Thursday, June 2, 2022

Many Behavioral Health Program Directors Feel Unprepared for 988 Rollout, RAND Report Suggests

Beginning July 16, people in the United States experiencing a mental health crisis have to remember only three numbers—988—to connect with trained staff who are part of the National Suicide Prevention Lifeline network. While the rollout of the 988 emergency phone service is just over six weeks away, a RAND Corporation report released today suggests that many state, regional, and county behavioral health program directors are feeling unprepared for this transition.

The findings were based on an online survey of 180 state, regional, and county behavioral health program directors who, according to the authors, “represented jurisdictional coverage of more than one-third of the U.S. population and 23 states.” The survey, which was conducted between February 8 and March 17, asked the directors questions pertaining to four domains: strategic planning, financing, infrastructure, and service coordination.

More than half (51%) of survey participants reported that they had not been involved in the development of a strategic plan related to the launch of 988. Similarly, only 16% of respondents reported that they had helped develop a budget to support 988 operations.

Other key takeaways from those surveyed were as follows:

  • 85% of respondents reported that there was a mental health emergency response hotline or call center operating in their jurisdiction; 48% reported that at least one of their crisis call centers or hotlines was part of the Lifeline network that will field the 988 calls; and about 22% reported they did not know whether the number that services their jurisdiction is part of the Lifeline network.
  • 48% of the respondents’ jurisdictions had a short-term crisis stabilization program, but only 28% possessed urgent care units for mental health. Additionally, only 22% of jurisdictions had crisis call centers or hotlines that can schedule intake and outpatient appointments on behalf of individuals in need.
  • 55% of respondents reported that their crisis call center or hotline staff were trained to interact with children and adolescents; fewer than half reported staff with training to work with people who are homeless (46%) or identify as LGBTQIA+ (45%); and 22% reported staff trained to interact with individuals from Indigenous communities.

“Our findings have confirmed what many advocates and experts feared: communities throughout the U.S. have not had the time or resources to adequately prepare for the debut of the 988 hotline number,” Ryan McBain, Ph.D., M.P.H., of RAND said in a press release.

In December 2021, Psychiatric News reported on how some states, including Colorado, Nevada, Virginia, and Washington, had enacted laws to prepare for the 988 transition. These new laws are meant to help build out local call center infrastructure, manage increases in call volume that are expected when 988 goes live, and create new local crisis services to serve those in need. Perhaps most importantly, each of these states has included in its law an ongoing means of funding these new crisis services by tacking a small user fee on residential and commercial phone bills, as has been done for 911 for decades.

“Although mandated at a national level, the launch of 988 will require substantial effort on the part of state and local agencies to ensure sufficient capacity to handle these calls and connect callers with local mental health emergency services if needed,” said Stephanie Brooks Holliday, Ph.D., M.S., of RAND. “Our findings show much more work needs to be done.”

In addition to working with district branches to advocate for legislation supporting 988 implementation in states that have not yet done so, APA joined a coalition in March to drive awareness and support among state and municipal officials for the nationwide transition to the new 988 hotline. APA urges members in states that have not passed legislation to implement 988 to contact their district branch and get involved in advocacy on this issue. For more information, contact Erin Philp of APA’s Division of Government Relations.

For related information, see the Psychiatric News article “Transition to 988 Offers Opportunity to Transform Crisis Care.”

(Image: iStock/Gajus)

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