Crisis Lines: Current Status and Recommendations for Research and Policy

Area of Science:

• Public Health
• Mental Health Services Research
• Telecommunications Policy

Background:

• The National Suicide Hotline Designation Act of 2020 established the 988 telephone number to improve access to the National Suicide Prevention Lifeline.
• Implementation in July 2022 highlights the need for adequate financial and training resources for effective crisis line operation.
• Existing literature on crisis support lines requires further examination in the context of the 988 transition.

Approach:

• A comprehensive literature review was conducted to assess the current state of research on crisis support lines.
• The review synthesized findings on suicidal and nonsuicidal caller outcomes, diverse crisis support services, and the efficacy of text- and chat-based modalities.
• Emphasis was placed on identifying research gaps, particularly concerning marginalized populations and digital communication channels.

Key Points:

• Current evidence for crisis line effectiveness is limited, primarily demonstrating short-term reductions in user distress and increased satisfaction.
• There is a notable lack of research focusing on crisis lines tailored to marginalized populations, such as sexual minority groups.
• Research on the effectiveness and implementation of text- and chat-based crisis lines remains underdeveloped.

Conclusions:

• Policy recommendations include increased investment in research, development of culturally competent training programs, and robust ethical oversight for data privacy.
• Scaling up state-level planning and comprehensive crisis systems is crucial for successful 988 implementation.
• Addressing current gaps in training and research is essential for enhancing the capacity and effectiveness of crisis support services.