Working for 988: Insider Perspectives
Curt and Katie received feedback on our recent one year follow-up episode on the rollout of 988. We received responses from a person who was working within the 988 system as well as someone who started going through the training for the text crisis hotline. We were able to put more depth into our understanding of how this system works. We explored training, supervision, funding, potential equity issues, and concerns for staff. We also share ideas for advocacy.
Click here to scroll to the podcast transcript.Transcript
In this podcast episode we report back on employee experiences within the 988/crisis response system
We share two insider experiences working within the crisis response system around 988.
Listeners shared their experiences with training as an emergency worker within the 988 system:
- For the text crisis hotlines, there were concerns about insufficient, online-only training models that lack supervision and focus on formulaic responses.
- For the call center, there was a report of extensive initial training (9 full time weeks of training) but minimal supervision post-training.
What are 988 insider concerns regarding AI and Data Privacy?
- Ethical concerns around AI tools used for measuring empathy and issues with data collection practices.
- Balancing AI integration with trauma-informed care and caller anonymity.
“Now I think it is important to talk about the funding source here, because this person that I spoke with talked about that a lot of the funding seems to be cobbled together. This is a system that, consistent with our emailer, is building the plane while it’s flying.” – Curt Widhalm, LMFT
How does 988 Funding work and what are potential equity Issues?
- Fragmented funding models tied to sources like Medicaid lead to inconsistent protocols and potentially inequitable care.
- Federal funding is needed to standardize practices and improve service quality.
“It seems to me, based on what we had researched, read, reviewed prior to the previous episode, that this is part of the disjointed nature of 988, as well. Because I think I could see different philosophies or other decision trees that are at different centers that would lead to more immediate hospitalization and/or police involvement, versus ones where there’s deeper training, like nine 40 hour weeks, where there’s a little bit more nuance in that assessment.” – Katie Vernoy, LMFT
An insider report on 988 Call Center challenges:
- High burnout rates among staff due to limited resources and support.
- Gaps in follow-up care for callers due to funding and staffing constraints.
Takeaways and Solutions for 988 and the full crisis response system:
- Advocacy is needed for dedicated federal funding to ensure consistent training, equitable care, and trauma-informed practices.
- It would be best to have standardized protocols to strengthen the 988 crisis hotline system.
- Thoughtful integration of AI to enhance efficiency while maintaining ethical standards.
- Support for call center staff to prevent burnout and improve service outcomes.
Resources for Modern Therapists mentioned in this Podcast Episode:
We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!
Lyssn: lyssn.io
Screen Shots that were emailed to us:
This is a screenshot of their “Updated Policies”
This screenshot is the progression of the conversation that the hotline operator was expected to go through.
Screenshots of training examples:
The following is a screenshot of what a 988 operator can expect from the coaches they will be working with:
The following screenshot is how to respond to questions like “Are you going to snitch?”
Relevant Episodes of MTSG Podcast:
What Therapists Should Know about the Rollout of 988
Two Years In: Is 988 Actually Helping People Facing Mental Health Crises?
Special Series: Fixing Mental Health Care in America:
Fixing Mental Healthcare in America, An Interview with Dr. Nicole Eberhart and Dr. Ryan McBain
Serious Mental Illness and Homelessness, An Interview with Senator Henry Stern and Dr. Curley Bonds
Who we are:
Curt Widhalm, LMFT
Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com
Katie Vernoy, LMFT
Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com
A Quick Note:
Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.
Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Consultation services with Curt Widhalm or Katie Vernoy:
Connect with the Modern Therapist Community:
Our Facebook Group – The Modern Therapists Group
Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/
Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):
Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).
… 0:00
(Opening Advertisement)
Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.
