988: Reimagining Crisis Response

What is 988?

Right now, too many New Jerseyans don’t get the help they need before and during a mental health crisis. Nationwide, people with mental illness are booked into jails two million times each year. Between 2015-2020, one-in-four fatal police shootings have been of people with mental illness – and of those, one-in-three are people of color.

NAMI NJ believes that people experiencing a mental health crisis deserve a mental health response.

In 2020, Congress took an important step in reimagining crisis response by passing the bipartisan “National Suicide Hotline Designation Act”, designating 988 as the new three-digit number for the National Suicide Prevention Lifeline (NSPL) and expanding its scope to mental health and substance use crisis. This legislation requires telecommunications companies to rout all 988 calls to the National Suicide Prevention Lifeline, a national network of over 200 24/7 call centers, by July 16, 2022.

988 is a once in a generation opportunity to reimagine our behavioral health crisis standard of care, but responsibility for its success ultimately lies with the states. While the federal government is providing some funding for startup costs, funding for call centers and crisis system of care services will also need to come from states.

 

What Should the Crisis System of Care Look Like?

When we talk about a behavioral health crisis system of care, we are talking about three main components: someone to talk to, someone to respond, and somewhere to go.

Someone to talk to: 24/7 Crisis Call Centers

Calls to 988 should be answered by 24/7 local crisis call centers. Staff should be trained to respond to a wide range of behavioral health crises and be able to connect callers to a wide range of local behavioral health crisis services.

Someone to respond: Mobile Crisis Teams

Mobile crisis teams should be available for people who need more support than can be offered on the phone. Staff should include mental health professionals, including certified peers, and be able to de-escalate crises and connect individuals to services. Mobile crisis teams should collaborate closely with law enforcement, but only include police as co-responders in high-risk situations.

Somewhere to go: Crisis Stabilization Programs

Programs that provide short-term observation and stabilization, preferably in “living-room settings” should be available for those who need more assistance. These programs should accept all police referrals with quick turnaround times. They should be trauma informed and be able to provide “warm hand-offs” to follow up care.

 

New Jersey 988 Implementation Legislation: S311/A2036

NAMI NJ is actively supporting S311/A2036, which would establish a statewide behavioral health crisis system of care. The bill would coordinate crisis services around the 988 Hotline and require the Department of Human Services to contract with call centers to provide 24/7 service with links to mobile crisis teams, psychiatric stabilization, and follow-up services.

Importantly, the bill would establish a “9-8-8 System and Response Trust Fund Account” that can only be used for 988 services. Included in the trust fund is a monthly fee on mobile service lines, similar to those that fund 911 services, and legally permitted by the National Suicide Hotline Designation Act. While funding for the 988 trust fund may include grants and state appropriations, NAMI NJ supports the fee as a reliable source of revenue for a system that is likely to grow rapidly in demand and benefit all New Jerseyans. The bill would also require insurance carriers in the state to cover behavioral health crisis services, though employer-sponsored plans would be exempt from this state requirement due to the Employee Retirement Income Security Act of 1974 (ERISA).

 

Get Involved

1. Your voice can make a big difference. Email your state legislators and ask them to support S311/A2036:

2. Share your story directly with your legislators. Reach out to Advocacy Engagement Manager Matt Camarda ([email protected]) for help setting up an appointment.

3. Recruit other advocates by posting on social media to demand a mental health response to mental health crises.

4. Subscribe to the NAMI NJ Advocacy Network for updates on 988.

 

Resources

– Advocacy Updates

NJ Assembly Health Committee Moves Bill to Establish Statewide Behavioral Health Crisis System, Fund Mental Health & Suicide Hotline (3/10/2022)

NJ Senate Health Committee Advances Bill to Establish Core Behavioral Health Crisis System, Fund Mental Health & Suicide Hotline (2/10/2022)

– 988 Poll

A joint poll by NAMI NJ, Project ASPEN, and the Eagleton Center for Public Interest Polling found that a broad subsection of New Jerseyans support 988 services and funding through a variety of sources. The poll was conducted from February 25 to March 4 and surveyed 1,044 adults.

– In the News

As a Crisis Hotline Grows, So Do Fears It Won’t Be Ready

988: A new number for National Suicide Prevention Lifeline, but funding in question

Suicide hotline will route expert help to caller’s home — without involving police

– Reports, Articles & Toolkits

Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System

SAMHSA 988 Partners Toolkit

National Guidelines for Behavioral Health Crisis Care: Best Practice Toolkit

Implementing The 988 Hotline: A Critical Window To Decriminalize Mental Health