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Perspectives

9-8-8’s Success Hinges on Support of Mental Health Crisis Programs

March 15, 2021

A new crisis hotline will take effect in 2022, giving us an opportunity to replicate the success 9-1-1 has had on our physical health by providing people the hope of getting help with their mental health, suicidal feelings or crisis due to addiction when they dial 9-8-8.

But that hope only becomes a reality if there are crisis services and then ongoing care available for the 9-8-8 call centers to refer people to. The success of 9-8-8 will depend on the mental health crisis system behind the scenes that we design and implement to help those who call for help.

A new report from the Committee on Psychiatry and the Group for the Advancement of Psychiatry and released today by the National Council for Behavioral Health outlines the steps we must take now—before the launch of 9-8-8—to ensure people in crisis receive the high-quality behavioral health services they need. We can’t expect every community to know what an ideal mental health crisis system looks like. And we can’t expect all communities to complete the work to design and implement a mental health crisis system prior to July 2022 because it’s a massive undertaking.

So a diverse group of behavioral health professionals immersed themselves in this effort to provide communities with a practical, evidence-based blueprint: “Roadmap to the Ideal Crisis System.”

The Committee on Psychiatry and the Group for the Advancement of Psychiatry were driven by the understanding that 9-8-8 represents an essential community service, just like 9-1-1. Also like 9-1-1, this will require the communities to organize and fund services to get people out of crisis and provide them with ongoing treatment. We have an obligation to provide those who call for help the best service possible every time.

As we point out in the report, “…society is beginning to recognize that behavioral health crises are common and can happen to anyone—to any individual or family—just like crime, fire, flood and emergency medical events. Communities are further recognizing that failure to respond properly to these crises is dramatic in its personal, social and economic cost, resulting in incarceration, devastation, homelessness and death. As a society, therefore, our collective perspective is changing about how behavioral health crisis services should be prioritized.”

In other words, we must take this opportunity to ensure communities can care for people in crisis.

We all know by now that the COVID-19 pandemic has created a second public health crisis in America. A new study published in the Journal of American Medical Association found that nearly 12% of adults surveyed seriously considered suicide in the prior month while 29.6% reported COVID-19-related trauma- and stressor-related disorder symptoms, 33% reported anxiety or depression symptoms, and more than 15% reported increased substance use.

Yet it’s not enough simply to unveil 9-8-8. It’s imperative that we design a system people and communities can rely on. That requires providing much-needed guidance.

Designing the ideal crisis system begins by putting the patient in the center of that framework. That requires developing standards, guidelines and criteria intended to create a positive experience for individuals.

The group developed detailed guidance and outlined measurable criteria for design and implementation to help communities along the way. A mental health crisis system is more than a single program. It is an organized set of structures, processes and services that are in place to meet all types of urgent and emerging mental health crisis needs in a defined population or community, effectively and efficiently.

We also included numerous examples from communities that have completed design and implementation of mental health crisis systems so others can learn from their experience.

The exhaustive new report attempts to address every point in the continuum of crisis services. And because it is the first report of its kind, this blueprint will serve a vital role for any community that is planning its crisis system.

No community can know exactly what a mental health crisis system should look like if they haven’t designed or implemented one. But every community should understand the importance of having a mental health crisis system in place. With 9-8-8 fast approaching, it’s time to begin the work to plan, design and implement that system of care so the resources are in place when people call for help.

Joe Parks, MD, is vice president for practice improvement at the National Council for Behavioral Health and co-chair of the Medical Directors Institute. Ken Minkoff, MD, is vice president and senior system consultant at ZiaPartners and part-time assistant professor of psychiatry at Harvard Medical School. He is also a member of the Medical Directors Institute.

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