Curt Widhalm 0:12
Welcome back, modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the things that go on in our field, the things that go on in our profession. And this is a follow up to our follow up episode on the 988 mental health crisis line, and we, several months ago, had done an episode following up on 988 two years in, what was publicly available as far as information, we had a call to action at the end that anybody who has some familiarity from the 988 systems to let us know what we’re missing. And we had a couple of listeners respond back to us and say what you’re talking about is accurate and it’s not the complete picture.And we wanted to be able to share some of this information. The people who did reach out to us because they like having jobs, they like having some anonymity. We’re going to respect that, and we’re going to relay some of the information that was given to us. So Katie, I’m gonna let you start on this, and we’re gonna start at the very beginning. People who apparently want to go and work the call centers for 988 seem like very good people with very good intentions. And one of the concerns that we’ve brought up is how good is the actual training to be a call center person. So I’m going to kick it over to you and let you start with one of our listeners who emailed in.
Katie Vernoy 1:48
So this person wrote in 2023 I thought I’d volunteer for Crisis Text Line. So somebody that was doing the the texting that was going on. I’m a mod in an online support group. I thought I’d give a try at a suicide hotline, as I was actively supporting young, troubled people via text in the support group, anyway, on Reddit and Discord. Besides that, I’m an RN, so this is a pretty qualified person, and have many patients in crisis, and wanted to learn more on how to speak to them. Plus, I’ve been somewhat suicidal myself throughout my life. Therapy helped a lot, but when it was wasn’t available, hotlines were my backup. I’d say I personally had made maybe 10 calls over 30 years. Three were exceptionally helpful in the moment. Three were just duds that were a waste of time. The rest were helpful to break my rumination. So we’ve also got lived experience here. So I wanted to do something to give back and to improve my communication skill. Googled volunteering and Crisis Text Line came up big. I assumed incorrectly that it was run by the national government, or that it and the 988 hotline were one in the same. Moreover, I didn’t even realize then how fragmented 988 really is, I learned after completing the training. So there’s some screenshots here, and I’ll just get some of that information here in here. Launch of 988 beginning July 16, 2022, 988 will be the new three digit dialing code, blah, blah, blah for anyone experiencing mental health related distress. What does this mean for us? Some of these chats and texts will be routed to Crisis Text Line, making it so that more people are able to get support. This will not change the nature of the conversations on the platform, the skills of developing rapport with texters, blah, blah, blah. So it’s basically this is a backup to 988, this Crisis Text Line. So our listener did the background check. Began the training. No actual instructor involved in the training. It was an online module with simulations of what it’s like to message someone on their platform, how to use the platform and how to use their formula for helping, a clear progression from intro, information gathering, reflecting and supporting, summing up and closing, you’re expected to use correct grammar and spell. Grammar and Spelling, probably to help the AI interpret and learn, preferred adjectives and descriptive and action words, and to adhere generally to patterns of interaction that get a texter calmer in about 20 minutes. And so there’s a, you know, some pictures of the training, and it does look very much modular, very much it’s a computer program, is really what I’m saying.
Curt Widhalm 4:05
And for reference, we’ll put these pictures in our show notes over at mtsgpodcast.com so you can see what we’re referencing as well.
