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Robust Crisis Response Systems Support Mental Health and Prevent Suicide

Renee Gross, JD
Renee Gross, JD
Senior Health Policy Consultant, Kaiser Permanente Institute for Health Policy

As a volunteer counselor for crisis support services in Alameda County, California, I answer calls from people in crisis who come from very different backgrounds and social circumstances. Their stories reflect a tapestry of emotions, challenges, and perspectives. I am often struck by a caller’s willingness to share their life experiences and struggles, and desire for human connection as part of their path forward. A recent influx of calls reveals that the COVID-19 pandemic and economic recession have negatively affected many people’s mental health in new and profound ways. The growing mental health crisis in our country makes the months and years ahead a critical time to examine our collective plan for augmenting crisis care support and services.

As we turn our attention to National Suicide Prevention Month in September, our country has much to reflect on in terms of strengthening our mental health crisis response systems. The U.S. Department of Health and Human Resources’ Substance Abuse and Mental Health Services Administration (HHS SAMHSA) hopes to reach more people in crisis with the launch of 988 – our nation’s new three-digit phone and texting number for national suicide prevention and mental health crisis. One goal of this  simplified number is to help people living with mental health conditions and their friends and families quickly access help during a crisis.

While we are in the early days of understanding how 988 will be used and implemented across states, there are several considerations that are critical to its ultimate effectiveness and adoption:

  • Stigma reduction and increased awareness will drive up demand. In just the first week of launching 988, the line saw a 45% increase in calls. As more people are affected by mental health issues, experts expect 988 to generate a greater call volume – growing from 4 million in 2021 to 13 million by 2026.
  • Growing the mental health workforce will remain a critical piece of the puzzle. Many states already use a combination of volunteers and paid staff to operate their crisis call centers, along with routing calls to back-up and out-of-state centers. The need for services will put greater demands on mental health providers, a profession facing countrywide shortages.
  • States will need continuous support to improve their readiness and engage in long-term planning. Given high inflation and rising federal interest rates, it’s a challenging time for states to levy new fees on consumers that would provide a predictable source of funding to operate crisis centers. To assist with implementation, the Biden administration allocated $272 million in grants to states and territories, along with an additional $150 million included in the gun violence legislative package passed by Congress in late June 2022.
  • The 988 number communicates a sense of urgency in addressing our country’s mental health needs. HHS Secretary Xavier Becerra underscored that 988 is much more than a functional number, “it’s the signal to America that…we want to strengthen that service and we want to make it consistent. We won’t have the luxury of decades like 911 had to get on the ground and running.”

The launch of 988 is a positive step toward building a continuum of care that ensures appropriate responses to those in crisis, while also reducing stigma, increasing awareness, and creating more avenues for all people to access mental health crisis care.

Kaiser Permanente is committed to building a system that increases the effectiveness of crisis response. For example, Kaiser Permanente Washington is working with state leadership to access information about members who call 988 or their local crisis line so that we can coordinate follow-up appointments with a health care clinician. Additionally, our Northwest region is increasing the number of behavioral health consultants in all primary care clinics to help meet the increased demand for mental health services. All regions are updating their online and written materials to reflect the new 988 number, and we aim to raise additional awareness among our patients and members in the months ahead.

In addition to 988, Kaiser Permanente supports several other opportunities to expand access to high-quality crisis care services:

  • We support state-level task forces charged with developing and coordinating improvements to crisis stabilization programs.
  • We support the expansion of funding for regional crisis call centers so that these centers can provide 24/7 intervention through different modalities (phone, text or chat).
  • We support providing additional federal and state grants to ensure centrally deployed mobile crisis teams are available 24/7. This is a critical tool for building responsive crisis call centers.
  • We support state funding for residential crisis stabilization programs to offer short-term, cost-effective, subacute care for individuals who need support and observation.

As I reflect on the many pressures and struggles expressed by callers in recent years, I am reassured by our country’s renewed focus on mental health and finding new ways to bolster our existing systems. Our success hinges on building a more enhanced crisis support network and overcoming challenges facing states and mental health providers. By expanding crisis support services, like 988, we will be able to increase awareness and timely intervention, making a real difference in many lives.

If you need suicide or mental health-related crisis support, or are worried about someone else, please call or text 988 or visit the National Suicide Prevention Lifeline’s chat to connect with a trained crisis counselor. Support is also available in Spanish and translators are available for 250+ languages. All conversations are confidential.

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