On July 16, 2022, the newly established National Suicide Prevention Lifeline – 988 – was launched. According to the National Council for Mental Wellbeing’s CCBC Success Center, “The transition of the National Suicide Prevention Lifeline (NSPL) to a new three-digit dialing code (988) will help expand access and promote systems of high-quality, community-based crisis response, similar to the medical, fire, and public safety emergency response systems associated with 911.” “Suicide rates are higher than they’ve ever been, including for young people,” HHS Secretary Xavier Becerra said during a press briefing promoting the Lifeline on Friday.
The Certified Community Behavioral Health Clinics (CCBHC) around the country will play an important role in providing treatment and support for people referred by the National Suicide Prevention Lifeline Suicide hotline. CCBHCs are “boots on the ground” whose Mobile Crisis services supports the 988 lifeline. “The CCBHC model is a useful approach that can link individuals in crisis with a network of services either performed onsite or through designated collaborating organizations.” — Report to Congress on 988 Resources, SAMHSA, December 2021.
“The 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) is made up of an expansive network of over 200 local – and state – funded crisis centers located across the United States. The counselors at these local crisis centers answer calls and chats from people in distress that the Lifeline receives every day. The Lifeline’s crisis centers provide the specialized care of a local community with the support of a national network,” according to the 988 Suicide and Crisis Lifeline.
CCBHCs provide a comprehensive range of mental health and substance use disorder services to the most vulnerable individuals in the community, including 24-hour crisis response for 988 referral and follow-up services. including mobile crisis teams, emergency crisis intervention services, and crisis stabilization services. The CCBHC either manages their own crisis hotline or utilizes a community crisis hotline for this clients.
Before July 16, 2022, each CCBHC directly providing 24 hour crisis services was managing its own crisis phone line. Now, the National Suicide Prevention Lifeline is in place. The local crisis center usually serves your entire community, often 24/7 and free of charge. These centers connect callers to providers in their community that can support their needs. For a list of the national lifeline crisis centers you can visit this website.
With the launch of this lifeline, we reached out to a handful of our CCBHC customers to ask for their thoughts on the CCBHCs role in the 988 crisis and suicide lifeline.
Community Counseling Solutions
Community Counseling Solutions, is a CCBHC in Heppner, OR. In Oregon, the state has decided to have the initial 988 calls fielded by a contractor “Lines for Life”. According to the Oregon government website, The Oregon Health Authority (OHA) and Oregon’s 988 call centers are collaborating with 911 Public Safety Answering Points to develop a roadmap on how 911 and 988 can coordinate with each other in the future. 988 crisis counselors are trained to use the least invasive interventions. Oftentimes, responding to a call, text or chat is all that is needed to help someone in crisis. In fact, more than 95 percent of current calls are resolved over the phone.
If a 988 call cannot be resolved over the phone, a mobile crisis team or first responder may be dispatched. This is where the CCBHCs come in. For the counties Community Counseling Service covers, they will be the point of referral for 988. If a client calling 988 requires a mobile crisis team to be deployed or requires ongoing “non emergent” services, Community Counseling Solutions will be that source of services in their catchment area. Thad Labhart, Clinical Director at Community Counseling Solutions says, “Our role as a CCBHC plays a vital role with the 988 National Suicide Prevention Hotline going live. Our CCBHC programming promotes enhanced staffing levels and expedited crisis response times for those referred. It also provides opportunities for primary care and peer follow up.”
Oaklawn Psychiatric Services
Oaklawn Psychiatric Services, is a CCBHC in Goshen, IN. Oaklawn got involved with the launch of 988 in Indiana at the state level by working on the state planning committee. The state of Indiana is in the early stages of fully implementing the 988 line at the state level.
According to an official website for the Indiana state government,
Indiana is using the arrival of 988 to invest in a broader crisis response system to help all Hoosiers. This will ultimately include more than just someone to contact at a 988 center, but also someone to respond and a safe place to go for help, if needed.
What it will mean, throughout the coming years, is: A simple, short number for anyone experiencing mental health-related distress – whether that is thoughts of suicide, mental health, or substance use crisis, or any other kind of emotional distress.
The establishment of mobile crisis teams who are trained and skilled in responding to anyone experiencing mental health-related distress.
Mobile crisis teams are comprised of behavioral health professionals and peers skilled in providing specialized crisis care to people on site in their community.
A greater ability to refer Hoosiers in crisis to a network of local crisis specialists who are familiar with the community and better equipped to provide culturally competent support and referrals to local resources and other lifesaving follow-up care.
The work to develop this complete system is well underway and will continue over the next seven to ten years. Pilot projects are being funded right now, and we are evaluating the best way to establish these services through providers throughout the state.
One of those providers working with the state is Oaklawn Psychiatric Services. The 988 committee is working in conjunction with “911” and the first responders to determine how to route consumers ho issues cannot be resolved during the 988 phone call. For now, Oaklawn will maintain its 24/7 crisis hotline that so many of its consumers and the community are so familiar with.
When asked about why the CCBHC treatment model is so important to the success of the 988 roll out, Kelli Leichty, Director of the CCBHC at Oaklawn said, “988 is in close alignment with the goals of the CCBHC model. A significant emphasis of the CCBHC model is for Mental Health organizations to play a lead role in responding to individuals in the community who are experiencing a mental health or substance use crisis and the roll out of 988 aids in this and is an important step for our community. “Kelli will continue to work on the roll out of the 988 Suicide and Crisis Lifeline statewide initiative.
Lutheran Social Services of Illinois
Lutheran Social Services of Illinois , is a CMHC located in Chicago in Illinois. LSSI recently applied for a SAMHSA CCBHC expansion grant and anxiously awaits the “Notice of Funding “announcement expected in September 2022. While awaiting a response in this very competitive application process, LSSI is beginning preparations for adopting some of the CCBHC requirements. The mobile crisis requirements in becoming a CCBHC was one of the stronger areas of LSSI’s application.
LSSI is going to serve as the mobile crisis response team for zip codes on the north & northwest sides of Chicago. When 988 further develops in Illinois, LSSI will receive the crisis calls that cannot be resolved on the phone and needs an in-person intervention.
LSSI currently have their professional staff and new peer/engagement specialists in place to respond as a 2-person team. LSSI has been doing 24/7 crisis response for several years, but the engagement specialist role is a new addition to line up with the 988 response plan.
Julie A. Kovacin, Executive Director of Behavioral Health at Lutheran Social Services of Illinois says, “States are in different stages of development and the state authorities for EMS, police, public health, and behavioral health have complex systems to coordinate. In Illinois, we are looking forward to seeing how this evolves over the next few years.”
In doing my research for this article, I learned that as of Monday morning, the Department of Health and Human Services had not responded to questions from MedPage Today on how many states were fully prepared for the launch. However, officials on a press call last week told reporters that 911 took nearly 5 decades to be brought to scale. The current 10-digit National Suicide Prevention Lifeline (1-800-273-TALK) will remain active indefinitely, the lifeline’s sponsors said.
“Media publication of 988 is critical. There are too many individuals and families who are not aware that help is available, and to have a national response line can be a game changing service to support people in crisis, wherever they are located” said Julie A. Kovacin, Executive Director of Behavioral Health at Lutheran Social Services of Illinois.
In conclusion, the CCBHC treatment model will play a major role in the 988 Suicide and Crisis Lifeline as it matures over the next 5 years. As states work to support the rollout, Qualifacts will continue to track the success of 988 in each state and will bring you updates from time to time with a focus on the ongoing challenges and how more support for mental health and 988 and the CCBHC treatment model benefits everyone.