Four years after the launch of the 988 Suicide & Crisis Lifeline, more than 26 million people have used the number to connect with trained crisis counselors by phone, text or online chat. But many older adults, who face one of the nation’s highest suicide risks, remain largely unaware that this resource exists, a new poll finds.
A new University of Michigan National Poll on Healthy Aging found that nearly one-third (31%) of adults age 50 and older said they have never heard of any mental health crisis line. Nearly seven in 10 (69%) said they had never heard specifically of 988, suggesting that while some recognized older crisis resources, awareness of the national three-digit number remains low.
The findings point to a significant challenge for public health professionals and for journalists covering aging and mental health. Expanding crisis services is only one part of suicide prevention. Knowing where to turn, understanding what will happen when people reach out, and trusting that services will address their concerns are also critical.
Although suicide prevention efforts have increasingly focused on adolescents and younger adults, researchers say older adults require tailored strategies that account for the realities of later life.
Why awareness matters
A 2025 review published in Nature Reviews Psychology found that older adults have higher suicide rates than other age groups and that older people who engage in self-harm are more likely to have greater intentions to die and use more lethal methods.
The review identified several age-related contributors, including declining health, loss of independence, reduced social connection, bereavement and barriers to mental health care. The University of Michigan poll offers a starting point for that reporting.
For health journalists, the Michigan findings offer several avenues for story ideas:
- How visible is 988 in your community? Ask hospitals, primary care practices, senior centers, health care systems and Area Agencies on Aging how they promote the service.
- Who is using crisis services? Request local 988 data by age, race, ethnicity and language, if available.
- Are older adults receiving age-specific crisis care? Explore whether local crisis centers train counselors on dementia, caregiving stress, grief, chronic illness and disability.
- How sustainable is funding? Examine how your state is supporting 988 call centers and mobile crisis response programs.
Who knows about 988 — and who doesn’t
The poll, conducted by the University of Michigan Institute for Healthcare Policy and Innovation, surveyed 2,379 adults ages 50 to 95 as part of a nationally representative survey conducted by NORC at the University of Chicago. Among respondents, awareness varied by demographic group.
Men were less likely than women to report knowing about a mental health crisis hotline. Hispanic adults were also less likely to report awareness; nearly half (46%) said they had never heard of any mental health crisis hotline.
The results suggest that lack of familiarity is a major barrier. After survey respondents received an explanation of what 988 provides, three-quarters (75%) said they would feel at least somewhat comfortable contacting the service if they or someone they knew experienced a mental health crisis. However, men remained less likely than women to report comfort using the service (68% compared with 81%). Many older adults also continue to see health care providers, family members or friends as their first sources of help.
That pattern is consistent with a 2025 study published in Health Affairs Scholar examining mental health crises and help-seeking among U.S. adults. Researchers analyzed nationally representative data from the COVID-19 and Life Stressors Impact on Mental Health and Well-being (CLIMB) study and found that 8.9% of adults reported experiencing a mental health crisis in the previous year. Among those who sought help, 53.2% contacted a healthcare provider and 39.8% relied on family or friends, while 17.5% contacted 988. The authors concluded that improving awareness and access to trusted support remains a key challenge.
Privacy concerns may limit use
Even when older adults know about 988, concerns about confidentiality may prevent some from reaching out.
The Michigan survey found that 49% of adults age 50 and older expressed at least one concern about contacting a crisis line. Privacy was the most common concern, cited by 26%. Knowing they could remain anonymous would make them more likely to use 988, 40% of respondents said.
Explaining what happens during a 988 call may be an important part of reducing stigma and increasing use among older adults. All communications with counselors at the 988 Lifeline are confidential, and emergency responders are not automatically sent unless there is an immediate risk requiring intervention under applicable laws. The service also provides specialized support through the Veterans Crisis Line and offers access for people who are deaf or hard of hearing and for those who prefer languages other than English.
What research shows about 988’s impact
Research examining the early impact of 988 has found encouraging results. Early evidence suggests 988 may contribute to improved suicide prevention outcomes, although researchers caution that the findings do not prove causation.
A 2026 JAMA study by researchers from Harvard Medical School found that suicide mortality among adolescents and young adults was lower than expected during the first two-and-a-half years after the launch of the 988 Lifeline. The researchers estimated an 11% reduction among people ages 15 to 34 compared with projected rates based on earlier trends, with larger declines in states with higher 988 utilization.
However, older adults remain an important population requiring more attention. Although the study found encouraging results among younger age groups, suicide rates among older adults remain among the highest of any age group, and awareness and use of crisis resources such as 988 remain comparatively low.
Expanding outreach to older adults — and ensuring crisis services address issues more common in later life, including chronic illness, grief, pain and social isolation — will be critical to maximizing the impact of 988, researchers said.
What’s next
“We recognize that there is still important work to do to ensure awareness of 988 becomes more widespread. We appreciate the research and insights that help us better understand where opportunities for growth remain and will use these findings to strengthen our outreach and marketing strategies so that more people know compassionate support is available through 988 whenever it is needed,” said Wendy Martinez Farmer, vice president of 988 strategy, quality improvement and clinical standards at Vibrant Emotional Health, the company that supports the the 988 Suicide & Crisis Lifeline.
The findings do not mean 988 alone prevents suicide. Researchers emphasize that crisis lines are one component of a broader prevention system that includes health care access, social supports, treatment for mental illness and interventions addressing isolation and other social factors.
