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Embedding Equity into 988: Imagining a New Normal for Crisis Response

Year: 2022

The current emergency response system was not designed to meet the needs of those in behavioral health crisis. First responders are not equipped with training necessary to expertly intervene. Inadequate interventions occur too frequently for people in distress, and the consequences of this are increased trauma and inequity. Specific communities have experienced the most inequity and trauma: people who identify as LGBTQIA+; black, indigenous and people of color (BIPOC); rural communities; immigrants, refugees, and non-English speaking people; people living with disabilities; older adults; people experiencing homelessness or housing instability; formerly incarcerated or justice-involved populations; survivors of trauma; and neurodiverse people. Evidence shows these populations hesitate to call 911 in times of need because they fear the response will result in more harm than good (Sasson, et.al, 2015). This July, the United States will launch the first ever national emergency line devoted to psychiatric response and preparedness: 988. A historic time in healthcare, it is an opportunity for local and federal leaders to employ necessary tools that ensure previous experiences and failures are rectified and its implementation is equitable.

To address this, the Kennedy-Satcher Center for Mental Health Equity (KSCMHE), an entity of the Satcher Health Leadership Institute at Morehouse School of Medicine has partnered with Beacon Health Options, to establish concrete recommendations towards equitable and effective administration of 988. This has been done through a comprehensive literature review to understand the context of inequity in psychiatric response, and complemented with a leadership experience survey that was anonymously responded to by dozens of leaders in the behavioral health field across the country. Each recommendation also has opportunities for exploration and measurement of success into the future. Efforts to embed equity into 988 must be continuous and comprehensive.