Katie Vernoy 4:14
As a responder, you might have several texts ongoing with different texters at the same time, and you have a supervisorin a group chat in the window as well, along with a library of resource lists and AI prompts on where to take the conversation, it asks you to fill in blanks from the beginning, like asking for a name and location. Of course, the supervisor can monitor and enter the convo. The training has a modern, happy, positive, breezy, kind of Amazon flavor to encourage the trainee, like, don’t stress, you’ll have support the entire time. We’re there for you. You’re doing great, and you’ve got this asking you to fill in the blank and pick the best word response to a texter. At the end was one sample text Convo graded by a real employee. And there’s a picture of that there. You’ll see that over in the show notes. Not gonna lie, it reminded me a lot of when I did surveys at another place a few years back. In effect, teaching AI how to respond most naturally and helpfully. I didn’t much care for asking texters their info and filling out those data points. That also reminded me of a job I had, calling customers to sign them up for a rental service and putting their info to a database. But I trudged on through the training, ignoring my feelings until I came across the breezy claim that we’re data nerds. We meaning Crisis Text Line and the whole body of people working there, I suppose. But what data nerds? It was presented as a good thing. But honestly, I couldn’t figure out what made it a good thing in the context of an anonymous hotline. That one sentence kind of destroyed my trust. All of a sudden, I started Googling the company then, and found that there had been a whole for profit data exchange with an AI company. Crisis Text Line insists that never, ever will happen again. I’m like, okay, that’s twisted, but makes more sense now, and I don’t believe it can’t happen again. My first shift taking real texters, I had a supervisor watching the interactions closely, and I had a question come up from the texter, “Are you a snitch?” Before I could answer that, the supervisor gave me text to copy paste. I screenshotted that as I screenshotted a lot of training, because I thought I might need to refer to that text again. So we have a screenshot there, and I think there’s enough crossed out so we can put that in the show notes, too. To this day, I can’t decide if the text Convos on that first day were real or more training. It felt like I was possibly speaking to an AI. I didn’t sign back in after that first day. It was too uncomfortable to think that real people were coming there for help, and the only thing, and the only help I could give was by formula, and if their life were truly in danger, I was supposed to collect their name and location and turn them in. But I was also supposed to make up stuff like we are a confidentiality hotline. But on the other hand, all the past conversations are not deleted and can be accessed by supervisors. It honestly gave me heebie jeebies, not least because I myself has have used suicide hotlines or similar. I thought hard and decided I couldn’t participate. Just wanted you all to hear my story. These, those are my current concerns. Of course, if you use any of my statements on the show, like to bring them out of so we can keep that there. And that’s that’s that person’s experience. So talking about the training being pretty interesting, not very extensive, and concerns about AI and data. So, so that was part of our accurate, but potentially incomplete.
… 7:16
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Curt Widhalm 7:20
I had the opportunity for an anonymous interview with one of our listeners, who spent the best part of an hour talking with me about their experience in working in what I will call the greater Southeast United States, as far as kind of a geographical region. And I know in some of our past episodes, more of our research had come to things that were based more locally for Katie and I in Los Angeles. So I had asked about the training as part of our interview, and this listener had responded that they had nine 40 hour weeks of supervised training in order to be able to start working the phones in response to people calling in. So this seems like…
Katie Vernoy 8:07
Wow, that’s a lot of training.
Curt Widhalm 8:08
That is a lot of training, and it’s highly supervised, highly hands on, which I think is quite different than the experience of the person that you read their email here. However, once the training is complete, the level of supervision and quality control is, quote, nil.
Katie Vernoy 8:29
Oh, wow. Okay, so it goes from let’s hold your hand for nine weeks and then you’re on your own.
Curt Widhalm 8:36
Speaking to the concerns around AI is that some of the training seems to be working to train AI. And second hand report is that there’s a particular AI program called Lyssn, l, y, s, s, n that does seem to be working on measuring empathy within artificial intelligence. And we’ll include a link to some stuff about Lyssn in our show notes as well, and part of what workers are encouraged to do is to make sure that they are using certain keywords in protocols to ensure that AI is following along.
Katie Vernoy 9:16
Okay, that seems pretty consistent with this other training from the other person. That they are trained to respond in potentially a clunky way in order to tag with keywords.
Curt Widhalm 9:31
Yes. Now when I picture 988, I picture a call center room, maybe some cubicles, some very wonderful people picking up ringing phones, people who are calling in in the the worst moments of their lives, looking for help. And I was told that this is part of the job, but it’s not entirely accurate. That part of the way that some 988 systems work is that 988 is contracted with various different funders, and we’ll get back to the funding piece here in just a little bit. But some of these funding programs allow for people to put their information into the funding source. Say, I need somebody to reach out to me, and the 988 centers have staff who call the individual members so or call the people who are in crisis. So it’s not just pick up the phone call, 988, sometimes it’s the staffers who are calling and reaching out to people because they’ve put their information in.
