Behavioral health leaders focus on increasing awareness about availability of crisis lines in Florida

By

Shane Ersland

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Helping residents understand where to find help when they are going through a crisis is a key priority for Florida behavioral health leaders.

Industry leaders discussed Florida’s efforts to build a strong crisis system at the 2024 Florida State of Reform Health Policy Conference in April. Melanie Brown-Woofter—president and CEO of the Florida Behavioral Health Association (FBHA)—said providers need to focus on addressing the entire continuum of care for patients from birth to death, and consider interventions that are appropriate for children, adolescents, young adults, older adults, and the elderly. 

“We see a barrier as people don’t know where to go and what services are available,” Brown-Woofter said. “They also delay seeking treatment for two to three years because they don’t realize they have symptoms. The family doesn’t realize they need an intervention. There’s got to be some education and more discussion. We made so much progress in the last few years in breaking the stigma, making it OK to have conversations around behavioral health around the dinner table. For many years that was taboo.” 

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Clara A. Reynolds is president and CEO of the Crisis Center of Tampa Bay, which answers Florida’s 988 Suicide & Crisis Lifeline, six other crisis lines, and the state’s substance abuse hotline. The center answered national suicide/crisis line calls prior to the implementation of 988. 

“We would take between 10 and 15 suicide calls a day,” Reynolds said. “The first day (of 988 operation) on July 16, 2022, we quadrupled that call (amount), and we have seen elevation. The cool part about that is 97 percent of the time, we don’t have to engage mobile response or law enforcement to intervene. We are able to de-escalate those individuals and get them to the right care.”

Despite the crisis line’s increase in calls, some residents who need assistance may not be getting it because they aren’t aware of its services.

“We’ve got this incredible system and nobody knows how to access it yet. So I think our big challenge is creating that messaging, and making sure it is as simple as what (federal officials) are looking at us to do. It’s so complex right now, depending on where you live and who actually engages when you call for help (law enforcement, the child welfare system, or a mobile crisis response unit). That’s where the cool opportunity is because that’s just marketing and education. The infrastructure pieces are being built, and now it’s just [about] the next step.”

— Reynolds

Amanda Regis, senior strategic initiatives advisor for the Florida Department of Children & Families (DCF), noted that many people call 911—even when they are in a crisis despite 988’s availability—because they are more familiar with it. So DCF staff have begun working with 911 dispatch centers.

“When you’re in an emergency situation, whether your cat is stuck in a tree or you’ve just found your child with a needle in their arm and they’re comatose, you’re calling 911,” Regis said. “One of the things we’re really excited about is actually placing some of our staff in 911 dispatch centers. Because (for) 911 operators—that is unbelievably difficult work—your job is to get information and dispatch. It is not to de-escalate; it is not to get to the root of the problem.” 

The move creates co-responder options for callers, Reynolds said.

“It will make it easier for people who are in crisis that don’t need a police officer, but need some other response—whether there’s a mobile response or something else—we will have people in place that have the knowledge and time to be able to do that work,” Reynolds said. “Until we get to a place where everyone knows to call 211 or 988, depending on what you need, I think we have to utilize what people already know, and figure out how to tweak that to make the system work.”

The Florida Legislature appropriated $126 million for DCF to expand behavioral health services and reduce waitlists for them in 2022, Regis said. 

“We allocated some funds to invest in our mobile response teams. We were able to bring our mobile response teams up from 39 to 51. We were also able to expand the service capacity of the mobile response teams. Prior to 2022, they only served individuals up to (age) 26. Now they serve all civilians of all ages. Mobile response teams have an 82 percent diversion rate. So they’re able to keep individuals in the community and out of a higher level of care.”

— Regis

DCF plans to focus on certified community behavioral health clinics (CCBHCs) in the coming months, Regis said.

“We are looking forward to seeing the impact a large network of CCBHCs will have on the state,” she said. “Another thing we need to consider is the difference in accessibility for rural vs. urban communities. We need to tailor that and ensure those services are available in all communities, and all of our authorities are able to be reached when they need services.”  

FBHA is also focused on working with CCBHCs, Brown-Woofter said.

“The CCBHC model increases access, gives people real-time services, and provides links to the community,” Brown-Woofter said. “Behavioral health is a continuum, and it’s not just episodic. So when we begin to look at moving from an episode treatment to a continuum of treatment, we can see you in the home, we can see you in crisis, and then we follow up. Follow-up is wraparound services; it’s providing therapy, (or) a peer counselor or mentor. When we look at crisis, we look at the moment, what led to it, how we can de-escalate it, and prevent the crisis from happening again.”

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