Is your facility or organization prepared?

An opportunity to expand mental health and substance abuse care is coming to the United States very soon.

In the midst of all the chaos generated by the pandemic, the Federal Communications Commission adopted rules established by unanimous consent by Congress to create 988 as a new nation-wide 3-digit phone number for citizens to call to reach suicide prevention and mental health crisis counselors.

While the implications for citizens are pretty clear to us, there is also a wave of things local mental health and substance abuse facilities should begin considering now to prepare.

First, let’s look at what the new 988 crisis number is.

In the same way one might call 911 to receive emergency services, beginning in July 2022, dialing the number 988 will connect you to already established regional mental health and substance abuse crisis line whose experts can dispatch mobile crisis units or direct you to appropriate resources.  While the focus seems to be suicide prevention, crisis hotline counselors will also be referring people to local treatment providers.

“People deserve help, not handcuffs,” said Angela Kimball, national director of advocacy and public policy at the National Alliance on Mental Illness. “The idea is to assume that the vast majority of crisis calls really aren’t going to need law enforcement involvement, and more and more locations are starting to explore that model.”

But there is one glaring challenge with this plan:  Are local treatment providers ready and able to provide these additional services?

“The intent is that 988 would eventually be able to dispatch and connect with a range of crisis response services – mobile crisis teams, crisis stabilization programs,” Kimball said. “However, that infrastructure is highly localized, so whatever might be available in one state may be very different.”

There are already models in some cities like Eugene, Oregon, where two-person teams consisting of a medic and a crisis worker respond to mental health crises calls through a program called Crisis Assistance Helping Out On The Streets (CAHOOTS). White Bird Clinic, a health care center in the city, launched the program as a community policing initiative in 1989.

In order for the national roll-out of the 988 system to work, however, there will need to be coordinated local effort between 988 crisis hotline teams, law enforcement and local treatment providers.

Some things to consider now:

  • Determine the scope of the problem in your area by researching regional statistics. Theoretically, after 988 is implemented, there will an increase in referrals.
  • Does your community need an organized effort to establish or increase funding and resources for a 988 Lifeline Center? While the main Lifeline system is federally funded, the network’s local call centers require their own funding.
  • Are your local elected and emergency services leaders ready to collaborate with treatment providers to provide mobile mental health crisis services? If the conversation hasn’t been started, maybe now is a good time to reach out to them.
  • Is your leadership team thinking about what impact an increase in referrals may have on your organization? If not, you only have two short years to develop a strategy for managing capacity issues.
  • Are your providers and facility credentialed to provide mobile crisis services? Because the credentialling process can take a long time to complete, now may be a good time to start the process.
  • Is your billing team prepared to submit crisis-related claims? The billing codes and submission process is unique, so now is a good time to start researching the specific details for billing crisis services.

It’s an exciting time to be a mental health and substance abuse treatment provider.  The president issued an executive order in October 2020 increasing federal support for mental and behavioral health needs.  The FCC is working hard to establish a mental health crisis number by July 2022.  SAMSHA is developing grant opportunities to increase capacity for the coming years.  A global pandemic is creating higher demand for your services.

We at Substance Solutions hope this blog post and the resources linked below give you some ideas for how your treatment facility can start preparing now for the opportunities that are coming.

Feel free to reach out to us anytime with questions, comments or concerns.  We love working with providers to find answers to big challenges.

 

RESOURCES

Implementation of the National Suicide Hotline Improvement Act of 2018 (WC Docket No. 18-336)

SAMHSA Grant Announcements 2021

National Suicide Prevention Lifeline Network Partnership Information

National Guidelines for Behavioral Health Crisis Care Best Practice Toolkit

A Community-Based Comprehensive Psychiatric Crisis Response Service Informational Monograph

Crossing the Quality Chasm: A New Health System for the 21st Century (Institute of Medicine, 2001)

CAHOOTS:  Crisis Assistance Model Program