Katie Vernoy 10:34
Oh, that’s interesting. So somebody can pre pay for their their calls. They they put they go to their funding stream, and I’m assuming that’s like Medicaid, or whatever their their health insurance is, their mental health insurance, as they go to that site and put their information in and 988 calls them back, or calls them initially, they initiate the call.
Curt Widhalm 10:56
Yeah, that’s my understanding. Is that there’s also an outbound call, depending on who the funding source is. Now I think it is important to talk about the funding source here, because this person that I spoke with talked about that a lot of the funding seems to be cobbled together. This is a system that, consistent with our emailer, is building the plane while it’s flying. And the more that I talk with people, and the more that I hear about 988, it’s not just building the plane while it’s flying, but it’s like the plane has been sling shotted out into the air, and everything needs to be built before it just comes crashing down.
Katie Vernoy 11:40
Including the engine.
Curt Widhalm 11:41
Including the engine. But currently, the way that things stand is a lot of funding seems to be based in the CCBHC model for care, and that stands for the Certified Community Behavioral Health Clinic model, or public health funding model. And this is where there has been pockets of federal funding for pilots in various ways, with the expectation for states to pick up the funding along the way and consistently across both of our episodes, and the people who helped us contribute to this episode are saying it leads to this very fragmented system where things are going to be wildly different from one jurisdiction to another. And on the worker side of things, it is very clear not to have steady funding. Now, last week, in our episode, we were talking about the way that money works and the way that grants can kind of make it to where certain protocols have to be met in different ways, and that means that different protocols end up having to happen based on who the funding source is. And the way that this looks in, where this listener works, is based on the type of contract that is funding, which callers are calling in in crisis, it entirely changes the protocol in how the caller has to respond to who’s calling in in crisis.
Katie Vernoy 12:08
Okay, so let me make sure I’m understanding. So we’ve got someone puts their information into their funding source, so an insurance plan, a federal plan like Medicaid or those types of things, or a state plan like Medicaid, and when they get the call back, where their funding comes from, determines how they are treated on their call?
Curt Widhalm 13:09
Exactly.
Katie Vernoy 13:10
Okay. That seems a little bit weird and maybe not equitable,
Curt Widhalm 13:16
And that was one of the things that stood out to me, is based on how wealthy or how good somebody’s insurance is changes how well they may be treated. Some of the various funding, as you pointed out, is from Medicaid. There’s also USDA contract program called AgriStress for farmers and ranchers to deal with their mental health, which was news to me that face value sounds really good and positive for very targeted markets. But the point is, is that as a worker, the protocol can be entirely different from one person to the next. Now, the goals are that for people who are calling in calls have to be answered by the second ring.
Katie Vernoy 14:25
Okay.
Curt Widhalm 14:27
And this is fingers crossed, hoping that call centers are staffed well enough that it’s not ring, ring, hello. Can you hold on while I am finishing up another call? It doesn’t seem like that, but the documentation is also very different depending on which contract is funding calls.
Katie Vernoy 14:44
So there’s the equity piece, which is depending on how good your insurance is, or how good the facilitator of your plan is, and making sure that you have targeted, you know, kind of response to these calls. It’s also, from, I’m just thinking from a clinician side, or from a worker side. I have to know the protocol or, I mean, I guess a good manager could just say, you respond to the Medicaid calls, you respond to the other call. You know this funding sources calls. But it seems like that would get even clunkier too. It just seems like a hard thing to manage from the worker side that I have to follow through on a different protocol depending on which insurance this client has.
Curt Widhalm 15:30
Now, for people who call in and a call center worker ends up picking up the phone, I’ve been reading a lot of online responses. I’ve been reading a lot of online reviews. People might be concerned that merely calling in with suicidal thoughts will lead them to have law enforcement interactions or having safety protocols put in place that might be above the level that is actually needed, especially the way that 988, is being advertised as kind of a crisis line, rather than a hey, the cops are going to show up at your door, kind of line.
