Summary: A multi-institution research team reports that fewer young Americans took their own lives in the 30 months after the national 988 suicide-prevention number went live than would have been expected based on prior trends. The decrease was most pronounced in states with the highest volumes of 988 contacts, but authors warn that funding shortfalls and service changes could threaten continued access.
Study design and data examined
The analysis, published on Wednesday in the Journal of the American Medical Association, was led by investigators at Harvard Medical School in collaboration with Brigham and Women’s Hospital, Massachusetts General Hospital and the National Bureau of Economic Research. Researchers used quarterly suicide-death records from the National Vital Statistics System for the years 1999 through 2022 to model a counterfactual - that is, what suicide mortality would likely have been from July 2022 through December 2024 if the 988 service had not been implemented.
Those model projections were then compared with the actual recorded deaths during the same July 2022 to December 2024 period to estimate the net change in suicide mortality associated with the period following the rollout of the 988 shortcut.
Main findings
Researchers found that 35,529 Americans aged 15 to 34 died by suicide in the 2.5-year study window, a total that was 4,732 fewer deaths - or an 11% reduction - than the projected count. The study described this decline as significant. Among people aged 65 and older, suicide mortality also fell during the same period, though by a smaller margin of 4.5%.
The reductions among adolescents and young adults were largest in the 10 states that recorded the highest levels of 988 call volume during the study period, the authors reported.
Hotline use and investments
The study notes that overall contacts with the National Suicide Prevention Lifeline more than doubled during the first three years after the 988 shortcut became operational in 2022. Those increases in demand coincided with approximately $1.5 billion in investments aimed at expanding the crisis-center workforce and capacity nationwide. JAMA-cited data referenced by the study indicate that adolescents and young adults made up a disproportionately high share of hotline users.
As of last July, the hotline had received 16.5 million contacts since launch, including 11.1 million calls, 2.9 million texts and 2.4 million chats, according to the data cited in the paper.
Additional observations and related data
Investigators also drew attention to a specialized 988 service that had been tailored to young LGBTQ adults - a group that previously accounted for 10% of all 988 hotline contacts - noting that the specialized service was eliminated by the Trump administration last summer. The authors suggested the change may have discouraged usage by that population.
In related figures, the Crisis Text Line reported receiving more than 1.5 million texts last year, which the organization said averaged to one incoming text every 20 seconds and represented the highest volume in the nonprofit’s 12-year history, surpassing even the peak during the COVID-19 pandemic.
The researchers also cited wider context for the hotline’s creation: more than 516,000 people took their own lives between 2014 and 2024, and firearms accounted for over half of those deaths, based on the health-policy data included in their report.
Capacity concerns
While the study ties the simplified 988 shortcut to lower-than-projected suicide deaths among young people, it additionally cautions that maintaining access to suicide and crisis services requires continued public and private investment. The authors warn that current funding levels will likely be insufficient to meet demand in nearly half of U.S. states unless resources are sustained or increased.
Conclusion
The Harvard-led report concludes that the national three-digit 988 hotline corresponded with fewer suicides among adolescents and young adults in the months after its introduction, particularly in states with the greatest hotline traffic. At the same time, researchers underscore the dependence of such gains on ongoing investment and highlight the potential implications of programmatic changes for vulnerable subgroups.