4 Years Later, 988 Suicide & Crisis Lifeline Shows Successes and Opportunities for Improvement

July marks four years since the National Suicide Prevention Lifeline transitioned from a 10-digit phone number to the 988 Suicide & Crisis Lifeline, representing a major investment by the federal government in the nation’s crisis response systems. The three-digit number is a simpler, more accessible way for people experiencing suicidality and other mental health emergencies to reach a crisis counselor who can provide immediate support and resources.

Since its launch, the 988 Lifeline has received more than 23 million contacts, including more than 15 million calls, 4 million texts, and 3 million chats. The number of total contacts increased 11.5% from the first quarter of 2025 to the first quarter of 2026, demonstrating substantial growth and demand for these services. The rise in use also underscores the continued unmet mental health needs in the United States, and the critical role that the crisis response system plays in suicide prevention.

Impact of 988 on suicide outcomes

Research suggests that the 988 Lifeline is contributing to improvement in suicide-related outcomes, particularly among adolescents and young adults. A recent study found that from July 2022 through December 2024, suicide deaths among people ages 15-34 were 11% lower than projected rates based on pre-988 trends—that represents 4,372 lives saved. Notably, reductions in suicides were significantly greater in the 10 states with the highest uptake in 988 calls.

Dr. Richard McKeon, former senior adviser at the U.S. Substance Abuse and Mental Health Services Administration’s (SAMHSA) 988 & Behavioral Health Crisis Coordinating Office, played a critical role in establishing 988. He is currently deputy director for strategy at the National Action Alliance for Suicide Prevention.

“We were deeply gratified by the study associating 988 contacts with reduced suicide among America’s youth and young adults,” McKeon said. “The development of a 988 text service and the dramatic improvement in answer rates for the Lifeline’s chat service were likely crucial in expanding access to help.”

Researchers from SAMHSA also examined caller feedback to better understand the effectiveness of the 988 services. They spoke with 437 adults who used the Lifeline; approximately 98% of those surveyed reported that contacting 988 was helpful, while 88% said that the call stopped them from engaging in suicidal behavior.

Two-thirds of callers reported working with crisis center counselors to develop a plan for managing future suicidal thoughts or actions. Callers with such a plan were more likely to report that the 988 Lifeline was helpful and prevented them from acting on suicidal thoughts, compared with callers who did not develop a plan. This finding highlights the importance of safety planning, a brief intervention where a patient and healthcare provider—or, in this case, a crisis counselor—collaborate to identify strategies and steps that the patient can take in the event of a future suicidal crisis.

Callers also reported positive outcomes when crisis counselors demonstrated strong suicide prevention and intervention skills, including fostering engagement through a supportive environment and collaborative problem-solving. This points to the importance of ensuring crisis counselors and healthcare providers are adequately trained in suicide prevention. However, recent data shows that 988 call centers are still largely understaffed nationwide.

Opportunities to expand and enhance care

The SAMHSA survey results representing 77% of all U.S. call centers indicate that 71% of responding centers report staffing challenges. Two of the most prominent issues reported are staff recruitment and retention due to financing and operational challenges.

States have an integral role to play in addressing these gaps and ensuring 988 call centers have the capacity, resources, and long-term sustainability needed to provide high-quality crisis support. Although it’s a federally established lifeline, states are entrusted to maintain funding and implementation.    

Further, while call centers act as the first line of support during a crisis, they lack meaningful outcome data—such as what supports callers received and their mental health outcomes—that could shape protocols and practices for future callers. According to McKeon, “988 will likely experience significant increases in volume for years to come as more and more people learn about its life-saving potential. For this full potential to be realized, 988 [call] centers will need to have access to information and data regarding what happens after the 988 call, text, or chat to serve as a continuing driver for improvement.”

The progress of the 988 Lifeline represents an important step forward in building a stronger national crisis response system. But continued investment will be essential to ensure that the service can meet growing demand and continuously improve care for those in crisis.

Stacey Baxter works on The Pew Charitable Trusts’ suicide risk reduction project.