it was edited by Rebecca Ramirez, and fact checked by Tyler Jones. Robert Rodriguez was the audio engineer, Beth Donovan is our senior director, and Colin Campbell is our senior vice president of podcasting strategy. I'm Emily Kwong and you're listening to Short Wave, the science podcast from N.

[Amazon Ad]

This message comes from LinkedIn ads. One of the hardest parts about B2B marketing is reaching the right audience. That's why you need LinkedIn ads. You can target your buyers by job title, company role, seniority, and skills. All the professionals you need to reach in one place to get a $100 credit on your next campaign. So you can try it yourself, just go to LinkedIn.com results. That's LinkedIn.com results. Terms and conditions apply only on LinkedIn ads.

[Amazon Pharmacy Ad]

This message comes from NPR sponsor Shopify. Shopify is the commerce platform behind millions of businesses around the world and 10% of all e commerce in the US from household names like Mattel and Gymshark. Get started with your own design studio. With hundreds of ready to use templates, Shopify helps you build a beautiful online store to match your brand's style. If you're ready to sell, you're ready for Shopify. Sign up for your $1 per month trial and start selling [e-mail] NPR.