Centerstone’s Crisis Center Follow-Up Improvement Initiative (CCFII) - Centerstone’s Crisis Center Follow-Up Improvement Initiative (CCFII) will expand efforts within Centerstone’s 988 Suicide and Crisis Lifeline Center, which provides follow-up in 20 primary, mainly rural counties and backup in 2 secondary, urban counties in Tennessee. CCFII will build capacity to support engagement post-crisis in enhanced follow-up and support/linkages for consenting persons from an anticipated 7,510 help-seekers (Y1: 2,050; Y2-3: 2,730/yr.). Focus population demographics/socioeconomics are expected to mirror those of the primary catchment area (e.g., nearly 50% male; 50% female; 24% under age 18; 41.5% ages 18-49; 35% ages 50+; 13% in poverty; 11% Veterans). The secondary area comprises a greater percentage of persons in poverty. Clinical characteristics of the focus population will mirror state rates: In the past year, among those ages 12+, an anticipated 16% will have substance use disorder (SUD) and 4% will have misused opioids; among those ages 12-17, 20% will have had at least one major depressive episode (MDE); and among adults ages 18+, 26% will have any mental illness (AMI) and 7%, serious mental illness (SMI). Ongoing demand for crisis services points to a need for follow-up programming: In 2025, Tennesseans made 60,000 phone calls and 36,000 chats/texts to 988, a 24% and 70% increase year over year, respectively. Over the past year (July 2025-June 2026), Centerstone’s Tennessee 988 team has received over 12,500 calls, with 26% reporting thoughts of suicide. CCFII strategies to increase capacity while improving outcomes for individuals post crisis include strengthening care coordination across the crisis and recovery continua and improving linkage and navigation to ongoing treatment, recovery, and community supports. Enhanced follow-up protocols will be guided by evidence-based strategies/best practices and will include evidence-based approaches such as the Columbia-Suicide Severity Rating Scale and Guidance for Screening, Assessment, Intervention, and Monitoring for Suicide Risk and Overdose Risk by the New York’s Office of Addiction Services and Supports for screening; Stanley Brown for safety planning; and Motivational Interviewing to encourage service access/engagement. CCFII’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 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. CCFII 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 5 percentage points annually; 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%.
