The Substance Abuse and Mental Health Services Administration (SAMHSA) 988 State and Territory Cooperative Agreement funding opportunity will assist Alabama with capacity building and readiness efforts to ensure state originated crisis calls are properly routed and answered and sufficiently equipped to meet 988 demand. 988 Alabama Building Capacity (988 ABC) seeks to establish an interconnected statewide system to address mental health crises at optimal levels to ensure all Alabamians have access to a comprehensive crisis delivery system of Someone to CALL, Someone to RESPOND, and Somewhere to GO. Understanding the significance of the point of initial contact, the call, 988 ABC seeks to build capacity by maximizing and leveraging resources of its current Lifeline Member Center designees, onboarding new/additional Lifeline Member Center designees, and existing infrastructure to enhance and expand suicide prevention efforts and behavioral health crisis response. Alabama is located in the southeastern United States, bordered by the states of Florida, Georgia, Mississippi, and Tennessee. The capital city of Alabama is Montgomery (located in Montgomery County) and the most populous city is Birmingham (located in Jefferson County). Based on Census 2020, the State of Alabama has 4.8 million residents with a 12-17-year-old population of approximately 380,000 and an 18 and older population of approximately 3.7 million in its 67 counties. In the age group of 12-17-year-olds, males make up 50.9% of the population, while females are 49.1%. In the age group 18 and older, males make up 47.7% of the population, while females are 52.3%. Alabama is racially made up of 69.8% White, 26.6% Black, 1.3% Asian, and 0.7% American Indian/Alaska Native, and 0.1% Native Hawaiian/Other Pacific Islander. Hispanic/Latino accounted for 4.1% of the population while 1.5% of the population is made up of two or more races. Understanding that Alabama is primarily rural and land mass is vast, 50,633.2 square miles and a water area of 1,773.0 square miles, addressing the needs of all Alabamians is critical in the consideration of optimal access, reach, follow-up, and the assurance local needs are met, therefore signaling a regional response approach. Addressing health disparities and promoting health equity are essential to the success of the Alabama Crisis System of Care and service delivery will incorporate culturally relevant practices. The population of focus will be all Alabama 988 callers, texters, and chatters. 988 ABC seeks to continue efforts toward a systematic approach to crisis care that is accessible, interconnected, just, and employs best practices. The goals of 988 ABC are to: (1) Improve workforce recruitment, retention, and training efforts to ensure necessary capacity for Someone to Call, Someone to Respond, and Somewhere to Go; (2) Support existing and onboarding Lifeline Member Center designees to ensure adequate resources, coordinated efforts, necessary referrals, and linkages to care; and (3) Improve Alabama capacity to readily meet 988 implementation demand as it relates to crisis contact. The objectives of 988 ABC are: (1) By June 2022, Alabama Lifeline Member Centers will obtain a state call answer rate, chat, and text response to meet or exceed 90% of total calls received; (2) By June 2022, reduce the national backup center calls to 10% or less; (3) By June 2022, establish a monthly reporting metric for all Lifeline Member Center designees to track average speed to answer to ensure at a minimum 95% answered in 20 seconds, 90% answered in 15 seconds; and (4) By the conclusion of FY23, 100% of Alabama calls will be covered in-state.
High-tech crisis call centers are a core element of transforming crisis services in Alabama and an essential component of the Alabama Crisis System of Care. 988 ABC will provide a pivotal capacity building opportunity to ensure the needs of all Alabama callers are met.