The Daily Agenda: Crisis helpline improves access, but still needs work
A three-digit number is easier to remember ... Thousands of Southern Arizonans use the system ... Ortega still hasn't filed his campaign finance report.
Last July, the National Suicide Prevention Lifeline switched from a toll-free to a three-digit number in the hopes of improving access to crisis support to meet the nation’s growing needs.
Leading up to the launch, mental health providers nationwide, including Tucson’s Crisis Response Center, braced themselves for what they expected to be an influx of people seeking care by adding staff, programming and clinical space to meet the anticipated demand.
In Southern Arizona, a person who calls 988 will be routed to the Arizona crisis line for evaluation. If the call taker believes the caller is experiencing a mental health emergency, a mobile crisis team will be dispatched or the person will be directed to the Crisis Response Center for further treatment.
Both the CRC and the state’s crisis line have seen an increase in Southern Arizona residents seeking help. During the first six months of the year, the crisis line received more than 200,000 calls, according to Solari Crisis and Human Services’s data dashboard. Solari is a nonprofit that provides crisis line services for Arizona and Oklahoma.
Experts consider the switch to the three-digit number a success on many fronts. The number received more than 5 million contacts in its first year, including 1.43 million calls, 416,000 chats and 218,000 texts, according to Psychiatric Times.
And in the first six months of this year, Arizona’s crisis line — which fields a combination of direct calls to the toll-free number and calls routed from 988 — received more than 50,000 calls from Southern Arizona.
But the system is far from perfect — and local experts continue to urge Arizona residents to call the state line (1-844-534-HOPE) or use the web-based chat rather than the 988 number to easily access local help. All of these go to Solari’s statewide crisis line.
That’s because the current 988 system doesn’t have the ability to geolocate callers. When someone calls 911, their location can usually be tracked. But 988 uses the caller’s area code to determine the call center.
This means that if Caitlin, who has a Central California area code, calls 988 in Tucson, she’ll be routed to the closest call center in California, which would not be able to deploy a mobile team and would have a hard time connecting Caitlin with local resources.
The federal government is working to improve the geolocation system, according to Dr. Margie Balfour, chief of quality and clinical innovation at Connections Health Solutions, which has been managing and staffing the Crisis Response Center since 2014. And while 988 will never be able to pinpoint a person’s exact location — to preserve anonymity — it should soon be able to pinpoint the closest cell tower, she said.
Luckily, Arizona’s 844-534-HOPE line, which has been in place for decades, is one of the most robust in the nation, Balfour said.
“Arizona has been in a unique position. Unlike most states, we have a very mature and robust crisis system including a dedicated crisis line,” Balfour said. “It’s still the case that the Arizona crisis line gets about eight to ten times more calls to it directly than calls that come through it via 988.”
While Tucson’s Crisis Response Center is an option for people who call 988 or Arizona’s crisis line, it’s also available 24/7 for urgent care services for people who haven’t been able to access psychiatric help. Last March, the CRC hired a dedicated psychiatrist provider to expand access to urgent care services.
The urgent care provider is on duty from 7 a.m. to 7 p.m. each day and handles medication evaluations and refills, enrolling patients in outpatient services like therapy and making referrals to community resources. Adding a dedicated urgent care staffer last March resulted in a fourfold increase in the number of people seen for such services, with the CRC now seeing about 250 adults per month in urgent care.
For now, the feds are paying a huge portion of the bill for 988 and local crisis resource centers. But that money is not guaranteed.
The federal government has invested almost $1 billion into 988, and in May 2023, the U.S. Department of Health and Human Services announced an additional $200 million in new funding for states, territories and tribes to build local capacity for crisis services.
Arizona is among 24 states that don’t have a dedicated revenue stream to ensure that if that federal money goes away, crisis call centers don’t go away with it.
Luckily, Arizona has built its crisis system up over the past few decades through a combination of Medicaid, federal block grants from SAMHSA, and state and local funds.
But as the demand for mental health services increases, the state should be evaluating whether services need to be expanded, as resources are still scarce.
A Kaiser Family Foundation assessment of the nation’s mental health workforce revealed that one-third of the population lives in areas that are underserved and about 80% of rural counties don’t have a single psychiatrist.
“It is hard to get into outpatient services and sometimes it’s even harder if a person is privately insured than if they’re in the Medicaid system,” Balfour said.
Perhaps the biggest advantage the 988 system has over the old hotline system is the ability to text and chat, which has helped drive a spike in use from kids and teens in southern Arizona. Before transitioning to 988, the lifeline could only “sufficiently process” about half of the text messages and 30% of the chats it received. And although text volume has increased by more than 700%, the text answer rate in May was 99%, according to the article.
“You should be able to provide services in ways that people like to communicate, and it really shows that there was an unmet need in this area,” Balfour told Psychiatry Times.
They need some IT help: The campaign manager for Miguel Ortega, a Democrat running for the city council seat in Ward 1, explained to Jim Nintzel at the Tucson Sentinel why Ortega was one of the only candidates who didn’t meet the Monday deadline to file his campaign finance report.
“Campaign manager Billy Peard said that he’d run into technical difficulties and expected to file by Wednesday,” Nintzel reported.
(Ortega’s updated financial report still was not posted to the City Clerk’s Office website by close of business Wednesday.)
Between a rock and a hard place: Two months after the Biden administration ended a major policy that kept thousands of people from being able to ask for asylum at the U.S.-Mexico border, asylum seekers are still dealing with confusing policies, Alisa Reznick reports for KJZZ’s Fronteras Desk. They can use an app touted by U.S. officials as an easy way to make an appointment or they can put their name on a list and wait. Both take forever.
Already preparing for 2024: Pima County Elections Director Constance Hargrove wants to add more voting centers to make sure voters don’t have long wait times during next year’s elections. In Hargrove’s July 14 quarterly report, she recommended adding a voting center at the Highlands at Dove Mountain, where nearby voters have to drive more than 13 minutes to get to the nearest voting center, and at the University of Arizona’s Hillel Foundation.
We’re also looking ahead to 2024. But we need your support to get there! If you’re a free subscriber and like what we’re doing, why not switch to being a paid subscriber?
Taking their business elsewhere: Rio Rico residents voiced their concerns about a massive rezoning plan near Interstate 19 at a public meeting Tuesday, the Arizona Daily Star’s Henry Brean reported. The rezoning is the brainchild of local landowner Andrew Jackson, who wants to develop commercial, residential and industrial space near the river as infrastructure for a large zinc and manganese mine planned in the nearby Patagonia Mountains. Pat Risner, president of the Australian mining company’s project in the area, said they could always build offices and facilities somewhere else.
“We haven’t made the decision to site these anywhere, much less Rio Rico,” Risner told residents.
Let the animals through: Federal officials agreed to put openings for wildlife in the border wall in Southern Arizona, Capitol Media Services’ Howard Fischer reports. Some of the openings will be big enough to allow bears, Sonoran pronghorn, and jaguars to keep migrating across the border. The agreement addresses, at least partially, one of the main complaints Southern Arizona environmental groups raised when the Trump administration started building the 30-foot-tall wall in 2019.
224,000: That's the number of times pedestrians legally crossed the border through ports of entry in Nogales in June, according to recently released statistics from U.S. Customs and Border Protection. They're mostly people who live on one side of the border and work on the other, family members visiting each other, shoppers, tourists, and the like. Last fiscal year, the total was 2.4 million.