College Students Appear Resistant to Using 988 Crisis Phone Line

Alexandria, Va. (February 20, 2024) — The 988 Suicide and Crisis Lifeline launched across the U.S. nearly 2 years ago. But college students — who are particularly vulnerable to substance use problems and related mental health crises — appear disinclined to use it, according to new research published in the Journal of Addiction & Offender Counseling, a publication of the American Counseling Association.

“While the 988 Lifeline is intended to be used for substance use crises, the majority of students would not refer to this service for said concern,” Georgia State University doctoral student Afroze N. Shaikh and her colleagues concluded in their research. “Further effort is needed to assist college students in gaining awareness of crisis resources while supporting the agency to make informed decisions regarding their substance use.”

According to federal government data, 8.2 million adults ages 18–25 meet the criteria for a substance use disorder. Researchers have identified a link between substance use, depression and suicidal thinking, but studies also show that college-age students are unlikely to seek help for substance use and mental health problems.

The U.S. Department of Health and Human Services helped launch the 988 Lifeline in 2022 to provide an easy-to-remember dial code, akin to 911, for people in need of emergency help during a mental health crisis. Shaikh and her colleagues wanted to assess college students’ intentions to call or text 988 for substance use concerns. They recruited 446 undergraduates at a university in the southeastern U.S. and had them anonymously fill out a battery of questionnaires. The participants anonymously rated their level of tobacco, alcohol, marijuana and other drug use within the previous three months. They also were asked about their use of and experience with the 988 service.

More than 60% of the students reported using drugs or alcohol less than once a month or not at all. Roughly 18% reported daily or near-daily substance use, and another 10% reported weekly use.

Overall, the students said they were most likely to seek help from a friend or intimate partner for mental health problems and suicidal thoughts. They indicated that if they ever were to call 988, it would be for help with depression, anxiety or emotional distress. Only 15% said they’d use it for help with substance use problems. Fewer than 20% of the heaviest substance users indicated they would use the Lifeline for help.

The researchers cautioned that their study relied on self-reports — which can’t account for participants’ biases or lies — and involved mostly heterosexual, cisgender students at a single university. They called for more research involving a wider range of settings and cultural identities.

However, the findings signal the need for colleges and universities to guide students in making informed decisions about their substance use, they wrote. In addition, state governments can make sure students and other individuals in crisis know about the new crisis number. College counselors may consider developing resource guides for students that include suicide risk factors and crisis resources, including the 988 Lifeline, they added.

Shaikh’s collaborators on the study were her Georgia State colleagues Alec Prince and Mark Burgan; San Diego professional counselor Lauren Flynn; Virginia Tech doctoral student Alexis Isaac; and Jamian Coleman, PhD, of the University of Tennessee, Knoxville.

The study, “Implications of the 988 suicide and crisis lifeline among college students experiencing substance use crises,” is available at https://doi.org/10.1002/jaoc.12131.

NOTE TO JOURNALISTS: To schedule an interview with the authors, please contact ACA at news@counseling.org.

Founded in 1952, the American Counseling Association (ACA) is a not-for-profit, professional and educational organization that is dedicated to the growth and enhancement of the counseling profession. ACA represents nearly 60,000 members and is the world’s largest association exclusively representing professional counselors in various practice settings. Driven by the belief that all people can benefit from the power of counseling, ACA’s mission is to promote the professional development of counselors, advocate for counselors, and ensure that ethical, culturally inclusive practices protect our members’ clients and all people who seek counseling services.