988 Crisis Line Implementation

Task Force and Task Force Member Activities

988 Crisis Line Implementation The transition to the new 988 code to access the Suicide and Crisis Lifeline begins tomorrow. The potential of this resource is enormous but realizing its full potential will take years. Courts have a stake in the design and implementation of 988 and should be at the table as plans are made to roll it out to communities across the country. This new Task Force Court Leadership Brief provides an overview of the courts’ role, and links to relevant resources.

A Look at the 988 Soft Launch On July 16, 2022, the United States will “soft launch” a new emergency number for behavioral health emergencies. The 988 number will provide 24/7 access to crisis counseling for anyone experiencing a mental health or substance use crisis via phone, text, or chat. The purpose of this column is to provide practical guidance about the 988 soft launch. What does it mean? What doesn’t it mean? What should you tell your patients and their families? What should you tell your colleagues and staff? What is the best way to take advantage of this new opportunity and contribute to the successful development of crisis systems in your community? Co-authored by Task Force member Dr. Ken Minkoff.

Behavioral Health Resource Hub Redesigned “The Hub” is a one-stop compilation of resources for courts and communities looking for the latest research and resources related to behavioral health and the justice system. The redesigned site expands on the Sequential Intercept Model design of the original site and includes even more information and links to curated resources.

Fall Miami Site Visit Schedule Announced Three dates have been secured for site visits to Miami: October 26-27, November 17-18, and December 15-16.  Up to 25 slots will be available for these guided visits to experience the Miami Model. Hosted by Judge Steve Leifman, each event will include observation of and interaction with their jail diversion programs, competency restoration alternatives, extensive CIT initiative, AOT program, peer specialist initiative, and a chance to visit the new one-stop Miami Center for Mental Health and Recovery.  Registration will be available shortly. For more details contact Rick Schwermer.

More New Task Force Resources Released

Research and Resources

NACM Behavioral Health Guide The 2022 Behavioral Health Guide emphasizes the importance of addressing mental illness through collaborative efforts of the justice and behavioral health systems. The Guide is presented in support of the work of the National Judicial Task Force to Examine the State Courts’ Response to Mental Illness and the development of statewide multi-branch commissions, committees, or task forces focused on this issue while encouraging all state and local courts to lead and promote systemic change in the ways courts and communities respond to individuals with serious mental illness.

Assisted Outpatient Treatment (AOT) Toolkit This Michigan based Assisted Outpatient Treatment (AOT) toolkit is an evidence-based tool that promotes recovery and reduces harmful behavior, hospitalization, emergency room use, and costs. The toolkit strives to improve the practice of providing outpatient treatment under civil court order to individuals with SMI who have demonstrated difficulty engaging with treatment on a voluntary basis. The toolkit aims to provide general information about the process of AOT and more specific guidance for key components of the system: courts, mental health providers, hospitals (including emergency rooms and inpatient psychiatric care), individuals under AOT orders, families and advocates, and law enforcement.

Are Police the Key to Public Safety? The Case of the Unhoused In this paper, Professor Barry Friedman discusses this issue in the context of one of the most intractable and challenging problems in the United States: that of unhoused individuals living among us. Rather than doing what we are able to do to help them find their way to safety, we criminalize their conduct. This does not solve the problem—indeed it creates a revolving door of street to jail to street. This paper suggests alternative approaches to public safety, instead of relying so heavily on the police. One of them is an untried idea of creating an entirely new set of first responders—individuals holistically trained, including in social services, mediation, and much else—to deal effectively with social needs they encounter on the streets.

CSEC Treatment Courts: An Opportunity for Positive, Trauma- Informed, and Therapeutic Systems Responses in Family and Juvenile Courts Juvenile and family courts are uniquely positioned to intervene in cases involving CSEC (commercial and sexual exploitation of children). Several jurisdictions have already created treatment courts to specifically address the needs of survivors and those at risk of CSEC, particularly those who are involved in the child welfare or juvenile justice systems. The goal of treatment courts for survivors of CSEC centers on the idea that the court process can be therapeutic for participants and produce improved outcomes. With proper training on trauma-informed systems and CSEC, the actors within the court process can help further therapeutic outcomes for survivors.

Boarding Mental Health Patients in Minnesota Emergency Departments--The Unintended Consequence of an Inadequate Mental Health System This Article begins by describing the overall problem of boarding mental health patients in Minnesota emergency departments and the underlying problem of a statewide inpatient psychiatric bed shortage. Next, it proceeds by drawing attention to another contributing factor, which is delayed discharges from inpatient psychiatric units due to a shortage of “step-down” mental health programs. Then, this Article addresses the impact of emergency room boarding on patients, providers, and health care systems as a whole.

