The 988 Suicide & Crisis Lifeline was launched in 2022 to help strengthen crisis response and has received more than 16 million calls, texts, and chats ever since.
It is funded by the Substance Abuse and Mental Health Services Administration and administered by the mental health company Vibrant Emotional Health, connecting Americans with counselors at more than 200 crisis centers who are available 24 hours a day, every day.
Now, new data shared by researchers at New York University and Johns Hopkins Medicine reveals the states that have utilized this lifeline the most.
“At the state-level, past-year 988 contact incidence rates ranged from highs of 45.3 and 40.2 per 1,000 population in Alaska and Vermont, respectively, to lows of 12.5 and 14.4 per 1000 population in Delaware and Alabama, respectively,” the authors of the research letter published in the journal JAMA Network Open said.
Regionally, the highest number of calls, text messages, and chats was recorded in the West. The lowest volume was in the South, and the same was true for the previous year’s estimate.
New York and Colorado were also high on the list, according to a map revealing use during that time frame.
The authors noted that demographic information was not available when they estimated the 988 use prevalence.
“We then adjusted these prevalence estimates to reflect assumptions about repeat contacts to 988,” the authors wrote. “Using data on repeat contacts to the Crisis Text Line to inform our assumptions, we adjusted the lifetime prevalence estimate to reflect the assumption that every person who contacted 988 used it a mean of 2.0 times and adjusted the past-year prevalence estimate to reflect the assumption that every person who contacted 988 used it a mean of 1.5 times.”
They found that there is still an opportunity to increase use, highlighting that the contact rate is less than half the rate of adult emergency department visits that include a mental health diagnosis.
The authors said state variation in use was consistent with state variation in funding and legislative attention.
“Lower rates of 988 use in the South, which is more politically conservative than other regions, is also consistent with prior research showing less favorable attitudes toward 988 among Republicans than Democrats,” they wrote.
Notably, funding for the crisis line’s specialized services for LGBT+ youth is on the chopping block. Although the Health and Human Services fiscal year 2026 budget proposal maintains funding for the lifeline. Lawmakers have spoken out in opposition to the cuts to the services that they say get an average of 2,100 contacts per day.
Some one in four U.S. adults had a mental illness in the past year and nearly three in 10 high school students reported poor mental health, according to the Centers for Disease Control and Prevention.
If you are based in the U.S., and you or someone you know needs mental health assistance right now, call or text 988, or visit 988lifeline.org to access online chat from the 988 Suicide and Crisis Lifeline. This is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week. If you are in another country, you can go to befrienders.org to find a helpline near you.