Katie Vernoy 16:10
Yeah.
Curt Widhalm 16:10
And in my interview, we talked about the there are several different decision trees that end up being presented to the callers that help to determine the level of imminent risk. And so I’m actually a fan of this in crisis type situations, and there’s lots of research in various fields that show that the less we’re relying on in the moment decision making, the better off that we tend to be. The interviewee that I talked with had spoken about that at least at their call center, all of the staff has a very good idea of the risks involved in calling law enforcement. So that seemed to be a really big point of emphasis in their training, and that there is a lot of follow up questions. For example, if somebody says, Hey, I’m really stressed out. I banged my head against the wall. That’s not immediately assigned as this is self injury leading towards imminent death, that there’s follow up questions that need to be asked about levels of severity.
Katie Vernoy 17:19
It seems to me, based on what we had researched, read, reviewed prior to the previous episode, that this is part of the disjointed nature of 988, as well. Because I think I could see different philosophies or other decision trees that are at different centers that would lead to more immediate hospitalization and/or police involvement, versus ones where there’s deeper training, like nine 40 hour weeks, where there’s a little bit more nuance in that assessment, and it’s not something that’s gone too quickly. Because some of the the stories that we saw in those articles were, it felt at least that those callers had been kind of referred to law enforcement pretty early. And, you know, it’s always perception of the person and how they’re talking and those kinds of things. Some people have a different dramatic flair and how they talk about things, versus don’t, and I’m hoping that the training is sufficient to help parse through that and sort through it, and help callers understand the consequences of how they’re speaking to whether or not the law enforcement is called. But to me, it sounds like this, at least this center where this listener works has sufficient training to actually protect callers, which is nice. It’s good to hear that.
Curt Widhalm 18:44
And I think that there’s also some really, I will call it, not necessarily completely trauma informed, but based on some of the bigger fears, as far as actually working at some of these places. This caller said that in a typical eight hour shift, there’s no expectation that calls have to have a certain time limit, that if it goes well beyond an hour that is okay. And in a typical eight hour shift, you might expect to end up working 10 to 28 calls and no worker is expected to immediately take back to back calls, that there is a time off in between each calls. I didn’t ask a follow up question as far as how long, but it seemed to be at least 10 minutes to be able to gather and that there is ongoing trainings as part of new grants that end up coming in as far as funding. So it does seem to be kind of responsive to the workers needs, although I will point out that the pay at this particular call center is $18 an hour. Which was described as you get what you pay for. And so it’s not necessarily a long term idea around this is something that is realistically going to be, something where you expect to have a long career.
Katie Vernoy 20:17
Sure, and I think that’s a general understanding about crisis hotlines, right? I don’t see that as a long standing job. I feel like it would be irresponsible to stay on it too long as people probably get pretty burned out. I would imagine, just from the compassion fatigue.
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Curt Widhalm 20:36
Additionally, for every 988 call, the call centers offer follow up calls, and this is part of not just responding to people as they’re calling in. And they can offer a follow up call. They get consent. They get consent to leave a message if somebody else is picking up a phone. It can be a follow up call at an hour, it can be a couple of hours, and it could be potentially even the following day. So follow up calls are something that is offered.
Katie Vernoy 21:11
That’s cool, it provides a little bit of additional support, which I think can be really critical for folks who are at the stage that they’re considering suicide.
Curt Widhalm 21:23
So a mixed bag so far, but a lot of our discussion ended up coming around some of this disjointed aspects, and really around making 988 a regularly funded and working and not such a patchwork program. And I asked what would be the best answer to this? And the listener had responded that in some areas that have a large population, you’re going to have potentially better supported call centers, so you’re going to have funding that looks at, okay, there are several million people in the Los Angeles area, for example, whereas in more rural states, some of these call centers are covering multiple states and…
Katie Vernoy 22:12
Oh, wow.
