Webinar presenters John Snook and BJ Wagner answered a number of your questions after their presentation, 988 and the Future of Crisis Response: What Criminal Justice Professionals Need to Know (part 2). Here are just a few of their responses.
Audience Question: How do we figure out who our organization is that is heading up 988 in our area?
BJ Wagner: That is a really good question, and I wish I could tell you there’s an obvious group there isn’t? I think you could. I don’t know if there’s an easy solution, other than I would look to some of the groups that you’re already partnered with. If you’ve been working on a, for example, a HIPAA data sharing group or a group that’s been working with your CIT teams. Often CIT is one of the pieces is coordinating with local mental health. That’s probably the place that I would start, but there isn’t one answer for any community, unfortunately.
Audience Question: How many of the integrated response teams are on the street at any given time? For example, normal patrol officers and normal EMTs on duty.
BJ Wagner: I will say, on a team, there, is a police officer, a medic, and a clinician, and it’s a licensed clinician, typically a social worker, preferably one that has psychiatric hospital experience. Just because of the dynamic nature of a psychiatric ER. But there is a clinician, a paramedic, and a police officer on a team in a vehicle together at any given time. But in a community, it depends on the community size, the call saturation, and the community need. So, in Abilene, Texas, there’s one team on duty, at any given time, on high call days. There’s one team on duty with an overlap of the second team before the first team goes off duty. But in Dallas, there are up to seven teams on duty at any given time. So, even though a team is made it made of three professionals, the community size and need will determine how many are at work at any given time.
Host: And I’m assuming, it’s certainly based on patrol area’s population, and like you said maybe even a review of previous calls for service.
BJ Wagner: Absolutely. Review of call for service data is critical to determining how many teams you put to work.
Audience Question: What is the involvement with tribes in rural areas?
John Snook: In terms of 988, I think there’s been a strong focus on both. I can tell you that SAMHSA did a special report to Congress that focused on what they called special populations. Tribes and reservations were one of the focus, as were rural areas. And rural mental health has been a key priority on the Hill, and at SAMHSA. I think there are materials on their way. I can’t guarantee that those are going to be out before the July deadline, but I can say that they have done a report focused on that, looking at some solutions, to make sure that they focus on both of those really important populations. And there are some good examples on the ground already.
BJ Wagner: Even though we do work outside of Texas, I’ll speak just to Texas since we’re focusing there for today. And over 75% at the municipal police departments in our state have 70 officers or less. So, even though we have some really large cities in our state, we are primarily a rural state or municipal police departments, and we have to modify, sometimes, how these programs may look for rural departments, which means they may not work every day. So, some rural cities may look at their data and decide they’re going to roll out a team, Monday, Wednesday, and Friday, for seven hours, or six hours a day. So, for rural areas, we really encourage them to look at how they can resource a team, and when they need to resource a team. But certainly, to keep the fidelity as a team structure. Because that’s really where the sweet spot is. And having those professionals working together in a health forward approach is the most important thing that structures when and where you need it according to your size.
Audience Question: Can you talk a little bit more about what it means to have a 988 infrastructure with a fee versus not having a fee?
John Snook: So, I think the reality is, it’s a recognition that communities have been very under-resourced for establishing those three pillars of the crisis surface. So, while a cell phone fee is not a prerequisite to setting up 988. It’s basically just an option that the federal government opened up in order to ensure that there are resources available. And I think it’s honestly, it’s very similar to the process for 911 often. There’s been, for a long time, many states have had a 911 fee. It’s very similar to that, it’s not a prerequisite to having these 988 resources available in the community. But it gives you a steady pot of funds that can be used to fund both ongoing operations of the system itself and then the broader, ongoing operations of whether it be the crisis response team that ability to answer the calls or even those facilities themselves that you need to have somewhere to take first.
Audience Question: How do you anticipate or how in Texas are existing law enforcement and counselor CRTs coordinating with 988 calls? Is it through a dispatch system? Or how does that work being done?
BJ Wagner: I think a lot of 911 centers are still looking at how they can work well with 988. And now the field teams, any police officers, or specialty teams working in the field will work directly with their PSAP. Or public safety answering points. So, they won’t be dispatched to or communicate directly with 988 unless there is a drastic shift that happens in our state. So, if there is a call that is transferred to is happening in 911 that originated with or has 988 elements to it that go out into the field, then this field teams will work with a call from that point. That is, a lot of our 911 centers are still, you know, working to identify how to help 988 centers. How to communicate with 988 centers, and how to be able to have risk matrices to determine when they can move a call out of their 911 center when it’s safe to do so. But 911 Centers will still be the direct communicator, augmented, and specialty response teams that have public safety professionals on at this point.
Audience Question: Have you worked with businesses and campuses that have multi-line telephone systems PBX or VOIP to program their systems to recognize 988, and translate it to the national number?
John Snook: That is a great question. And I think that is one of the reasons that the folks from Vibrant who are operating the crisis line, are a good group to connect with. They are working out in every state to connect, because I think those are the sort of on-the-ground obvious questions that we need to get answered, that I, unfortunately, don’t have a great answer for right now.
Host: No, I certainly understand. What was the name again?
John Snook: Vibrant. They are the operating group that runs the National Suicide Crisis Lifeline. And so, they are going to be staffing the 988 system. So, they are connecting in every state, and they’re a great resource for that conversation of who to talk to. I didn’t even think of that before. They are a great resource to use.
Audience Question: Will 988 provide support for persons with intellectual and developmental disabilities?
John Snook: Yes, that is another one of those special populations that SAMHSA is focusing on. I think there is a lot of work that needs to be done, obviously, but ——- and a number of groups, have been very involved in the conversations. And there are a host of special populations that, come up, that we’ve known for years. 911 has been trying to figure out how to make sure they addressed as well, and it’s the same process. Whether it be people that have sight issues or hearing issues or developmental disabilities, autism, substance abuse issues. All of those are special populations that need to have a particularized response. And that is one of the key issues that SAMHSA, the federal agency for mental health is working to provide information on. And I think it will be a bumpy road state to state honestly. I think SAMHSA is going to provide information, the state mental health program directors are doing some focus on that as well. But there will be different processes in different states because the existing infrastructures for some of those responses are different state to state. So, the process will need to fit in with the existing state-level systems as well.
