Best Practices
The Lifeline provides mental health professionals and crisis centers in the Lifeline network with innovative best practices and resources in the field of suicide prevention and mental health.
Research and Evaluation
Since 2001, the 988 Lifeline has been evaluating and strengthening crisis centers’ efforts through an iterative process. In recent years, the 988 Lifeline has also partnered with external researchers on analyses of extant data. The 988’s high service utilization and abundance of analyzable data provides opportunities for researchers to further evaluate the impact of the 988 Lifeline, as well examine other research questions initiated by investigators.
The 988 Lifeline is often approached by researchers to collaborate on new research and evaluation projects.The 988 Suicide and Crisis Lifeline welcomes opportunities to collaborate on research projects with the goal of preventing suicides and mental health crises, and providing a pathway to well-being.
More information, including the application for access to 988 RAD, can be found here.
Resources and Publications
Suicide Safety Policy
In December 2022, the Suicide Safety Policy was released as an update and replacement of the Suicide Risk Assessment Standards and the Helping Callers at Imminent Risk of Suicide Policy. The Suicide Safety Policy (2022) ties together the need for consistent, uniform assessment of safety/risk and clear unified parameters for assisting callers/chatters and texters at highest risk, and requires that 988 Lifeline network centers:
- Utilize the Safety Assessment model to connect and assess the immediate safety of individuals seeking support, listen to and clarify an individual’s story, collaboratively develop a plan for safety, and offer follow-up as needed.
- Utilize active engagement, this encompasses behaviors undertaken by crisis counselors to effectively establish a connection with individuals seeking support from the Lifeline. “Engagement” refers to the building of an alliance that facilitates connection and makes it possible to collaborate with, and empower, the individual to secure their own safety, or the safety of the person they are reaching out about. The word “active” reinforces the need to focus on engagement in phone- or text-based crisis counseling, consciously and intentionally.
- Utilize least invasive interventions and take all action necessary to prevent a person from dying by suicide. In doing so, centers must actively collaborate with individuals at risk to support their own safety and prioritize alternative interventions to 911 emergency service interventions.
- Engage emergency services involuntarily only as a last resort and when a voluntary intervention is not possible.
Formalize collaborative relationships with mobile community crisis services and emergency services.
Follow Up
Research indicates that follow-up with hotline callers and people recently discharged from an emergency department (ED) or inpatient setting has positive results for both consumers and providers of mental health services. Given that suicide risk is highest one week after discharge from an inpatient setting, the 24/7 availability of crisis centers’ services are invaluable. For medium to high risk callers, studies show that centers help to minimize ideation, hopelessness, and psychological pain. Further, crisis center follow-up before a service appointment is associated with improved motivation, a reduction in barriers to accessing services, improved adherence to medication, reduced symptoms of depression and higher attendance rates. Follow-up by crisis centers is also cost effective; it reduces utilization of emergency services and offers diversion to more appropriate services for patients who do not require admission to the hospital.
In a 2015 review of crisis center practices, of 134 centers sampled, 91% (122) provided some form of follow-up service. Programs ranged from follow-up services for frequent callers, monthly check-ins for high risk callers, ED/inpatient discharges, high risk callers, and third party calls.
More Publications
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