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Tags Posts tagged with "Crisis Care"

Crisis Care

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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.

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American Rescue Plan Funding Will Support State Efforts to Transform Suicide and Mental Health Crisis Care

Today the Department of Health and Human Services, through its Substance Abuse and Mental Health Services Administration (SAMHSA), will make critical investments in suicide prevention and crisis care services, announcing $282 million to help transition the National Suicide Prevention Lifeline from its current 10-digit number to a three-digit dialing code – 988.

In 2020, Congress designated the new 988 dialing code to be operated through the existing National Suicide Prevention Lifeline. Converting to this easy-to-remember, three-digit number will strengthen and expand the existing Lifeline network, providing the public with easier access to life-saving services. The Lifeline currently helps thousands of people overcome crisis situations every day. The 988 dialing code will be available nationally for call, text, or chat beginning in July 2022.

Standing up the 988 dialing code is a key part of the Biden-Harris Administration’s focus on ensuring that those in crisis have someone to call, someone to respond, and somewhere to go. The 988 code is a first step toward transforming crisis care in this country, creating a universal entry point to needed crisis services in line with access to other emergency medical services.

With funds from the Biden-Harris Administration’s Fiscal Year (FY) 2022 budget and additional funds from the American Rescue Plan, SAMHSA’s $282 million investment will support 988 efforts across the country to shore up, scale up, and staff up, including:

  • $177 million to strengthen and expand the existing Lifeline network operations and telephone infrastructure, including centralized chat/text response, backup center capacity, and special services (e.g., a sub-network for Spanish language-speakers).
  • $105 million to build up staffing across states’ local crisis call centers.

“As we continue to confront the impact of the pandemic, investing in this critical tool is key to protecting the health and wellbeing of countless Americans – and saving lives. Giving the states a tool to prevent suicide and support people in crisis is essential to our HHS mission of protecting the health and wellbeing of everyone in our nation,” said HHS Secretary Xavier Becerra. “We know that remembering a three-digit number beats a ten-digit number any day, particularly in times of crisis, and I encourage every state to rev up planning to implement 988 for the sake of saving lives.”

To support the initial transition to 988, SAMHSA’s investment represents a budget increase of more than 10 times the FY 2021 budget amount of $24 million. A large portion of FY 2022 funding will be distributed to crisis centers across the country.

“This investment in states’ crisis call center operations will help strengthen our partnership as SAMHSA works with states to meet the suicide prevention and behavioral health needs of people across our nation,” said Miriam Delphin-Rittmon, Ph.D., the HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA. “Transformation of this scale is never easy – but too many Americans are experiencing suicide and mental health crises without the support and care they need. The federal government cannot do this alone.”

Suicide is the second-leading cause of death among young people and was the tenth-leading cause of death in the nation in 2019, according to U.S. Centers for Disease Control and Prevention data. In 2019, one death by suicide happened almost every 11 minutes in the US.

More recently, SAMHSA’s 2020 National Survey on Drug Use and Health (NSDUH) data show 4.9 percent of adults aged 18 or older had serious thoughts of suicide, 1.3 percent made a suicide plan, and 0.5 percent attempted suicide in the past year. Among adolescents 12 to 17, 12 percent had serious thoughts of suicide, 5.3 percent made a suicide plan, and 2.5 percent attempted suicide in the past year. The findings vary by race and ethnicity, with people of mixed ethnicity reporting higher rates of serious thoughts of suicide.
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