Puerto Rico 988 Crisis Center Follow Up Improvement Project (PR-Follow Up Improvement) - The Puerto Rico Mental Health and Anti-Addiction Services Administration (MHAASA), Puerto Rico's State Mental Health Agency (SMHA) and Single State Agency (SSA) for substance use services, proposes the Puerto Rico 988 Crisis Center Follow-Up Improvement Project to strengthen the capacity of PAS Line, Puerto Rico's statewide 988 Suicide & Crisis Lifeline, to provide timely, evidence-based follow-up services for individuals experiencing suicide risk, substance use, and other behavioral health crises. Operating 24/7 since 2001, PAS Line serves all 78 municipalities of Puerto Rico (population: 3.18 million) and, since 2022, has also served as a National Spanish Backup Center for the 988 Lifeline. The project responds to the continuing need to improve post-crisis continuity of care for individuals experiencing suicide risk, substance use crises, and other behavioral health emergencies. Between 2023 and 2025, PAS Line responded to 24,630 local 988 contacts, including 1,775 suicide-related crises, 713 substance use-related crises, 1,012 Veteran-related contacts, and 339 Mobile Crisis Team (MCT) deployments. The proposed project will enhance Puerto Rico’s existing statewide crisis system through evidence-based follow-up, expanded partnerships, workforce development, quality improvement, and strengthened data infrastructure. Specifically, the project will: 1) Enhance PAS Line’s capacity to provide timely, evidence-based follow-up services through standardized protocols, rapid follow-up initiation, and individualized follow-up for a minimum of 90 days and up to 12 months, as clinically indicated. 2) Strengthen coordination across Puerto Rico’s behavioral health crisis continuum by expanding collaboration with hospitals, Mobile Crisis Teams (MCTs), Certified Community Behavioral Health Clinics (CCBHCs), 911/Public Safety Answering Points (PSAPs), behavioral health providers, and other community partners to improve care transitions and treatment engagement. 3) Strengthen organizational capacity and accountability by expanding workforce capacity, enhancing data collection and quality improvement systems, participating in SAMHSA’s national evaluation, and using performance data to guide continuous program improvement. Project performance will be monitored through the Performance Accountability and Reporting System (SPARS), the Crisis Services Program Data Center (CSPDC), and project-specific performance measures aligned with SAMHSA requirements. Expected outcomes include improved access to follow-up services, stronger continuity of care, increased linkage to behavioral health treatment and recovery supports, enhanced system coordination, reduced recurrent behavioral health crises and unnecessary emergency response utilization, and a stronger, more sustainable statewide behavioral health crisis system serving all residents of Puerto Rico. By strengthening Puerto Rico’s statewide crisis response infrastructure, the project will advance SAMHSA’s Strategic Priorities and the Administration’s Make America Healthy Again initiative.