Systemic, Racial Justice–Informed Solutions to Shift “Care” From the Criminal Legal System to the Mental Health Care System The current configuration and function of the U.S. societal structures drives the overrepresentation of people with serious mental illness in the criminal legal system. Although the causes are multifactorial, the mental health system poorly serves those at highest risk of criminal legal system involvement. Responsibility for addressing the needs of those with severe mental illness should rest with the mental health system rather than with the criminal legal system. However, the current division of labor between the two systems is just part of the problem. Simply put, the mental health system is not consistently accessible to or effective for those at highest risk of criminal legal system involvement.

New Resource: Advisory—Peer Support Services in Crisis Care This SAMHSA advisory discusses the role of peer support workers and models of peer support services that are available to assist individuals who are experiencing a crisis. Peer support services are a vital component of crisis care.

JPLI Newsletter Includes a link to the recent Judges and Psychiatrists Leadership Initiative Leadership Summit, a submissions opportunity for prosecutor-led diversion map, and more.

July RJC Digest This Rural Justice Collaborative publication resources include Mental Health First Aid for Rural Communities; Tailoring Crisis Response and Pre-arrest Diversion Models for Rural Communities; and Improving Behavioral Health Services for Individuals with Serious Mental Illness in Rural Communities.

Texas Initiative Aims to Reduce the Wait for Inpatient Competency Restoration Services The “Eliminate the Wait” initiative provides strategies and tools for partners at all points in the criminal justice system to help reduce the number of people waiting in jail for inpatient competency restoration services. The project includes training, educational materials, and tools such as checklists for police, sheriffs and jail administrators, judges and court staff, prosecutors, defense attorneys, and behavioral health providers.

Diverting Youth from the Justice System Courts need to prepare to effectively serve young people who have experienced school disconnectedness, social isolation, and exacerbated mental health needs. NCSC's six-part webinar series focuses on how juvenile court stakeholders can best support young people in the post-pandemic era across the justice system.

SAMHSA Headlines The latest list of upcoming webinars and other resources from SAMHSA.

SMI Advocate This Summer 2022 issue of SMI Advocate covers legislative news from April 5 to June 29. We are celebrating the enactment of eight bills that will reduce treatment barriers for people with severe mental illness (SMI) in five states and have many updates to share.

NRI Newsletter The NRI Newsletter is a bi-monthly publication offers news and events relevant to the public behavioral health system. This edition includes a recently published article "Dementia and the Aging Population: Cognitive Screening Within Correctional Health," information about the Alliance for Health Policy’s 2022 Summit on Mental Health in America, and other related resources.

CSG Justice Center Justice Briefing This edition includes preparing for the implementation of the 988 Suicide and Crisis Lifeline; the Justice Reinvestment Initiative in action in Wyoming; an upcoming event; and more.

In the News

988 is the new mental health hotline. Can it change how we respond to crisis? Starting July 16, anyone in the US experiencing emotional distress or a mental health crisis can call the phone number 988 and reach a crisis counselor. NPR guest host Anna Sale talks to Hannah Wesolowski, chief advocacy officer of the National Alliance on Mental Illness, about bringing local call centers into this network, what challenges they're facing and how it will reshape how we view mental health resourcing.

New 988 Suicide Hotline: Hope or Hype? According to a national poll, 46% of adults have never heard of 988. Use of the Lifeline is expected to grow exponentially in coming years, potentially attracting more than 10 million individuals, according to some estimates. By 2026, volume could reach up to 24 million callers or texters per year. This has led to increasing questions and concerns over whether the hotline will be able to meet the already vast demand. According to New York Times data analysts, approximately 17% of the 2 million calls in 2021 were abandoned before the caller could receive help. This may be a result of long hold times and limited staffing in call centers.

Drug Courts Face Choice: Close Or Expand Access After Prop. 47 Fallout Last year, Yolo County tried an experiment: No one arrested for simple drug possession would be prosecuted or sent to drug court. Instead, those arrested with drugs were directed to the county health department. “What I was trying to do was test the hypothesis that this was solely a health issue,” said the plan’s architect, Yolo County District Attorney Jeff Reisig. “It was a total failure.” Data provided by the county show that fewer than 12% of people referred to the county’s Health and Human Services Agency even answered an initial phone call to establish a treatment plan in the first six months of 2021.

