A Once-in-a-Lifetime Moment to Reimagine Crisis

In 1962, after a 7-year investigation, the Joint Commission on Mental Health and Health issued a report that led then- President Kennedy to push for deinstitutionalization through the Community Mental Health Act. The promise was that individuals with mental health conditions would no longer be locked up, abused and mistreated, and that they would get support in their communities.

And while the institutions were closed, we did not deliver on the promise of community-based supports and have since re-institutionalized people with behavioral health issues in our prisons.

Almost 50 years later, we have learned a great deal about the types of community supports that are needed. We better understand the road to more wellness and how to help people thrive in their communities.

The upcoming availability of 9-8-8 as a nationwide, 3-digit phone number to access crisis services offers a vision that goes beyond just the moment of crisis to also assist in finding the right supports to avoid further crises. This is the moment to deliver on President Kennedy’s vision. It is the most momentous initiative in support of community-based behavioral health care since 1962.

And we are ready. In 2020, COVID-19 increased awareness of behavioral health issues and elevated conversations about public safety and police roles, putting this topic on the front pages. Recently NAMI (National Alliance on Mental Illness) released survey results from a public opinion poll on mental health and mental health concerns. That survey shows that we have reached critical mass in how we all are thinking about these issues.

But the survey also found that only 4% of people have heard of 9-8-8 and the opportunity to deploy a fit-for-purpose system that will ensure people get the help they need. The picture below is from a real system in Arizona. It shows that focusing on the right care in the least restrictive setting means 85% of those who connect with the system while in crisis, go on to remain stable in community-based care.

We know what we need to do. We know it will work – several states have been working on this for a decade or more. Most of us, across the entire country, agree it’s the right thing to do. We just need the mojo!

What can you do?

You can help increase awareness of the importance of 9-8-8 in your community. You can talk with your police, your local government, your neighbors. Direct them to easy-to-read introductory material. Explain that it’s not helping any of us to clog our emergency rooms with folks that cannot receive treatment there and offer to connect them to MAMH, NAMI, MHA or any of the other 40 organizations developing implementation plans for the system we all deserve. We can all help deliver on President Kennedy’s vision. It’s past time, let’s get this done.

Some learning resources:

• 988 Crisis Hotline: Reimagining Crisis Services in Massachusetts (MAMH blog with links to issue brief and fact sheet)
  
• Consensus Approach and Recommendations for the Creation of a Comprehensive Crisis Response System (policy brief and recommendations)
• NAMI 988 Crisis Response Research (survey research findings)
• Cops, Clinicians, or Both? (NASMHPD technical assistance report)
• Webinar Series – Help Not Handcuffs (NAMI webinar series)
• Crisis Now Jam (weekly call and loads of helpful materials)
• SAMHSA 988 implementation webpage and FAQs