Building a Lifeline: 988 Crisis System Insights

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Yesterday, I attended the National Alliance for Mental Illness’ 2024 Pennsylvania Mental Health and Wellness Conference, right within a day trip drive for me.

Deputy Secretary Deb Smith of PA’s Office of Mental Health and Substance Abuse Services delivered the opening remarks. The discussion focused on the 988 crisis system, examining its implementation, challenges, and the intersection of lived experience and policymaking. Here are some key takeaways from the session.

The Intersection of Lived Experience and Policymaking

Deputy Secretary Smith emphasized the importance of integrating lived experiences into policymaking. She highlighted how personal credibility and rhetoric are vital in creating policies that truly serve those in crisis. Lived experience brings invaluable insights, ensuring that the policies crafted are not just theoretical but practical and effective.

Building a Crisis System that Works for Everyone

A robust crisis system hinges on three main components: someone to call, someone to respond, and somewhere to go. The 988 prevention lifeline is central to this structure.

  1. Someone to Call (988 Prevention Lifeline). The 988 lifeline has seen a significant increase in call volume, with an 89% answer rate. While this is commendable, it’s perplexing that it’s not 100%. This gap indicates a need for more call centers and increased capacity to ensure that every call is answered promptly. More call centers are coming online, which is a positive step towards meeting the growing demand.
  2. Someone to Respond. Mobile crisis outreach teams are another critical component. Currently, 80% of areas have access to these teams, although some regions, like PA, have struggled to reach full availability. In PA, the responsibility for building this capacity has been designated to the 67 counties, bringing the decision-making closer to the people in need.
  3. Somewhere to Go. Walk-in and stabilization centers are essential for providing immediate support. However, building and maintaining these centers are resource-intensive. The Substance Abuse and Mental Health Services Administration (SAMHSA) aims to improve access to these centers, but the current funding of $5 million seems insufficient given the resource demands.

Challenges and Solutions

Smith pointed out several barriers to implementation, such as zoning issues and inconsistent funding. One innovative approach to overcoming these barriers is breaking down 988 data by census tracts. This granularity can help identify specific areas of need and tailor resources more effectively.

In conclusion, while significant strides have been made in implementing the 988 crisis system, there are still challenges to address. Integrating lived experiences into policymaking, increasing call center capacity, expanding mobile crisis outreach, and securing adequate funding for stabilization centers are crucial steps. The session underscored the importance of a comprehensive approach to building a crisis system that truly works for everyone.

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