Understanding Factors Associated with 911 and 988 Use in Mental Health Crises

The 988 Suicide and Crisis Lifeline was launched in July 2022 as an alternative to 911 for mental health crises. However, little is known about the factors influencing decisions to use 911 or 988 among individuals most likely to benefit from 988, including those with suicidal ideation. This study analyzes individual characteristics associated with the likelihood of calling 911 during a mental health crisis and examines awareness of, willingness to use, and concerns about 988. An anonymous online survey was conducted in early 2024 with 1,894 U.S. adults aged 18-50, oversampling racial minorities. Logistic regression models were estimated for four dichotomized outcomes: likelihood of calling 911 in a mental health crisis, awareness of 988, willingness to use 988, and concerns about 988. Independent variables included demographic characteristics, mental health indicators, perceived stigma, and financial stress. Overall, 53.9% of respondents reported they would call 911 in a mental health crisis, and 22.2% of respondents had heard of 988. After receiving basic information, 71.5% expressed willingness to use 988. However, 87.1% reported at least one concern, and individuals with suicidal ideation were much less likely to express willingness to use 988. Commonly endorsed concerns included law enforcement involvement, forced hospitalization, and service fees. Perceived stigma and financial stress were strongly associated with a higher likelihood of expressing concern. Although many individuals expressed willingness to use 988 when informed, widespread concerns may limit uptake. Our findings suggest that targeted outreach and accurate information could promote greater utilization

Depression (economics · Logistic regression · Mental health · Outreach · Public health · Stigma (botany · Suicidal ideation · Suicide prevention · Mental Health Treatment and Access · Migration, Health and Trauma · Suicide and Self-Harm Studies

• Deflecting Suicide Calls From Law Enforcement With an Embedded Crisis Line Specialist at a 911 Center

  Open Access•Leonard Swanson, Aaron Gottlieb et al.•Community Mental Health Journal•2026

  Incluir item

• Reluctance to Contact Crisis Services Among Youth Who Carry Handguns

  Open Access•Dylan B Jackson, Cashen M Boccio et al.•Youth & Society•2026

  Incluir item

• Deaths of people with mental illness during interactions with law enforcement

  Open Access•Amam Z Saleh, Paul S Appelbaum et al.•International Journal of Law and…•2018

  Incluir item

• The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales

  Open Access•Kurt Kroenke, Robert L Spitzer et al.•General Hospital Psychiatry•2010

  Incluir item

• Contact Between Police and People With Mental Disorders

  James D Livingston, James Livingston•Psychiatric Services•2016

  Incluir item

• The Police and Mental Health

  H Richard Lamb, Linda E Weinberger et al.•Psychiatric Services•2002

  Incluir item

• Deaths Due to Use of Lethal Force by Law Enforcement

  Open Access•Sarah Degue, Katherine A Fowler et al.•American Journal of Preventive…•2016

  Incluir item

• Validation and Utility of a Self-report Version of PRIME-MD The PHQ Primary Care Study

  Robert L Spitzer•JAMA•1999

  Incluir item

• Aggression, Escalation, and Other Latent Themes in Legal Intervention Deaths of Non-Hispanic Black and White Men

  Alina Arseniev-Koehler, Jacob G Foster et al.•American Journal of Public Health•2021

  Incluir item