One Year Into Mental Health Lifeline 988, The Need For Mobile Crisis Teams Remains

It’s been one year since the official launch of the new national suicide prevention and mental health crisis lifeline, 988.

While call centers have been able to respond to increased call volume, state officials and lawmakers say there’s more work to do to ensure that people can get in-person help quickly, if needed.

The Los Angeles-based nonprofit Didi Hirsch Mental Health Services, the lead crisis center agency supporting the lifeline in California, reported that hundreds of trained counselors at 12 crisis centers across the state handled more than 280,000 contacts from calls, chats and texts since 988 launched last July.

California's in-state call volume increased 28% during the lifeline’s first year, according to Didi Hirsch.

‘We have to build that capacity’

More than just a new number to call for mental health crises, 988 is ultimately supposed to be a rethinking of how we respond to psychiatric emergencies, with someone to call, someone to respond and somewhere to go.

While the ‘someone to call’ aspect of the 988 plan seems to be meeting the need, L.A. County has struggled to increase the number of mobile response teams and placements for people experiencing a mental health crisis to address demand.

The L.A. County Department of Mental Health (DMH) has the goal of eventually having unarmed mental health crisis response teams working 24/7/365, but the agency has struggled to hire and retain enough staff. Families who call for help with a loved one in crisis often say they wait hours or even days for an emergency mental health response.

In order to change the lagging response times so that mental health emergencies have more parity with physical ones, advocates and lawmakers alike have noted that hundreds more mental health crisis workers need to be brought on board.

Stephanie Welch, deputy secretary of behavioral health at California’s Health and Human Services Agency, said Tuesday that mobile mental health crisis response teams needed to be aggressively expanded throughout the state.

“We really have to build that capacity to be honest with you. It is something that the state is dedicated to, but it is something we are in the process of building right now,” Welch said.

More support coming

L.A. County added contracts with the nonprofit behavioral health agency Sycamores last fall to supplement its Psychiatric Mobile Response Teams (PMRT), which are made up of two unarmed clinicians from the L.A. County Department of Mental Health.

Sycamores' Mobile Crisis Outreach Teams (MCOT) began responding to mental health crisis calls alongside the county’s teams with the goal of getting the person psychiatric help without involving law enforcement. They’ve slowly increased the number of teams available and are officially launching the service this weekend, according to a press release.

Sycamores' two-person MCOT teams are made up of a licensed clinician (licensed clinical social worker or licensed psychiatric technician) and a peer support specialist (someone who has lived experience with mental illness).

As of late June, DMH had 33 PMRT and 6 MCOT units staffed. According to a county-ordered report from the group RI International, the county would need 138 mobile crisis teams in order to reach its 24/7/365 service goal.

“My vision for 988 is to have enough trained mental health teams ready so that anyone who needs an in-person response in L.A. County is able to get one quickly,” L.A. County Supervisor Janice Hahn told a press conference Tuesday. Hahn added that she and her colleagues were committed to recruiting and retaining mental health crisis workers.

According to Didi Hirsch, statewide, 98% of calls “are de-escalated, requiring no emergency intervention.”

The agency did not immediately provide information on what percentage of 988 interactions in L.A. County have led to a law enforcement response.