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988

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The Substance Abuse and Mental Health Services Administration (SAMHSA) has released updated National Behavioral Health Crisis Care Guidance aimed at enhancing the nation’s response to mental health and substance use crises. This effort is part of an ongoing initiative to address record-high rates of suicide and overdose, while also building on the transition to the 988 Suicide & Crisis Lifeline in 2022.

The updated National Behavioral Health Crisis Care Guidance is comprised of three key documents. These are the 2025 National Guidelines for a Behavioral Health Coordinated System of Crisis Care, Model Definitions for Behavioral Health Emergency, Crisis, and Crisis-Related Services, and a draft Mobile Crisis Team Services Implementation Toolkit, which is open for public comment until March 21, 2025. Together, these resources set forth a framework for reshaping community crisis care systems and ensuring timely access to care.

SAMHSA’s framework is built on three foundational pillars essential to an integrated crisis care system:

  1. Someone to Contact — The 988 Lifeline and other hotlines provide immediate, accessible support for individuals in crisis.
  2. Someone to Respond — Mobile crisis teams are a critical component, delivering rapid, on-site assistance to de-escalate crises and connect people with appropriate care.
  3. A Safe Place for Help — Stabilization services offer facilities where individuals in crisis can access care, resolve crises, and transition to ongoing treatment when necessary.

The new guidance emphasizes scalability and sustainability for these systems, equipping state, tribal, local, and territorial governments with the tools needed to design and improve crisis care services. It also provides practitioners with actionable steps for delivering quality care.

The 988 Suicide & Crisis Lifeline, launched nationwide in 2022, represents a significant shift in behavioral health crisis response. The easy to remember three digit number aims to provide individuals with immediate access to trained crisis counselors, significantly reducing reliance on law enforcement and emergency departments for mental health emergencies. The updated guidance builds on this progress while addressing the urgent need for comprehensive crisis care systems.

The guidance reflects substantial input collected through listening sessions, expert consultations, and public feedback. Crucially, it underscores the importance of a coordinated, flexible, and compassionate approach to behavioral health crises at a time when the nation continues to grapple with increasing demand for services.

With public comments being sought on the draft Mobile Crisis Team Services Implementation Toolkit, SAMHSA aims to refine and finalize tools that advance the capacity of crisis teams to stabilize situations and connect individuals with long-term support. Please forward your comments to RCPA COO and Mental Health Services Director Jim Sharp for inclusion in the RCPA response to SAMHSA. This will addressed in the February 18, 2025, RCPA 988/Crisis Services meeting. You can register for the meeting here.

The process to route cell phone calls to the 988 Suicide & Crisis Lifeline based on the caller’s approximate location, versus by area code, has started; FCC to vote next month on a final rule that would require all U.S. wireless carriers to implement geo-routing with specific timelines

The 988 Suicide & Crisis Lifeline announced that the process to start routing cellular phone calls to 988 contact centers based on the caller’s approximate location, versus by area code — known as “geo-routing” — began last week with two major U.S. wireless carriers that combined make up about half of all wireless calls to 988. The U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) and the 988 Network Administrator, Vibrant Emotional Health, have been working with all of the major U.S. cell phone carriers for more than a year to improve call routing to 988 so that callers on a cell phone can be connected more locally to centers that are better equipped to provide nearby resources and services.

These new rules, if adopted by a vote from the full commission next month, would require all U.S. wireless carriers to implement geo-routing. In addition, the rules will also establish an implementation timeline for geo-routing calls to the 988 Lifeline of 30 days following the effective date of the rule for nationwide wireless providers and 24 months after the effective date of the rule for smaller, non-nationwide providers.

More than 200 contact centers across the country provide support through the 988 Lifeline network. Geo-routing connects cell phone callers to the closest 988 contact center to the caller’s physical location. Geo-routing differs from geolocation in that it does not provide a precise location of the caller, allowing callers to maintain their location privacy. Studies have shown that after speaking with a trained crisis counselor, most callers feel more hopeful and less depressed, suicidal, and overwhelmed.

If you have additional questions, please contact RCPA COO and Mental Health Director Jim Sharp.