Rise of US Mental Health Courts Highlighted in ‘Any Given Day’ Documentary The documentary ‘Any Given Day’ from filmmaker Margaret Byrne follows Angela Roache-Pena, Daniel Brown Jr., and Dimitar Ivanov through a mental health court in Cook County, Illinois, as they try to break free from the carceral system. Although there is still research to be done, these programs do seem effective. A Loyola Chicago study reported that participants “indicated the program was encouraging, supportive and improved their lives.”

'Transformational' changes in the works for behavioral health in Idaho The governor and Legislature this year allocated $66 million over the next three years to implement a sweeping array of changes and improvements to Idaho’s behavioral health care system, recommended by a council that’s brought together all three branches of state government – the Legislature, the executive branch, and the judiciary.

Prisoners stuck waiting for state psychiatric services More than 2,300 people charged with crimes — and assessed to have some form of mental illness — are waiting up to 500 days to be seen and evaluated in a Texas state psychiatric hospital. For lesser offenses, the average wait is 231 days. For those that require a maximum-security bed — and that’s 885 people — the average wait time to get a psychiatric bed is 500 days.

Judge: Arizona Violates Prisoners’ Rights With Poor Care A federal judge has ruled Arizona has been violating the constitutional rights of incarcerated people in state-run prisons by providing them with inadequate medical and mental health care.

Opinion: Colorado's Mental Health-Care System Neglects Most Seriously Ill If family members can convince patients to go to emergency rooms or crisis centers, they may be put on a 72-hour hold. They may be given anti-psychotic drugs…if they’re lucky. And that’s it. Long-term psychiatric hospitalizations with counseling and access to life-saving monitored medications are almost non-existent in Colorado; SMI patients cycle in and out of psychosis, in and out of emergency rooms, in and out of homeless shelters, in and out of jail, and in and out of their families’ tattered lives.

PA’s controversial mental health law on involuntary treatment stands to get a test run more than 3 years after its passing Court-ordered outpatient treatment existed in Pennsylvania before the changes to the law, but through those changes, the state loosened the definition of who qualifies for it. Under the new AOT standards, people can qualify before they experience a mental health crisis in which they are deemed a danger to themselves or others. Counties were not required by the law to implement the new AOT standards, though, and since the law took effect, all 67 of Pennsylvania’s counties have consistently opted out. But five counties across the state are gearing up to launch the first assisted outpatient treatment pilot programs by 2023, if not sooner.

Editorial | Amid new criticism of 2004 ‘millionaires’ tax,’ mental health crisis must be confronted California voters nearly 20 years ago agreed something drastic was needed, approving a tax on millionaires that was hailed as a game changer in improving mental health services and reducing homelessness. But an investigative piece by the Los Angeles Times published Sunday found that while the tax has generated $29 billion and improved some outreach services since Proposition 63 was approved by 54% of voters in 2004, the program and promises have fallen far short of the initial goals.


NCJFCJ Judicial Wellness Initiative Personal wellness and self-care have emerged as critical core values of judicial leadership. Engaging in beneficial practices that develop positive physical and mental states of being increases self-awareness, connection with ourselves, and a deeper sense of community in all aspects of life. The goal of NCJFCJ’s Judicial Wellness Initiative is to promote judicial well-being, develop strategies to mitigate the impact of stress that is inherent in the work and share positive experiences in order to benefit others.

How judges can mitigate vicarious trauma A healthier and more self-compassionate judicial officer makes for a better decision-maker and community leader and should not be seen as weakness. To the contrary, it takes an incredible amount of honesty and self-awareness for anyone to admit the adverse impact of our work on our personal and professional lives so we can begin the process of accessing the tools available to develop resiliency. A judicial system with healthy, balanced professionals meeting the needs of those who are relying on the judiciary for help will result in more just and humane results for the community.

Leading by Example: Equipping Leadership to Support Mental Wellness and Build Happier, Healthier Teams During this time of “Great Resignation,” managers can support employees’ mental well-being by creating a healthy work culture with principles of diversity, equity, inclusion, and belonging at its core. To do so, organizations need to give leaders the tools to lead with understanding and compassion.

Want to get the Behavioral Health Alerts newsletter automatically? Subscribe here.

Have comments or feedback about Behavioral Health Alerts? Contact Rick Schwermer.


COSCA logo

NCSC logo