Strengthening the Western Montana 988 Suicide & Crisis Lifeline: Continuing Regional Crisis Response and Access to Care. - AWARE, Inc. (AWARE) is the 988 Suicide and Crisis Lifeline provider for Missoula, Flathead, Ravalli, Lincoln, Lake, Mineral, and Sanders counties in western Montana. With this grant, AWARE will strengthen systematic follow-up care and crisis continuum coordination, reduce suicide and overdose deaths, and decrease unnecessary law enforcement involvement in mental health crises across its seven-county 988 service area, building lasting partnerships across the crisis continuum so every caller reaches ongoing care. In 2022, its first full year of operation, AWARE's call center answered 1,025 Lifeline calls, 740 from repeat callers, indicating a significant unmet need for structured follow-up. AWARE has since answered 15,009 additional calls. This grant will build the capacity to provide systematic follow-up for an estimated 6,000 calls annually and 18,000 over the three-year project period. The capacity built through this grant will benefit all residents of the seven-county region who access 988, crisis, or emergency services, for themselves or others, as well as area service providers. Regionally, 20% of residents are under 18, 59% are 18-64, and 21% are 65 or older; the population is evenly split by sex. About 13% live below the federal poverty level (13% of youth, 11% of adults, 9% of older adults), 9.5% are veterans, and 2.1% are involved in the criminal justice system. To build capacity, AWARE will implement standardized care-coordination protocols and formal agreements with Certified Community Behavioral Health Clinics, hospitals, emergency departments, mobile crisis outreach teams, 911, and community behavioral health providers; integrate Certified Peer Support Specialists; expand staff training and wellness supports; and launch text and chat follow-up in coordination with the Montana 988 Program. Goal 1: Strengthen coordination across the crisis continuum. By Year 1, establish written care-coordination agreements with key partners; by Year 2, document successful linkage to community-based behavioral health or recovery services for at least 75% of participants accepting follow-up; by Year 3, sustain a model that re-engages individuals who do not initially connect to care. Goal 2: Build sustainable organizational capacity for 988 follow-up. Integrate peer support specialists and deliver ongoing evidence-based training in crisis intervention, suicide prevention, and trauma-informed care; develop a workforce program with standardized competency assessments; provide quarterly staff wellness programming to reduce burnout. Goal 3: Expand Montana's crisis continuum through innovation and collaboration. By Year 1, implement and evaluate text and chat follow-up and coordinate with the Montana 988 Program on statewide expansion; by Year 3, launch a community education initiative on 988 follow-up services. These goals advance SAMHSA Strategic Priorities, including expanding crisis intervention care and improving access to evidence-based treatment for mental illness, substance use, and co-occurring disorders.
