Maine Crisis Line Follow-Up Improvement Project - Project Abstract Project Name: Maine Crisis Line 988 Follow-Up Improvement Program The Maine Crisis Line 988 Follow-Up Improvement Program will sustain and strengthen statewide, follow-up for people who contact or are referred to the Maine Crisis Line (MCL), Maine's 988 provider, and need continued support after crisis contact. The project will build on follow-up capacity made possible through prior SAMHSA support through targeted quality improvement aimed at improving access of follow-up services for those who would benefit, efficacy of referrals for appropriate services, coordination with partners including emergency services, and expansion of follow-up through chat/text modalities. The Opportunity Alliance (TOA) operates MCL, Maine’s statewide crisis line and 988 Lifeline contact center, serving all 16 counties. MCL is a 24/7 crisis access point with established follow-up practice, clinical supervision, data systems, quality assurance processes, and crisis-continuum partnerships. TOA expects to serve/enroll 1,000 individuals annually and 3,000 individuals over the three-year project period. The population of focus includes people across the lifespan who consent to follow-up, including people with suicide risk, substance use or overdose risk, repeated crisis contact, barriers to treatment access, or care-transition needs. Maine’s need for follow-up is urgent. In 2024, 285 Maine residents died by suicide, and Maine’s age-adjusted suicide mortality rate was 19.2 per 100,000, compared with 13.7 nationally. The common use of emergency rooms for suicidal ideation and self-injury, rural distance, housing instability, transportation barriers, workforce shortages, and long waits for outpatient care can leave people without timely support after crisis contact. Follow-up helps turn an initial crisis response into continued connection and engagement. This award will preserve MCL’s statewide follow-up progress and improve continuity of care. MCL will begin outreach within 24 hours of referral or care transition as a standard for all follow-up enrollments, provide follow-up for at least 90 days and up to 12 months as appropriate, and use increased quality review to strengthen follow-up practice. Partner-facing work will include continued coordination with the Office of Behavioral Health and mobile crisis providers; quality improvement review with Public Safety Answering Point (PSAP) partners for selected transferred or referred 911/988 contacts; updated referral and workflow information with behavioral health, hospital, recovery, housing, and community partners; and establishment of chat/text follow-up parameters before initiating the service. Findings from data review and partner coordination will be used to update training, documentation, workflows, and sustainability planning. This project will preserve essential statewide 988 follow-up capacity for the people of Maine, extending crisis response beyond a single contact into the days and months that follow, when sustained support and timely resources can help people stay safe, stay connected, and rebuild the stability that crisis so often disrupts.
