The Impact of Suicide Hotlines on Health: Evidence from 988 Implementation | NBER
Skip to main content
Search
Search
The Impact of Suicide Hotlines on Health: Evidence from 988 Implementation
Benjamin Hansen,
Niketana Kannan
& Jonathan Zhang
Share
Bluesky
Threads
Link
Working Paper 35601
DOI 10.3386/w35601
Issue Date August 2026
This paper examines the impact of the National Suicide Hotline Designation Act, which introduced the universal 988 calling code and earmarked federal funding to suicide crisis call centers in July 2022. We use a difference-in-differences design that leverages pre-existing cross-state variation in crisis line capacity gaps, measured by the number of pre-988 calls routed to a state but not answered in-state. The rollout substantially improved crisis line operations in states with larger baseline capacity gaps: these states answered more calls in-state and increased their in-state answer rates. However, these operational gains did not translate into detectable reductions in suicide mortality. The mortality estimates are precise enough to rule out even modest short-run reductions. We also find no statistically significant improvements in broader population mental health outcomes. These findings suggest that expanding crisis line capacity alone may be insufficient to reduce suicide deaths.
Acknowledgements and Disclosures
Jiae Kim provided excellent research assistance. We thank Shari Eli, Bocar Ba, Jonathan Cantor, Julian Reif, Lise Vesterlund, Tianyi Wang, and seminar participants at ASHEcon 2025, BEDI Health & Wellness Conference, and Southeastern Health Economics Study Group for their valuable suggestions and feedback. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
Citation and Citation Data
Copy Citation
Benjamin Hansen, Niketana Kannan, and Jonathan Zhang, "The Impact of Suicide Hotlines on Health: Evidence from 988 Implementation," NBER Working Paper 35601 (2026), https://doi.org/10.3386/w35601.
Copy to Clipboard
Download Citation
MARC
RIS
BibTeΧ
Download Citation Data
Related
Topics
Public Economics
National Fiscal Issues
Health, Education, and Welfare
Health
Programs
Economics of Health
Public Economics
More from the NBER
In addition to working papers, the NBER disseminates affiliates’ latest findings through a range of free periodicals — the NBER Reporter, the NBER Digest, the Bulletin on Health, and the Bulletin on Entrepreneurship — as well as online conference reports, video lectures, and interviews.
2026, 18th Annual Feldstein Lecture, Mark Duggan, "Social Security Reform in an Era of Fiscal Deficits"
Feldstein Lecture
Presenter:
Mark Duggan
Mark Duggan, who is currently the Wayne and Jodi Cooperman Professor of Economics at Stanford University and will soon...
2026, Methods Lecture, Melissa Dell and Ashesh Rambachan, "Estimation and Inference with AI-Generated Data"
Methods Lectures
Presenters:
Melissa Dell
& Ashesh Rambachan
Research Associate Melissa Dell of Harvard University and Ashesh Rambachan of MIT delivered the 2026 Methods...
2026, SI Household Finance, Paul Goldsmith-Pinkham, "Using AI in Household Finance Research: A Practical Guide"
Video
Presenter:
Paul Goldsmith-Pinkham
Supported by the Vanguard Group
Follow
© 2026 National Bureau of Economic Research. All Rights Reserved.