Curt Widhalm 22:12
…that’s going to lead to some potential funding problems. And so what it’s going to take is dedicated funding at the federal level. I’m imagining, you know, alright state A says, Yes, we’re going to contribute. State B says, Well, if State A’s paying for it, we don’t have to, and that could be somewhat problematic. But the suggestion was that since federal funding is probably something that’s never going to happen on just a consistent level, that there should be maybe some calls to action towards creating some matching funding from the federal government that matches whatever states contribute to it, in order to make this a longer and more robust system.
Katie Vernoy 23:04
I like that idea. I actually like both ideas. But I think you’re right. I don’t believe that just blanket federal funding is likely. One of the things that can happen when there is consistent funding sources is that there’s also dedicated procedures, protocols that are consistent across a lot of different places. So the funding guides, the I don’t know what’s the opposite of truncated and divided, a unified, there we go, a unified process. And so, for example, someone who’s trained in California could also cover for a crisis hotline in North Carolina, right? So it could be something where there’s such consistency across all of the 988 hotlines that there’s quality control. There’s consistency. There’s a lot of, I don’t know, just a better process. The piece that that, I think, is interesting, that both of our listeners put forward, and I think was part of the conversations that we had previously on this topic, is the presence of AI, and whether they’re doing the the Crisis Text Line, whether there’s some AI process in sorting through, getting information up front, and all of that there, there’s some fear about that, because AI is still fairly new, and we’re concerned about, you know, what the ro-, you know the robot revolution, and they’re taking over. And I could see it as a big cost saving mechanism that would allow for, potentially, when you need a person on this crisis hotline, that person could be better trained, better compensated. And so I think that you. With caution. I think allowing for some of these AI processes might help with the funding mechanism, because it would be theoretically, once the development costs are covered, much cheaper. As we’ve talked about in our AI episodes. I think there’s potential for bias, and also less bias, and all of those things that might be very helpful.
Curt Widhalm 25:24
One of the things that I can see happening with AI, if there is more of a national unity, is the ability to based on where colors are calling in, is the AI can help assist whoever is working in the staffing center to be able to have a more dynamic approach and not just be Well, here’s the protocol, based on where my jurisdiction is, and so I can see that as a useful tool there.
Katie Vernoy 25:52
Well, it could even, you know, have a sort through resources, be able to provide a lot of information in addition to helping with improving the call quality.
Curt Widhalm 26:06
But that would have to go into some of the geo location stuff that we had spoken as being part of it. The person that I interviewed said that most of their programs don’t have geo location capabilities. We had talked about Vibrant is one of the companies behind some of the 988 centers, their programs, potentially, do. I imagine that this is going to continue to end up being kind of a larger piece of things, as we see 988 continuing to be built out.
Katie Vernoy 26:42
Sure.
Curt Widhalm 26:44
Some of the funding stuff, and this kind of was part of our part of the conversation around the support for the people taking the calls. And I had asked, What are some of the ways that things could be improved? And our listener had said that despite some of the structural things that we had pointed out to as far as some of the positives going all the way back to the beginning of the episode around the no support, really, beyond the training, is having more communication and support from management to the people who are taking the calls. And it’s not for a lack of want, but it’s a a lack of funding to have enough management support to be able to have the check in on people. And for anybody who’s ever worked in community mental health, this is probably very, very consistent to what you’ve experienced in those environments.
Katie Vernoy 27:42
Yeah, and I think that’s the biggest challenge is when you’re working leanly, because you’re very poorly funded, a lot of those trauma informed practices seem like niceties, seem like extravagances that you don’t have time for, and folks are already probably putting in more hours than they’re paid for in the management levels. Because, you know, a lot of these folks, because they’re not paid well, are, you know, working out of the goodness of their heart. And so, as we’ve talked about a bazillion times, it leads to burnout. It leads to compassion fatigue. It leads, leads to bad management because they’re so bitter and burned out that they don’t think about how their behavior is starting to impact the folks that are overseeing.