An excerpt from Pennsylvania’s Suicide Prevention Month Guide Start the Conversation:

September is Suicide Prevention Month, with the week of September 8–14 identified as National Suicide Prevention Week. September 10 is recognized as World Suicide Prevention Day in countries around the world. This year marks the beginning of a new three-year theme focused on changing the narrative on suicide, which involves moving beyond awareness to starting conversations and taking action. Across sectors and settings, changing the narrative requires both culture and systemic change to provide meaningful education, advocate for resources, and prioritize suicide prevention in an ongoing way.


Read the Start the Conversation guide to learn how to speak with others about suicide prevention as well as gain access to toolkits and resources.

This is an announcement that the 988/Crisis Work Group meeting scheduled for Wednesday, May 22, has been cancelled. RCPA will reschedule the meeting in the coming months. Currently, there is no movement or update in the OMHSAS Crisis Regulations release for public comment. Additionally, at this time, OMHSAS is making structural changes in their Policy and Crisis divisions. There are legislatively very few federal or state bills suggesting substantive changes in the development of the 988 system.

If you have any questions, please contact RCPA COO & MH Policy Director Jim Sharp.

Image by David Mark from Pixabay

President Biden signed the Further Consolidated Appropriations Act, 2024 into law on March 23. This Act includes the Labor, Health and Human Services, Education, and Related Agencies Appropriations Act, 2024. Notable FY 2024 funding totals for mental health and substance use include:

  • $385 million for Certified Community Behavioral Health Clinics (level with FY 2023);
  • $986,532,000 for the Mental Health Block Grant, which includes maintaining the existing 5% of the total set aside for evidence-based crisis care programs that address the needs of individuals with serious mental illnesses, children with serious emotional disturbances, or individuals experiencing a mental health crisis (level with FY 2023);
  • $153 million for the Behavioral Health Workforce Education and Training Program, including $40 million for the Substance Use Disorder Treatment and Recovery Loan Repayment Program (level with FY 2023);
  • $1,575,000,000 for State Opioid Response Grants (level with FY 2023); and
  • $1,928,879,000 for Substance Use Prevention, Treatment, and Recovery Services Block Grants (level with FY 2023).

Additionally, key provisions of the Act include an $18 million increase in funding for the 988 Suicide & Crisis Lifeline and a $1 million increase for the Primary and Behavioral Health Care Integration grant technical assistance program. There is also a $75 million increase for mental health research conducted by the National Institute of Mental Health. Various mental health and substance use programs maintained funding levels similar to those of FY 2023. For more information, you can access the full explanatory text as well as the comparative highlights table.

If you have any questions, please contact RCPA Policy Director Jim Sharp.

Message from the National Council for Mental Wellbeing:

Last week we reached out asking you to write to your congressional representatives in support of the 988 Implementation Act. We wanted to pop back into your inbox with a critical opportunity we have to expand the network connecting people to mental health and substance use care across the country.

The 988 Suicide and Crisis Lifeline has successfully served millions of people. But there is more work to do, and we need your support to do it. Support from you and your representative will go a long way that our crisis care system provides people in every community with someone to respond and somewhere to go if we hope to fulfill the promise of 988.

As a reminder it will only take 2 minutes to show your support. Here is why it’s paramount that your representatives support this legislation, 988 Implementation Act:

  1. Expands behavioral health workforce training programs and provides grant opportunities for local behavioral health centers;
  2. Expands Medicaid coverage for behavioral health services, including short term crisis intervention services;
  3. Increases support for mobile crisis response, ensuring that even those in rural areas have access to timely care;
  4. Creates new capital grants to be used for crisis response program facility renovation, construction, and expansion;
  5. Narrows the IMD exclusion so that services furnished in psychiatric acute care crisis beds administered by CCBHCs and other crisis care settings are eligible for Medicaid coverage; and
  6. Increases awareness of 988 through a national media campaign.

Contact your Congressional Representatives and urge them to support the 988 Implementation Act. By strengthening, and raising awareness for current resources, and building capacity at the state level for these on the ground crisis services, this legislation will make a difference, and save the lives of your friends, neighbors, and community members in crisis. Time is of the essence. Act today, and together we can strengthen the crisis care continuum.

Thank you for your advocacy.

Sincerely,
Rachel Abraham
Federal Policy and Advocacy Coordinator
The National Council for Mental Wellbeing