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SACHA PFEIFFER, HOST:

The 988 Suicide & Crisis Lifeline turns 2 tomorrow. Over the past two years, millions of people have contacted this lifeline in moments of crisis either by phone, text, or chat. Since then, the system has gotten a lot better at connecting people to help more quickly. But as NPR's Rhitu Chatterjee reports, it still has a long way to go.

RHITU CHATTERJEE, BYLINE: The first time Liz Orviz reached out to 988 was shortly after the number launched in July 2022. The 40-year-old lives near Detroit, Mich., and was struggling with depression and thoughts of suicide.

LIZ ORVIZ: They have an option to do text or call. And I was feeling, like, I'm not sure I can call, I'll try text. But when I went to text, there was so much you had to read.

CHATTERJEE: Tems, conditions, privacy and security declaration.

ORVIZ: When I am in a, like, depressive crisis, I'm not able to read, so I couldn't do it. So then I called, and they put me on hold.

CHATTERJEE: After waiting on hold for several minutes, Orviz hung up.

ORVIZ: It was very frustrating. It was just a really negative experience.

CHATTERJEE: When her suicidal thoughts came back a few months later, she tried calling 988 again. This time, it was a completely different experience.

ORVIZ: They picked up right away. They were very compassionate. They said, you know, what coping skills has worked for you in the past? Have you tried any of them? What else could we try?

CHATTERJEE: Just the kind of help she needed at that moment - since then, Orviz has called many times, and each time, she's been able to speak to a counselor. She's among the millions of people who've used the 988 Suicide & Crisis Lifeline, says Hannah Wesolowski.

HANNAH WESOLOWSKI: About 10 million people have reached out in the last two years.

CHATTERJEE: Wesolowski is chief advocacy officer with the National Alliance for Mental Illness, or NAMI.

WESOLOWSKI: Answer rates are high. People's wait times to talk to somebody on the phone are down. You know, there's a lot of good news coming out of 988, but we've always known that this was a work in progress.

CHATTERJEE: Take, for example, one of the findings of a new poll by Nami.

WESOLOWSKI: Of the people who report contacting 988, about 7 in 10 say they got the help that they needed. So we want that to be 10 in 10.

CHATTERJEE: One problem is that the 988 lifeline is a network of over 200 local call centers that operate with state laws and funding, and there's a lot of variation across states, says Angela Kimball. She's the chief advocacy officer at Inseparable, a mental health nonprofit.

ANGELA KIMBALL: And that means there are very disparate systems from state to state and even between counties in a state. So there is an unevenness, and I think that's a real challenge.

CHATTERJEE: In New York City, 36-year-old Dionna Peddy has contacted 988 nearly 15 times in the past two years. She says her overall experience has improved, but...

DIONNA PEDDY: Sometimes I'm on hold for, like, at least 15 minutes, and then eventually, I just hang up.

CHATTERJEE: And even when she's connected with a counselor, the help has been uneven.

PEDDY: Sometimes, I'll get somebody who maybe isn't really experienced, so they don't really know what to say. But there are times I'll get somebody who's, like, extremely helpful.

CHATTERJEE: And as the new NAMI poll shows, an even bigger problem for 988 is that only 1 in 4 people know about it. Bob Gebbia is the CEO of the American Foundation for Suicide Prevention.

BOB GEBBIA: I am starting to see posters, things on train stations. You're starting to see more of that, which is great, but we know we have to do a lot more to make the public aware of it because we know there are people who are struggling and are not calling.

CHATTERJEE: The Substance Abuse and Mental Health Administration is launching a five-month national ad campaign this year to raise awareness about 988. Gabba says, suicide remains a leading cause of death in this country.

GEBBIA: It's now over 49,000 people in our country are taking their lives. That number has to start to come down.

CHATTERJEE: And that, he says, should remain a priority going forward.

Rhitu Chatterjee, NPR News. Transcript provided by NPR, Copyright NPR.

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