Communication Toolkit Targets Groups at High Risk For Suicide

Spreading the word about 988, the national mental health hotline, is a work in progress. Research indicates that only about half of the population is aware of 988, though more than 5 million 988 contacts were recorded between the July 2022 launch and May 2023. 

Most suicide prevention advocates believe we can do better.

To increase awareness and improve the hotline’s usage, the National Action Alliance for Suicide Prevention commissioned the Ad Council to conduct research with those groups at the highest risk of suicide or disproportionately impacted by suicide.  From that came the Communication Toolkit  for organizations to use for targeted messages to these groups, which include: adolescents and young adults of color (American Indian/Alaska native, Asian-American, Pacific Islander, Black, and Hispanic), LGBQIA youth and adults; individuals who have attempted suicide or have had suicidal ideation; people with disabilities, and older men living in rural areas.

Noted in the Toolkit: “Many individual, relationship, community and societal conditions and factors contribute to suicide risk.”   These factor include negative social conditions such as: 

• Racism and discrimination 

• Poverty

• Lack of access to housing

• Education opportunities

• Physical care

• Mental health care

Though there is not a “one size fits all” for messages to these groups, they all shared these concerns about accessing a mental health hotline:  

• Privacy and trustworthiness. “People want to know that 988 counselors will protect their privacy and that conversations are confidential” 

• Training. People who might contact 988 “want to freely share their real experiences with another person, but fear they’ll reach someone who can’t relate or understand them”

• Availability. “People struggling with mental health want assurance they can call/text/chat 988 whenever they need someone to talk to, for free.”

There are subtle differences among the groups, and organizations who are reaching out to the at-risk groups are encouraged to review the Toolkit for more information. 

Here are examples for two of the high-risk groups, LGBTQ+ and rural older men:

LGBTQ+ youth and adults are concerned about the preservation of confidentiality, have reservations about whether or not the counselor they talk to will understand their situation, and worry that the hotline contact might result in a call to law enforcement or an unwanted trip to the hospital.

Rural older men have concerns about the credibility/expertise of the counselor they talk to  and worry that the response they get will be  too “scripted or not personalized.”

All the at-risk groups who participated in the Ad Council’s interviews say they might not use 988 because their individual need might not be “serious enough” and that contacting the hotline might hamper access for someone else who might need it more. 

On that note, a take-away from the research is that using the word “crisis” to describe the hotline, while necessary, can be confusing. “The word narrowed the definition of situations that would warrant contacting 988, thereby alienating the vast majority of our target audience.” 

Advice given in the Toolkit: communicators should avoid terminology that implies 988 is only for crisis/emergency situations.

“In reality, 988 is a source of immediate, free, caring help for those experiencing issues involving mental health or substance use, or those concerned about someone else who is experiencing such issues,” the Toolkit concludes.  

For more guidance on promoting 988, contact the 988 Messaging Task Force or 988Lifeline.org