Curt Widhalm 28:33
And some of the benefits for more advanced funding on this, the state where this listener is based, says that it’s not just for funding the 988 system itself, but it’s also funding the continuum of mental health care. And some of this is looking at being able to better fund the infrastructure in the communities for the handoffs for people that do need that higher level of intervention. And in this particular state, Medicaid accounts for over half of all mental health funding. So if you are one of those data nerds, you can probably narrow that down pretty quickly. You got a one in 50 chance.
Katie Vernoy 29:23
Sure.
Curt Widhalm 29:23
This would increase things like mobile crisis responses that may or may not lead to a higher level of care. It might lead to having more beds available for people who do need that funding, and would also, as it looks more at the actual 988, system being able to pay staffers more in order to prevent things like burnout and being able to have more consistent, more qualified, more experienced people who are responding so that way less has to be spent in investing for people to get trained in this entire system.
Katie Vernoy 30:05
Yeah, there is kind of this idyllic system, and we talked about it in the Fixing Mental Health Care in America episodes that we started long ago. And there’s a few that we were still working on and we haven’t put out to to the audience. So maybe we’ll revisit some of that, because it seems super relevant at this point, but this idyllic sense of you start with a dedicated hotline that is for mental health, you have an infrastructure put in place where it’s an array of services. It’s a spectrum of services, from the most gentle to the most intense. And I think that there’s really good thought around what this could look like. I think as a society, we so downplay the importance of mental health and the need for mental health services that trying to get funding streams for all of these different levels of care, including the 988 hotline and the adjunctive services that they could provide, or that they could lead to, or connect to, it just feels like this hopelessness around we’ve got this great idea and we can’t get it funded because people don’t care about mental health, or they don’t think that we should pay this much for mental health. And so I’m sure there’s advocacy there, and I’ve been waxing poetic, so I’ll turn it back over to you, but I just I do think that there’s a pretty solid plan here. Could it be funded and well trained?
Curt Widhalm 31:39
And I think it’s going to come largely at this point down to the state jurisdictions that come on this. And while the Biden administration has invested a lot of money in 988, over the the years that this has been in place, it’s still incredibly fragmented. It’s like many government programs, is not something that’s a perpetual funding. And so it’s going to rely on who’s in Congress. It’s going to rely on who’s in some of the state legislatures. And historically, things like this become All right, here’s going to be the potential sunset of this program. Now, I do think that something like this is probably not going away anytime soon, but the investments in this kind of stuff really come down to the human power of being able to respond to people in times of needs.
Katie Vernoy 32:42
Yeah.
Curt Widhalm 32:44
The funding does seem to largely rely on the company Vibrant that we had talked about in our previous episode, and while there are concerns around the AI that they may be developing or using. That’s where the funding seems to be going, and seems to be one of the places that I’ll reluctantly say, if it’s gonna go somewhere, and it’s a place that’s at least putting some things in place in order to help people in crisis. It’s better than nothing.
Katie Vernoy 33:24
Yeah, I think it is.
Curt Widhalm 33:28
The last quote that I will cite from our listener is, “If people are going to call in, the system needs to work.”
Katie Vernoy 33:41
Yes, yes, indeed.
Curt Widhalm 33:47
The statistics that we had cited in our last episode are that most people who call in and utilize the system do get help. The percentage of people that are receiving problematic calls does seem to be very much in the minority of people who are having interactions with the 988 system. The overall concerns are, can we do better? And usually, when it comes to systems like this, the answer is yes, and it comes down to money.
Katie Vernoy 34:22
Exactly.
Curt Widhalm 34:24
We will put a lot of things in our show notes. You can find those over at mtsgpodcast.com as always, we love listener feedback. It helps us to not just wax poetic about whatever Katie and my ideas are. Please let us know what your experiences are with things, what you would like us to cover in our episodes. You can do that through any of our social media, and by any we most often check Instagram and Facebook and email us, join our Facebook group, The Modern Therapist Group. And until next time I’m Curt Widhalm with Katie Vernoy.
… 34:59
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