Bornheimer, L. A., Lapidos, A., Brdar, N. M., Campbell, M., Palaniappan, G. S., Song, J., Miner, C., Anderson, E., Hoener, K., Florence, T., Sperry, S. H., & Ilgen, M. A. (2026). Modifying an intervention to increase use of the 988 Suicide and Crisis Lifeline among patients with bipolar disorder in community mental health. Journal of Affective Disorders, 397, 120922. https://doi.org/10.1016/j.jad.2025.120922
Abstract
Background
Although the 988 Suicide & Crisis Lifeline is considered a suicide prevention best-practice approach, national survey data show low rates of utilization and it is unclear if this resource reaches individuals with bipolar disorder (BD) who are at elevated for suicide. This study sought to modify a Crisis Line Facilitation (CLF) intervention to increase 988 Lifeline use when in suicide crisis with tailoring for specific BD symptoms in community mental health (CMH).
Methods
Participants (n = 11) included CMH stakeholder clients, mental health providers, peer support specialists, and leadership. Qualitative interviews were conducted to explore perceptions about CLF modifications, barriers and facilitators, and sustainability for CMH clients with BD. Data were transcribed and analyzed in Dedoose using a hybrid analytic approach with inductive and deductive coding.
Results
Participants perceived the CLF intervention to have potential to help clients with BD when in a suicide crisis, and qualitative themes highlighted the importance of BD symptom tailoring in suicide prevention efforts, addressing barriers to help-seeking such as stigma, bolstering provider skills to deliver tailored interventions with BD populations, and building awareness of the 988 Lifeline. Modifications to CLF from study findings included a BD-specific suicide risk checklist, visual aids of illness cycles, and enhanced clinician training.
Conclusion
CLF modifications for BD encourages the use of the 988 Lifeline and promotes provider readiness for delivering suicide prevention in CMH settings. These results set the stage for pilot testing that is forthcoming and the advancement of more research on its effectiveness and implementation.