Centerstone's 988 Crisis Center Follow-Up Program (C-CCFP) - Centerstone’s Crisis Center Follow-Up Program (C-CCFP) will expand efforts within Centerstone’s 988 Lifeline Crisis Center, which provides follow-up in 20 primary, mainly rural counties and backup in 2 secondary, urban counties in Tennessee. C-CCFP will develop infrastructure to support engagement post-crisis in enhanced follow-up and support/linkages for consenting persons from an anticipated 10,010 Lifeline callers (Y1:2,730; Y2-3: 3,640/yr.).
Focus population demographics/socioeconomics are expected to mirror those of the primary catchment area (e.g., nearly 50% male; 50% female; 82% White; 9% Black; 7% Hispanic/Latino individuals; 13% in poverty). The secondary area comprises a greater percentage of racial/ethnic minorities and persons in poverty. C-CCFP will serve subpopulations from among the areas’ rural residents (537,230); Veterans (148,500); minority communities (e.g., 1,028,245 racial/ethnic minorities and/or 95,570 LGBT adults/youth); and criminal justice population (e.g., 13,785 juvenile court youth; 7,530 released jail inmates). From 2016-18, catchment area calls to the National Suicide Prevention Lifeline increased by 73%, and since 988’s launch in July 2022, Centerstone has received 6,000+ calls, with 23% reporting suicidal thoughts. Catchment area populations at high-risk of suicide include an estimated 5% (96,480) of adults and 13% (24,920) of youth ages 12-17 who had suicidal thoughts. Subpopulations at heightened risk of suicide include an estimated 4,455 of Veterans, 10,983 of LGB adults, and 770 adults on probation with serious thoughts of suicide.
C-CCFP’s enhanced follow-up protocols will be guided by evidence-based strategies/best practices such as SAMHSA’s standards and the National Guidelines for Behavioral Health Crisis Care and will include evidence-based approaches such as the Columbia-Suicide Severity Rating Scale for screening; Stanley Brown for safety planning; and Motivational Interviewing to encourage service access/engagement. C-CCFP’s goals include: (1) Develop a sound infrastructure and increased capacity to deliver enhanced crisis follow-up services; (2) Increase coordination between and capacity within members of the local crisis care continuum; (3) Implement systematic enhanced post-crisis follow-up services for a minimum period of 90 days up to 12 months to support suicidal individuals post-988 contact; (4) Improve continuity of care, safety, and well-being outcomes among individuals at risk of suicide following contact; and (5) Develop/disseminate a documented service model for agency-wide and national replication/ adoption. As a result of these goals, C-CCFP will achieve the following measurable crisis workforce and capacity building objectives: hire/train 3 project staff, to include peers, in culturally responsive care, intersections of service access/social determinants of health; develop/formalize partnerships with 40 local crisis continuum providers and 22 post-crisis recovery support providers; share program processes with state personnel semi-annually; establish data sharing agreements with 1 epidemiological records team; work to establish a partnership with 3 area mobile crisis outreach and 3 short-term crisis stabilization organizations; and offer training to 300 Centerstone and other crisis workforce members. C-CCFP will achieve the following measurable participant-related objectives: Enroll 100% of consenting persons in follow-up; initiate follow-up within 24 hours for and request documented consent from 100%; provide initial screening, safety planning, and referral to crisis/post-crisis recovery services for 100%; conduct 3+ follow-up attempts and complete 2+ follow-up connections per participant; increase number accessing services by 50%; achieve 0 suicide deaths and 0 attempts among those engaging in services; achieve annual percentage of contacts requiring police engagement of 5%; and improve mental health/disposition outcomes by 70%.
