988 hotline linked to fewer teen and young adult suicide deaths

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Suicide deaths among U.S. teens and young adults fell by more than what researchers expected after the 988 mental health crisis hotline began operating nationwide, according to a study published Wednesday in JAMA. Researchers said the change is reflected in comparisons that estimate how many people ages 15 to 23 would have died by suicide had 988 not launched.

The analysis looked at the period from July 2022, when the lifeline launched, through December 2024. In that window, the study found suicide deaths among 15- to 23-year-olds were 11% lower than what researchers projected, based on modeling rather than on direct observation of a counterfactual scenario.

Dr. Vishal Patel, a clinical fellow at Harvard Medical School and lead author of the paper, linked the findings to a large federal investment in suicide prevention. “The 988 program is one of the largest federal investments in suicide prevention in U.S. history — roughly $1.5 billion cumulative — and our findings suggest that investment has translated into measurable reductions in young adult suicide deaths,” Patel said.

The researchers used nationwide death certificate records from 1999 to 2022 to model what suicide mortality would have been if 988 had not been launched. They then compared the model estimates with the actual number of deaths recorded during the study window.

Patel and the paper’s team said they could not say for certain that 988 was the sole cause of the decline, and that the overall U.S. suicide rate has also fallen. They said they ran other comparisons to “gut check” their results, including looking at how places that increased 988 call volumes differed from the overall expected pattern.

In those comparisons, the researchers said the 10 states with the largest increases in call volumes after 988’s launch also saw significantly larger gaps between expected and actual suicide deaths. The study also reported larger reductions among younger people than among adults older than 65, who the paper said are less likely to use the lifeline.

The researchers also compared the U.S. results with England, where no comparable lifeline existed during the study period. They said they saw no similar changes when looking at suicide deaths in England, a finding Patel said aligns with the overall interpretation of the U.S. results.

A spokesperson for the Substance Abuse and Mental Health Services Administration, which funds the hotline, pointed to prior evidence about what happens when people contact crisis counselors. “Studies show that after speaking with a trained crisis counselor, most people who contact the 988 Lifeline are significantly more likely to feel less depressed, less suicidal, less overwhelmed and more hopeful,” the spokesperson said in response to the study.

Jill Harkavy-Friedman, who leads the American Foundation for Suicide Prevention’s research program and was not involved in the paper, called the results “very heartening and very positive.” She said the authors did a “great deal of work” to weed out other possible factors for the decline, and she said 988’s ability to help people navigate the broader mental health system—such as connecting them to safety-planning resources, local crisis intervention teams, and longer-term care—plays a role in reducing risk. She also said simply having someone to call during a crisis can be lifesaving, describing it as “the strength of the crisis line,” adding that “When you call, it de-escalates the crisis so the person has greater capacity to address whatever it is that’s driving their emotions at the moment.”

Even with the new findings, experts said the patchwork of federal and state funding for call centers remains insufficient to match the level of need. Health Secretary Robert F. Kennedy Jr.’s federal budget request, the AP reported, maintains stable 988 funding at $534.6 million for fiscal year 2027 and projects 11 million contacts next year.

The hotline, according to Jonathan Purtle, a New York University mental health policy researcher, “is not a panacea for preventing suicide death,” but the impact it has already delivered “is a really big deal and underscores the need for sustained investment in 988 from federal, and especially state, lawmakers,” Purtle said.

The AP also reported that a Capitol Hill hearing Tuesday focused on whether 988 will restore specialized services for LGBTQ+ youth. Sen. Tammy Baldwin pressed Kennedy to follow a “legal requirement” to restore 988’s specialized line for LGBTQ+ youth after the administration abruptly cut the program last summer, despite evidence the population faces disproportionately high suicide rates. Kennedy told Baldwin, “Yes, we are working on getting it up now,” and the AP reported that spokespeople for SAMHSA and the Department of Health and Human Services did not immediately provide a timeline for the restoration.

Patel said specialized services for high-risk groups—including the LGBTQ+ line—are part of what makes the program work. “Our findings should be read as evidence that this is a program worth preserving and expanding, not one to scale back,” he said.

If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988.