Legislation aims to reduce police interaction in crisis situations and support call centers

Maryland lawmakers are considering a bill that would establish a 988 trust fund to help reimburse crisis call centers to switch and maintain 988 as the official health crisis hotline mental. Photo by Danielle E. Gaines.

Recognizing growing pressures on behavioral health providers and the need for additional resources during the COVID-19 pandemic, Maryland lawmakers are sponsoring bills to divert more mental health crisis calls from law enforcement and help the state prepare for a nationwide transition to the 988 crisis hotline.

In 2020, Congress passed the National Suicide Hotline Designation Act to shorten the national eight-digit number, “which … has been around for decades and is supported locally by local call centers across the country,” said Adrienne Breidenstine, vice president of policy and communications at Behavioral Health Systems Baltimore.

The FCC has given states and telephone companies a two-year grace period to prepare for the transition to the 988 hotline.

“What didn’t come with it was funding,” Breidenstine said.

Supported by dozens of state and local health organizations, Del. Karen Lewis Young (D-Frederick) and Sen. Malcolm Augustine (D-Prince George’s) are seeking to create a trust fund to help reimburse crisis call centers for the transition and keeping 988 as a helpline official mental health crisis telephone support. The crisis line currently established in state law is 211.

A hearing on the House version of the bill is scheduled for Wednesday.

According to the Fund Maryland 988 campaign website, the bill would help the state invest in more call centers, mobile crisis units and walk-in crisis centers through a funding source. sustainable.

Proponents of the bill are calling for $10 million to ensure centers are adequately staffed and operating 24 hours a day in 2022.

Maryland has eight local call centers that take calls from the National Suicide Prevention Hotline. But Breidenstine said the state is not providing adequate funding.

“That’s why Bill 988 Trust Fund is so important,” she continued. “If passed, it will mark the largest investment in behavioral health crisis call centers our state has ever seen.”

It couldn’t come at a more critical time – Breidenstine predicts a 30% increase in calls to crisis centers once the 988 number comes into effect in July.

“We need our call centers to be able to recruit staff to answer the lines [and] they need an infrastructure to support that volume of calls so they can respond in a timely manner,” she said. “…investment is needed – probably needed a while ago, but definitely needed now.”

Augustine said in a phone interview Friday that increasing the availability of mental health support benefits everyone in Maryland.

“I recognized coming into the legislature that there was a real crisis in behavioral health – even before the pandemic – and it was an area in which I just felt like it was a place where I could help make a difference in our community,” he said in a phone interview on Friday.

“We think it would be a victory”

Some call centers are expanding their services to divert mental health crisis calls from local police departments.

Augustine and Del. Lorig Charkoudian (D-Montgomery) are co-sponsoring legislation this session to require local health authorities applying for behavioral health crisis response grants through the Department of Health to include plans to reduce the interaction of law enforcement in their proposals.

Breidenstine said the language Augustine seeks to adopt in the law aligns with U.S. Department of Health and Human Services guidelines to reduce involvement in behavioral crisis response.

“Often these crisis lines just provide a person on the other end of the line who has been trained to speak to people as they face a behavioral health crisis and, if necessary, bring them to the next level of someone who can provide care for that,” Augustine said. “And law enforcement aren’t trained for that.”

When someone is in the throes of a mental health crisis, many believe their only recourse is to call law enforcement.

“Some people really call 911 because it’s the only thing they know,” said Quinita Garrett, director of call center and system coordination for Baltimore Crisis Response, Inc., during a telephone interview. “Sometimes they are often shocked to learn that this is another number they can call for their behavioral health issues.”

Through the city’s 911 Behavioral Health Diversion pilot program, emergency calls regarding suicide where no threat of physical harm is indicated are diverted from police and sent to Garrett’s call center.

If a caller says they are feeling suicidal, Garrett said a trained counselor will ask if they would like a mobile crisis response team to come to them to offer support.

“Some people say, ‘No, I just want phone support,'” she said. helps the person in distress develop a safety plan.

In the event that a person wants the support of a mobile crisis team, one will be sent to them.

Mobile crisis teams consist of a registered social worker or professional clinical counselor and a registered nurse. The crew consults with a psychiatrist to determine a treatment plan for the person in crisis.

If someone’s condition is too acute and the mobile crisis response team doesn’t have the proper tools, Garrett said they can submit an emergency request for the patient to be assessed. by an emergency physician to determine whether he should be admitted to a psychiatric hospital. hospital.

“It really depends on the needs of the person,” she said.

But some diversion calls must be forwarded to 911.

“If we feel that the caller may not be able to be safe — he says to us, ‘I’m going to kill myself’ or ‘I’m going to do something to someone else’ — then …he calls 911 and asks for a[n officer trained in crisis response],” she said.

Diversion programs are limited in who they can help: Calls can only be redirected to Garrett’s center for people over 18 who have suicidal thoughts and are not an immediate threat to them- themselves or for others.

According to Breidenstine, 911 dispatchers in the city of Baltimore receive about 13,000 behavioral health calls a year.

“Even if some of those were diverted to our crisis call center, we think that would be a win,” she said. “But to do that, we need to staff our crisis call center so they can handle this increased call volume.”

When asked if he thought it was possible to extend the diversion of 911 beyond suicidal episodes, Augustine replied “there is no doubt about it.”

“We need to build the capacity of our mobile crisis units, and that takes money,” he said. “I think it’s an appropriate investment that we can make so that we’re able to get more…of those calls to the appropriate people.”