Where the 988 mental health hotline is used most — and least
Why it matters: The service was launched nearly three years ago to help address America's mental health crisis — but gaps persist.
Driving the news: Alaska (45.3 contacts per 1,000 people), Vermont (40.2) and New York (38.8) had the highest 988 contact rates among states in 2024, per new research published in JAMA Network Open.
Delaware (12.5), Alabama (14.4) and Florida (15.6) had the lowest.
The big picture: The 988 service fielded more than 16.3 million calls, texts and chats between July 2022 and the end of 2024.
The national contact rate was 48.9 per 1,000 people during that period, and 23.7 in 2024 alone.
How it works: "Contacts" include all calls, texts and chats sent to 988, including those forwarded along to more specific services, like the Veterans Crisis Line and the LGBTQ+ Line.
Geography for calls and chats was assigned based on users' phone numbers, while texts were assigned by ZIP codes shared during pre-chat surveys.
What they're saying: Several factors may be contributing to the state and regional differences in 988 use, says study author Jonathan Purtle, associate professor and director of policy research at New York University's School of Global Public Health.
That includes differences in how 988 is being advertised by states and cities, as well as political attitudes.
Many Americans remained unfamiliar with 988 as of last summer, per Ipsos polling.
And surveys have found that Democrats are more likely than Republicans to use 988, Purtle says: "We see this shake out in the map — in the South and more right-leaning places, we see lower volume."
Caveat: Less populous states have more variability due to their relatively smaller sample sizes, Purtle notes.
The latest: The Trump administration's proposed Health and Human Services budget would cut 988 services specifically tailored for LGBTQ+ youth, Axios' Avery Lotz reports.
What's next: Last year's nationwide 988 contact rate was less than half the rate of adult emergency room visits related to mental health, the analysis finds, despite ERs' cost and access issues.
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