988 line is coming for mental health crises, and it complements Knoxville's police program

On July 16, everyone in the United States will have immediate access to mental health and substance abuse help and resources by dialing just three digits: 9-8-8.

Through the new universal 988 number – intended to be an alternative to 911 to broaden care access and decriminalize mental health crisis calls – trained counselors and response teams will be available 24/7. They will listen to the caller’s problems, assess their needs and provide support by connecting individuals with local resources, and alert local emergency crisis teams, if necessary.

Dialing or texting 988 will redirect to the National Suicide Prevention Lifeline, which currently links to around 200 local crisis centers across the country. Area codes determine which call center receives the call and the longer number (800-273-8255) will remain active even after 988 is implemented.

For Knoxvillians, Contact Care in Oak Ridge is one of those centers that take crisis calls and offers support through Frontier Health. And an existing program that pairs trained counselors with Knoxville police officers on crisis calls will continue.

“I think (988) could help in a unique way,” says Mental Health Association of East Tennessee CEO Ben Harrington, who believes the universal number will forge greater collaboration between 911 and existing crisis services available in Tennessee.

“All three doors are open for business … as long as the end result is that a person gets their crisis alleviated, they don't attempt suicide, they get served, or we can deflect away from law enforcement engagement and incarceration and get them connected to mental health services,” he said.

Decriminalizing mental health in Knoxville

One in four fatal police shootings between 2015 and 2020 involved someone with mental illness, according to the National Alliance of Mental Health. And one in 10 people who experience mental health and substance abuse emergencies engage with law enforcement before receiving care.

What is 988?: What you need to know about the new mental health crisis helpline

These interactions with officers can lead to arrests, hospitalizations and even injury or death, which could have possibly been avoided if mental and behavioral specialists were on the scene or providing support by phone before police arrived.

Recognizing this concern, Knoxville Police Department and McNabb Center partnered in 2021 to develop a co-response team that paired an officer and a behavioral specialist on mental health related calls.

Harrington believes this co-response team will be an asset once 988 goes into effect.

However, because an officer is dispatched with the co-response team, and potentially when someone calls 988, any police presence on mental heath calls remains a concern for some.

Knoxville HEART, an organization that advocates for alternative responses to mental health emergencies, has hesitation.

“The (988) line itself is great … (but) we believe that police should not be the first responders for mental health crisis calls & that you can improve outcomes with alternative response teams instead,” Knoxville HEART said in a statement to Knox News.

Calls to 988 will connect to local crisis centers and mobile crisis teams. But if you call 911, Knox County Emergency Communications will dispatch officers or the co-response team.

The responding unit will conduct a welfare check and then make the determination of how to handle the call, such as alerting a local 988 call center or mobile crisis teams.

“The first line of care for those in crisis should be mental health professionals trained in de-escalation, not police with weapons. Police presence often worsens mental health crises, especially for those with prior experience with police or folks from historically marginalized communities,” Knoxville HEART's statement continued.

McNabb representatives said they're uncertain how 988 will affect the co-response team or how police will respond to mental health emergency calls, but they are in favor of new avenues of support.

“We know the need for mental health care is great and it is important for people to have immediate access in their time of need. We applaud efforts to raise awareness and increase options for people who may be struggling,” McNabb regional clinical vice president Leann Human Hilliard told Knox News in a statement.

How prepared is Tennessee for 988 launch?

Marie Williams, Tennessee’s Department of Mental Health and Abuse Services commissioner, praised Knoxville’s alternative response efforts and says the state has been making improvements to its mental health emergency services and resources.

In fact, one of the reasons 988 hasn’t been heavily promoted nationally is because some states have yet to figure out ways to fund the program, which may require taxes or charges in the way 911 is funded by sates.

But that's not the case in Tennessee because the current infrastructure can seamlessly accommodate 988 needs.

“In Tennessee, we didn't need to do a tax,” Williams said. “Those other states are doing taxes. We already are funding the things that they want to fund, if you read about what 988's wanting to fund (like) crisis centers, mobile crisis, respite."

Tennessee has its own statewide crisis line (855-CRISIS-1) in addition to the National Suicide Prevention Lifeline. This line will remain active, too, once 988 goes live across the country.

Tennessee has six crisis centers and 13 provider lines throughout the state that provide immediate care and help find long-term solutions, and multiple mobile crisis teams. These resources continue to be funded and expanded through added staffing and into areas that may have limited access to support.

Tennessee call centers have already taken 158,907 calls this year, including 16,000 statewide calls, 112,000 provider calls, and 30,000 National Suicide Prevention Lifeline calls, according to Williams.

Williams knows the importance of differentiating between mental health and police responses, and the need for programs like Knoxville's to continue. .

“You still need those pairings (with trained officers) because when you get the call, then what do you do? So, you still need those teams to go out and be able to intervene in whatever's happening in the crisis.”

What happens after the crisis call?

One area Harrington said Knoxville and East Tennessee can improve is long-term care in the private sector.

988 and crisis centers offer immediate help regardless of cost. Those who don't have insurance and aren't enrolled in Medicaid or Medicare can receive expanded care through places like McNabb, Cherokee Health Systems and Ridgeview Behavioral Services.

But patients with insurance in the private sector, such as through an employer, may have limited mental health care options because nearby mental health professionals may not be taking new patients or may not be in their plan's network.

“That's where you start to get squeezed and you have to start searching and find somebody. All of that happens right below the crisis level but where you still need care and you need it quickly, and folks can end up waiting for service,” Harrington noted.

Tennessee’s statewide crisis number and the full National Suicide Prevention Lifeline number are currently available for emergency calls. These numbers will continue to be active after the launch of 988.

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This article originally appeared on Knoxville News Sentinel: How Tennessee prepared for nationwide mental health hotline 988