The Mental Health and Anti-Addiction Services Administration (MHAASA) of Puerto Rico will implement the PR 988 Crisis Center Follow-Up Project to expand efforts of the PR PAS Line/988 Lifeline crisis center to support individuals post-contact and provide continued support and linkages to decrease suicide risks. The PAS Line, as the only call center/988 in PR, attended 211,323 calls, including 505 calls through the 988/Lifeline, in SFY 2022. Through April of 2023 of the current fiscal year, a total of 134,440 persons have been attended by the PAS Line, 8,998 of which showed suicide behavior. The most recent data of May 2023 from the Spanish Crisis Line reflected 2,924 calls received. the PR Crisis Continuum of Services currently guarantees access to crisis counseling services, available for all PR through one Crisis Call Center (CC), 5 Mobile Crisis Teams (MCT), and coordination of services to Crisis Stabilization Faculties. The MCT's reported 842 contacts in 2022. A total of 18,441 referrals to private hospitals were made in SFY 2022, with 15,824 for adult hospitalization and 2,617 for the hospitalization of children. The contacts also resulted in 12,061 coordination of services for psychological assessments, and 12,506 for psychiatric assessments. Based on the increase of calls received by the CC through the addition of 988 contacts, and the continuing needs to serve individuals at risk of suicide and ensure follow-up services, the MHAASA proposes a 3-year 988 Crisis Center Follow-Up Project to achieve the following summarized Goals and Objectives: G.1) Improve connections for populations at risk of suicide and ensure the systematic follow-up of suicidal persons who contact the PAS Line/988 Lifeline Crisis Center through 24/7 crisis services; G.2) Ensure enhanced coordination of crisis stabilization, crisis respite, Mobile Crisis Outreach (MCO) response services and other services on the crisis continuum of care for individuals at risk of suicide that contact the PAS Line/988 Lifeline; G.3) Reduce unnecessary police engagement by linking the individuals at risk of suicide with the PAS Line/988 personnel; and G.4) Enhance the visibility of 988 services to ensure that the PR 988 processes are known, available, and accessible statewide and nationwide. Aligned with the needs, the objectives will be directed ensure: assessment of suicide risks in at least 95% of contacts; that 95% of the individuals identified at risk of suicide are offered follow-up services for a minimum of 90 days post contact and up to 12 months after contact; 100% of the PAS Line/988 CC's protocols and procedures follow Lifeline requirements; that at least 3 formal MOU's for crisis stabilization are developed and signed for crisis stabilization; and that at least 2 formal MOU's are developed with community-based organizations that provide follow-up recovery-oriented services; to ensure that the PAS Line CC workforce receives at least 2 trainings on working with populations at higher risk of suicide; and that training is provided to 100% of the personnel of the PAS Line/988; to provide at least one training to staff of each of the organizations included in the MOU's on 988 Lifeline requirements and standards; that police engagement is maintained at 10% or less through the MCT's interventions; that the PAS Line/988 CC director is designated and participate in the Commission for Suicide Prevention; and that PAS Line processes are shared on a semi-annual (6-month) basis; and to establish connection for suicide fatality review. The project will enhance continuity of care with engagement of hospitals, BH organizations and 911/Public Safety Answering Points, MCO and police, through post-initial contact with at risk individuals through 988. Data collection, analysis and reporting will be supported by a 0.2 FTE Data Administrator to ensure EBP fidelity and GPRA/SPARS compliance. A total of $500,000 a year for a 3-year grant period.