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Among those at Higher Risk for Suicide, Study Finds Key Factors that Drive 988 Lifeline Usage: Someone to Talk to 24/7 and Free Access

New research and toolkit provide critical insights aimed at increasing usage and access among populations at higher risk for or disproportionately impacted by suicide

Washington, D.C., November 8, 2023 — Today the Ad Council Research Institute, in partnership with the National Action Alliance for Suicide Prevention (Action Alliance) and the Suicide Prevention Resource Center (SPRC), and supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), have released crucial findings about the public’s awareness, perspectives, and current and potential usage of the 988 Suicide & Crisis Lifeline. As part of the collaborative 988 Formative Research Project, the partners are publishing insights and an actionable toolkit that can be used by individuals and organizations in their outreach and messaging efforts about mental health to make research-informed decisions about how to encourage use of and access to 988.

A number of participants ages 13-34 (14%) said their mental health is somewhat or much worse compared to a year ago, though it was slightly higher among 13-34-year-old American Indian/Alaska Native participants (17%) and Asian American, Native Hawaiian, and Pacific Islanders (19%). For LGBTQIA+ participants and participants who have experienced suicidal ideation, this increased to nearly a quarter (23% each).

The mixed-methods formative research study focused on key populations at higher risk for or disproportionately impacted by suicide, found that:

  • Roughly half of the respondents were aware of 988, but most said they don’t know much about it.
  • Young adults ages 13-34 (especially those who are Black) and LGBTQIA+ participants (ages 13-49) were more likely than other populations in the study to say they’d use 988, whereas rural older men (ages 49+) were least likely to say they’d use it.
  • Those who would consider using 988 when struggling with their mental health found its 24/7 availability most helpful. Other top reasons included:
    • The ability to communicate with someone who’s trained to help.
    • It’s anonymous.
    • The ability to communicate with a real person.
    • It’s free.
  • Those who would not consider using 988 would not do so due to concerns of:
    • Credibility and privacy (especially for rural older men ages 49+).
    • Opening up to a stranger (particularly among young adults ages 13-34).
    • Someone being called as a result of their contacting 988—like their parents (among teens), law enforcement, or a hospital. This was especially noted among those who have experienced suicidal ideation.
  • For receiving information on 988, the majority of study participants would most trust and turn to family and friends, followed by professional healthcare resources.

A toolkit for supporting culturally sensitive, responsive, and successful communications is also available at 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 strategic insights that can be used by communicators to craft and test more effective and personalized messages and campaigns tailored for each of the study cohorts, which included:

  • American Indian and 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 had attempted suicide or had serious thoughts of suicide during their lifetime (age 13+)
  • LGBTQIA+ individuals (ages 13-49)
  • People with disabilities (13+)
  • Rural older men (ages 49+)

"This research strengthens our ability to effectively message about 988, and is an important step in understanding how to better support populations that are more impacted by suicide,” said Colleen Carr, MPH, Director of the Action Alliance. "The Action Alliance and SPRC are eager to share these findings with partners across the country working to raise awareness of 988 among their communities. This research is a valuable foundation, though we know more work is needed to develop, test, and enhance 988 communications and campaigns, and better understand additional populations at high risk of suicide."

“We are immensely grateful for the unwavering support and dedication of our partners in this vital research initiative. Through collaborative efforts like these, we can not only raise awareness about 988 but ensure that it truly serves as a lifeline for people most at risk and/or disproportionally impacted by suicide. Together, we can make strides to ensure everyone knows they have someone who is skilled, compassionate and will listen 24/7, without cost when they are struggling with their mental health," said Derrick Feldmann, Lead Researcher and Managing Director of the Ad Council Research Institute. This study is an extension of the Ad Council’s large scale national Mental Health Initiative.

The research also uncovered important findings about trusted messengers from the study’s population groups. Additional formative research is currently underway among trusted messengers identified by this study’s cohorts. Those research findings are expected to be available in 2024.

Learn more about the 988 Formative Research at or download the report here.


Emily Kostic,

About the National Action Alliance for Suicide Prevention
TheNational Action Alliance for Suicide Prevention (Action Alliance) is the public-private partnership working to advance the National Strategy for Suicide Prevention and make suicide prevention a national priority. The Substance Abuse and Mental Health Services Administration (SAMHSA), through the Suicide Prevention Resource Center (SPRC) grant, provides funding to the Education Development Center (EDC) to operate and manage the Secretariat for the Action Alliance, which was launched in 2010. Learn more at and join the conversation on suicide prevention by following the Action Alliance on Facebook, Twitter, LinkedIn, and YouTube.

About the Suicide Prevention Resource Center (SPRC)
TheSuicide Prevention Resource Center (SPRC) is the only federally supported resource center devoted to building nationwide capacity to implement the National Strategy for Suicide Prevention. SPRC is supported by a grant from the U.S. Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS). Find up-to-date publications and professional development to support effective suicide prevention efforts in communities, states, Tribes, and health care systems at and on Twitter, Facebook, YouTube, and LinkedIn.

About the Ad Council and Ad Council Research Institute (ACRI)
The Ad Council convenes creative storytellers to educate, unite and uplift audiences by opening hearts, inspiring action and accelerating change around the most pressing issues in America. Since the non-profit’s founding, the organization and its partners in advertising, media, marketing and tech have been behind some of the country’s most iconic social impact campaigns – Smokey Bear, A Mind Is a Terrible Thing to Waste, Love Has No Labels, Tear the Paper Ceiling and many more. With a current focus on mental health, gun safety, the opioid epidemic, skill-based hiring and other critical issues, the Ad Council’s national campaigns encompass advertising and media content, ground game and community efforts, trusted messenger and influencer engagement, and employer programs, among other innovative strategies to move the needle on the most important issues of the day.

To learn more or get involved, visit, join the Ad Council's communities on Facebook, Instagram, LinkedIn and Twitter, and view campaign creative on YouTube.

The Ad Council Research Institute (ACRI) leverages the Ad Council’s insight-driven approach to examine some of the most important social issues of our time. Building upon years of research expertise, ACRI works with brand, corporate and nonprofit partners and clients to conduct research to gain a deeper understanding of the public’s perceptions, attitudes and willingness to act on social issues; develop and test messaging and narratives for social good campaigns; help build knowledge on the role influencers or trusted messengers can play to move the public to act; and identify key performance indicators for communications initiatives, and the tools through which to measure, assess and optimize them over time. Learn more about ACRI and our 2024 research agenda here.