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JAMA paper says more research is needed to optimize crisis hotlines, including “988” suicide prevention line

Crisis lines are often effective at reducing immediate distress and reducing suicide risk, but substantial knowledge gaps remain

RESEARCH TRIANGLE PARK, N.C. — In a new paper published in the Journal of the American Medical Association (JAMA), researchers at RTI International, a nonprofit research institute, highlight the need to better understand the factors that influence the effectiveness of crisis hotlines.

The paper comes in the wake of the launch of the 24-hour  “988” crisis line in the U.S., which connects callers to the National Suicide Prevention Lifeline. It was made available in July 2022 and is funded by the Substance Abuse and Mental Health Services Administration.

“While initial research supports the use of crisis lines, as a research community, we really do not understand how and to what extent they prevent  suicide deaths,” said Adam Bryant Miller, Ph.D., study author and a research clinical psychologist at RTI. “This paper brings that issue forward and offers a roadmap for future research to ensure crisis lines are backed with more scientific rigor.”

Available evidence reviewed by the authors found that crisis lines are often effective at reducing immediate distress and reducing suicide risk, but substantial gaps remain in the understanding of how crisis lines can be optimized to be most effective for individual consumers.

The paper includes a list of unanswered questions for future research, including:

  • How do cultural differences or similarities between the caller and counselor influence outcomes?
  • How do demographic factors such as age, biological sex, gender identity and race/ethnicity influence what happens in a crisis conversation?
  • What are disparities in accessing crisis lines in the U.S.?
  • Do counselor qualifications relate to crisis line effectiveness?

The paper was supported by grants from the National Institute of Mental Health and the Centers for Disease Control and Prevention.

View the JAMA paper