988: Reimagining Crisis Response

Too often, people with mental illness do not receive a mental health response when experiencing a mental health crisis. Instead, people in crisis often come into contact with law enforcement rather than a mental health professional. People in crisis deserve better.

The lack of a robust mental health crisis system leads to tragic results. One in four fatal police shootings between 2015 and 2020 involved a person with a mental illness, and an estimated 44% of people incarcerated in jail and 37% of people incarcerated in prison have a mental health condition — with 2 million people with mental illness booked into the nation’s jails every year. Millions more end up in emergency departments ill-equipped to address mental health crises, often waiting hours or days to access care.

NAMI is committed to advancing efforts to reimagine crisis response in our country. We believe that every person in crisis, and their families, should receive a humane response that treats them with dignity and connects them to appropriate and timely care. NAMI is calling for a crisis standard of care in every community that provides a continuum of crisis services — 24/7 call centers that answer 988 calls locally, mobile crisis teams and crisis stabilization programs — that end the revolving door of ER visits, arrests, incarceration and homelessness.

In 2020, the nation took a significant step forward with the enactment of the National Suicide Hotline Designation Act, a bill NAMI advocated for that created a nationwide three-digit number (988) to assist people experiencing a mental health or suicidal crisis. This number will be available in communities across the country by July 2022.

While an easy-to-remember number is important, we need more than a number. We need crisis response services that provide a mental health response to mental health crises.

What Should the Crisis Standard of Care Look Like?

NAMI is leading efforts to urge policymakers to invest in a crisis system that provides people with someone to talk to, someone to respond and somewhere to go. It will take federal, state and local action to implement the crisis standard of care in every community to ensure everyone in crisis gets the help they need, when they need it.

In addition to calling on federal policymakers to require that crisis services be covered by all health insurers and to provide substantial funding to states to cover services and costs that can’t be billed to insurance, mental health advocates need to urge their state leaders to action. Advocates must educate state policymakers about how our current response to crisis falls short, and how a reimagined crisis response system will help. This system should include:

  • 24/7 Crisis Call Centers
    “Someone to talk to”

    All calls to 988 should be answered locally by staff who are well-trained and experienced in responding to a wide range of mental health, substance use and suicidal crises. Crisis call centers should be able to connect people to local services, including dispatching mobile crisis teams and scheduling follow-up appointments with local providers.

  • Mobile Crisis Teams
    “Someone to respond”

    Mobile crisis teams should be available for people in crisis who need more support than can be offered over the phone. Staffed by mental health professionals, including peers, these teams can de-escalate crisis situations and connect a person to crisis stabilization programs or other services. Mobile crisis teams should collaborate closely with law enforcement, but only include police as co-responders in high-risk situations.

  • Crisis Stabilization Programs
    “Somewhere to go”

    Some individuals in crisis will need more assistance from crisis stabilization programs that provide short-term observation and stabilization. These trauma-informed programs may also identify additional treatment needs and provide a “warm hand-off” to follow-up care, from peer supports and outpatient services to more intensive services, such as hospitalization.

The legislation creating 988, which will route through the National Suicide Designation Lifeline, expanded the scope of the Lifeline to include mental health crises. Recognizing that this expanded scope and greater visibility for the Lifeline would create greater demand and expectation of response, the legislation also allows states to charge fees on phone bills to help fund these services. Many NAMI State Organizations across the country are working with state policymakers to implement state legislation that outlines the crisis services that will be available statewide and implement these fees, which are similar to 911 fees.

Learn more about model state legislation to implement 988 and crisis services.

Get Involved

Mental health advocates across the country have the power to demand that the crisis standard of care be offered in every community, to every person who needs it. You can help by making legislators aware of both the problem — our inadequate crisis system — and the solution. Here are five ways you can act today:

  1. Sign NAMI’s petition to show your commitment to reimagining crisis response in your community.

  2. Share your story to power our advocacy by telling us your own crisis response experience. The real-life experiences of people who’ve encountered good or bad crisis response help policymakers understand why change is needed.

  3. Email your members of Congress to tell them to fund a crisis response infrastructure.

  4. Learn about ways to influence your state policymakers. See if there is any current legislation in your state and connect with your NAMI State Organization to learn how they are supporting legislation and how you may get involved.

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

Take Action

 

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