California's project, the California 988 Suicide and Crisis Lifeline, serves all Californians by providing immediate, one-on-one support with trained crisis counselors to those in crisis. California's priority for this grant is to enhance the 988 programs in California by expanding the workforce and maximizing call, chat, and text response, thereby increasing access to the crisis care system in the State of California and improving outcomes for high-risk populations.
As the nation's most populous state, California experiences the highest volume of 988 calls in the country. California experienced an initial, rapid 28 percent increase in total 988 contacts received when 988 went live on July 16, 2022, rising from 23,950 National Suicide Prevention Lifeline contacts in June 2022 to 30,681 988 contacts in August 2022, the first full month after 988 implementation. The State is currently on track to exceed 339,000 total contacts received from July 2022 through June 2023, State Fiscal Year (SFY) 2022-23. Combining a linear regression analysis based on contact trends and Vibrant Emotional Health's volume projection estimates, the California Department of Health Care Services (DHCS) projects the annual total contacts received in California will increase to 378,603 in SFY 2023-24, 423,557 in SFY 2024-25, and 468,511 in SFY 2025-26.
Between July 1, 2022, and April 30, 2023, California reported state answer rates ranging from 87 percent to 90 percent with an average answer rate of 88 percent. The answer speed ranged from 32 seconds to 40 seconds with an average answer speed of 36 seconds. Only five 988 crisis centers in California offer 988 chat and text. Currently, no 988 crisis centers in California have the workforce and/or funding capacity to operate 24/7 for chat and text or offer follow up services.
DHCS has the following goals for this grant: 1) Recruit, hire, and train behavioral health workforce to staff California's 988 crisis centers to increase the capacity to respond, intervene, and provide follow-up to individuals experiencing a behavioral health crisis; 2) Enhance coordination among 988 crisis centers, 911, and mobile crisis services across California; and 3) Develop and implement a comprehensive 988 communication strategy, informed by enhanced statewide data collection.
The following objectives are derived from the aforementioned goals: 1) Expand workforce, including the utilization of credentialed peers, to enhance operating capacity to achieve at least a 90 percent answer rate; 2) Develop a sustainability plan for maintaining Key Performance Indicators (KPIs); 3) Deliver trainings relevant to high-risk populations and referral options; 4) Develop and submit a report to SAMHSA detailing mobile crisis service options; 5) Develop and submit a report to SAMHSA on current 988 and 911 structures and collaborations across the state; 6) Develop a plan to effectively communication 988 services to tribal populations; 7) Develop a statewide 988 communication plan; and 8) Enhance demographic data collection.
If awarded this grant, California's 988 network will expand access and increase crisis support services for Californians. DHCS will work with county governments, providers, community organizations, foundations, and other key partners as part of a collaborative effort to improve local 988 capacity within California. The grant will aid in reinforcing the 988 network's presence in all 58 counties by funding efforts to support coordination of behavioral health services, creating project sustainability, and increasing awareness of the behavioral health crisis resources in California.