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Legislation Seeks to Reduce Police Interaction in Crisis Situations, Support Call Centers

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

Recognizing the growing pressures on behavioral health providers and 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 national 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 locally supported by local call centers across the country,” said Adrienne Breidenstine, the vice president of policy and communications at Behavioral Health Systems Baltimore.

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

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

Backed 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 set up a trust fund to help reimburse crisis call centers to transition to and maintain 988 as their official mental health crisis hotline. The crisis line currently established in state law is 211.

A hearing on the House version of the bill is set 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 sustainable funding source.

The bill’s advocates are seeking $10 million to keep centers adequately staffed and running round-the-clock in 2022.

Maryland has eight local call centers that pick up calls from the national suicide prevention hotline. But Breidenstine said that the state doesn’t provide adequate funding.

“So that’s why the 988 Trust Fund bill is so important,” she continued. “If passed, it’ll mark the largest investment in behavior health crisis call centers that our state has ever seen.”

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

“We need our call centers to be able to staff up get people there to answer the lines [and] they need infrastructure to support that call volume so that they can answer in a timely manner,” she said. “…the investment is needed — probably needed a while ago, but it’s definitely needed now.”

Augustine said during a phone interview Friday that increasing the availability of mental health support is beneficial to all Marylanders.

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

‘We think that would be a win’

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 law enforcement interaction in their proposals.

Breidenstine said that the language that Augustine is looking to adopt into law is aligned with the U.S. Department of Health and Human Services’ guidance for reducing involvement in behavioral crisis response.

“Oftentimes, these crisis lines are just providing a person on the other end of the line who has been trained to talk to people as they are dealing with a behavioral health crisis and, if necessary, get them to that next level of actually someone who can provide some care for that,” Augustine said. “And law enforcement is not trained for that.”

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

“Some people really call 911 because that’s the only thing that they know,” Quinita Garrett, the director of Call Center and System Coordination for Baltimore Crisis Response, Inc., said during a phone interview. “Sometimes, they’re often shocked to find out that is another number they can call for their behavioral health concerns.”

Through the city’s 911 Behavioral Health Diversion pilot program, emergency calls pertaining to suicide where no threat of physical harm is indicated get deflected from the 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’d like a mobile crisis response team to come to them to offer support.

“Some people say, ‘No, I just want phone support,” she said. If that’s the case, the counselor on the other end of the line helps to de-escalate the situation, provides support counseling and helps the person in distress devise a safety plan.

In the instance that a person wants support from a mobile crisis team, one will be dispatched to them.

Mobile crisis teams are made up of a licensed social worker or clinical professional 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 appropriate tools, Garrett said that they can submit an emergency petition to have the patient evaluated by an emergency room physician to determine if they need to be admitted to a psychiatric hospital.

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

But some diversion calls need to be sent back to 911.

“If we feel that the caller may not be able to be safe — they’re telling us, ‘I’m going to kill myself,’ or ‘I’m going to do something to someone else’ — then … they’ll call back to 911 and request a[n officer trained in crisis response],” she said.

Diversion programs are limited in who they can assist: calls can only be diverted to Garrett’s center for people over 18 who are experiencing suicidal thoughts and don’t pose an immediate threat to themselves or others.

According to Breidenstine, 911 dispatchers in Baltimore City receive about 13,000 behavioral health calls annually.

“Even if a portion 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 up our crisis call center so that they can handle that increased call volume.”

Asked if he believes there is an opportunity to expand 911-diversion beyond suicidal episodes, Augustine said “there’s no question about it.”

“We’ve got to build up the capability for our mobile crisis units, and that takes money,” he said. “I think that’s an appropriate investment that we can make so that we’re able to get more … of those calls going out to the appropriate people.”


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Legislation Seeks to Reduce Police Interaction in Crisis Situations, Support Call Centers