These populations are also more at risk of incarceration. According to November 2021 data from the Washington Post’s police shooting database (7), of people killed in the United States by a police officer in the line of duty since January 1, 2015, 23% were Black, 16% were Hispanic, and 23% were identified as having a mental illness. This is especially vital for supporting marginalized and disenfranchised populations, who are disproportionately most at risk of police interactions turning deadly (6). However, a confluence of factors has magnified the need for change, including the COVID pandemic and increased awareness of racial and ethnic disparities in law enforcement interactions brought into focus by the murder of George Floyd by four Minneapolis police officers in May 2020.Īs a result, leaders have leaned further into finding alternatives to justice system entanglement for people with behavioral health and quality-of-life challenges and reforming crisis systems to better meet people’s needs. Tools such as the Sequential Intercept Model, developed by Munetz and Griffin (4), and resources promoted by SAMHSA’s GAINS Center, as well as Stepping Up (5), a national initiative to reduce the number of people with mental illness in jails, have helped advance this cause. This expanded framework for reform has been accompanied by greater recognition of inequities associated with reliance on law enforcement as the de facto responder for behavioral health and quality-of-life crises. In recent years, crisis care reform has expanded to include not only addressing long-standing problems in providing appropriate care to people in mental health crises but also ensuring that people experiencing substance use crises receive such care. We focus on imminent opportunities and provide links to resources helpful in regional or local crisis redesign efforts.ġ The term behavioral health has evolved to include both mental and substance use disorders.Ģ As of November 2021, there were 194 Lifeline accredited call centers, with seven more in the final onboarding phase. This paper describes examples and new resources to improve the care of people experiencing behavioral health crises. As states move toward 988 readiness, communities must capitalize on this momentum to meet local needs. Expansion plans have also included the evolution of crisis call centers into hubs that can dispatch mobile crisis teams and provide real-time data on and access to crisis facilities. Many communities across the U.S., increasingly aware of gaps in the overall crisis response continuum, had already started or planned to re-engineer and build out their systems, including mobile crisis services and crisis facilities. Three months after Pai’s announcement, Congress passed the National Suicide Hotline Designation Act of 2020, supporting 988 implementation and allowing states to apply a monthly telecom customer service fee to pay for 988-related services.
#Sequential intercept model and systems integration code
All 988 calls-and, potentially, texts-will go to the centers, filtered by area code unless callers press 1 to reach the Veterans Crisis Line, the national crisis call system operated by the Veterans Administration. The Lifeline, run by Vibrant Emotional Health, is a network of about 200 2 accredited call centers. The United States took a vital step toward this goal in July 2020, when Federal Communications Commission (FCC) Chairperson Ajit Pai announced a nationwide three-digit number that would “effectively establish ‘988’ as the ‘911’ for mental health emergencies.” Under Pai’s guidance, the FCC adopted rules requiring all phone service carriers to direct 988 calls by July 16, 2022, to the existing National Suicide Prevention Lifeline (2), which the Substance Abuse and Mental Health Services Administration (SAMHSA) funds.
Instead, experts envisioned a well-funded, interconnected emergency system for behavioral health crises, with a continuum of services and supports that would help foster parity while reducing stigma and criminalization. And, like 911, the innovation wouldn’t be just a number. For years, behavioral health 1 advocates and experts have pushed for a three-digit number for mental health, substance use, and suicide crises-a number that would be on par with and, hopefully, as ubiquitous as 911 is for medical emergencies. Most people cannot remember a time before 911, when people in an emergency dialed 0 for an operator or directly called or ran to the nearest police or fire station.
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