A new report examined the rollout of the 988 mental-health crisis line in each state, including Wisconsin.

The revamped National Suicide and Crisis Lifeline is nearing its second anniversary. While the report from the mental health advocacy organization Inseparable said progress is needed, it noted the change was a critical step toward providing better care.

For Wisconsin's operation, the findings show the call answer rate is 77%, below the desired level of 90%.

Abigail Spanjers, executive director of the La Crosse Lighthouse Peer Run Respite and Warmline, said for the broader service, she'd like to see more trauma-informed training.

"988 is a good overall resource for individuals," Spanjers noted. "However, we find that people are frequently put in a position where they have to navigate those calls differently, because if they come up with a 'trigger word,' it could end up triggering a wellness check."

She pointed out in some cases, the caller is simply looking for someone to talk with. In financing state-level systems, the report credited Wisconsin for having an enhanced Medicaid match for mobile response but it called on the Badger State to join others in adopting a telecom fee to help ensure more stable funding.

The report's authors said the overall goal is to reduce the effects of "deficient" crisis response. Since
2015, almost one in five fatal police shootings involved a person experiencing a mental health emergency.

Angela Kimball, chief advocacy officer for Inseparable, said too often, there is a tragic outcome when people cannot get the necessary help.

"At a less severe level, we see a lot of people who end up in crowded emergency departments," Kimball observed. "Frankly, emergency departments are getting so filled up with people with severe mental health challenges that they're experiencing something called 'ED boarding.'"

ED boarding refers to holding people in the emergency room as they await services. Meanwhile, the report found nationally, more than 80% of calls to 988 are resolved over the phone and for those who require mobile response teams, 70% are resolved in the field.

Nevada is among a handful of states to add a surcharge to all phone bills intended to help support the state's 988 mental health emergency hotline.

A new report by the mental health advocacy group Inseparable found if the surcharge were to increase from 35 cents to 98 cents, it would generate approximately $3 million annually for the Silver State.

Angela Kimball, chief advocacy officer for Inseparable, said the report is a tool to help policymakers and state leaders develop an equitable and sustainable crisis response system. They found Nevada's in-state answer rate sits at 68%, when it should be above 90%.

"We're still a long way from having the kind of system that everybody expects in every ZIP code, in every part of America," Kimball acknowledged.

Kimball pointed out with the implementation of 988, it also brought about changes in the way local jurisdictions respond to mental health crises. The report highlighted Nevada has convened a workgroup to build response processes for collaboration between 988 and 911. While it is a step in the right direction, the report showed Nevada could improve call center capacity, crisis response as well as system financing.

Nevada has the 39th highest suicide rate in the country and also ranks 50th in the nation for overall mental health, according to the Nevada Division of Public and Behavioral Health.

Kimball stressed the figures need to see improvement. She added not having an effective response system in place can make a difference between life and death for some.

"People going without help, being turned on to the streets, being in jail, being in emergency departments, being hospitalized -- voluntarily or involuntarily -- or, tragically, having their life end," Kimball noted.

Kimball added the report lays out policy examples for each of their policy recommendations which come from red and blue states moving the needle in the right direction. She hopes they can serve as inspiration for other states. If you or someone you know is experiencing a mental-health emergency, do not hesitate to call or text 988.

Florida is getting attention for its efforts to create a comprehensive crisis response system for mental health needs.

A new report by the mental health advocacy group Inseparable calls for policies to expand 988 call center capacity, increase the availability of mobile response units, create more crisis stabilization centers and establish stable funding mechanisms to sustain the services.

Melanie Brown-Woofter, president of the Florida Behavioral Health Association, said the Sunshine State is doing all that and more to provide care for anyone in crisis, including adding more clinics.

"And now the certified community behavioral health clinics, we are really building an entire system that allows an individual in crisis to seek care and be linked to the right level of care at the right time," Brown-Woofter explained. "And to have those resources available that they need."

She pointed out with Florida operating mobile response teams for over 30 years, it is well ahead of other states. She notes the increased state funding to expand services and to establish central receiving facilities, which are not yet available in every state.

The facilities provide what she described as a full continuum of care, from crisis intervention to residential treatment, detox services and child care, all in one location.

Angela Kimball, chief advocacy officer for Inseparable, said it features solutions designed to ensure everyone in a mental health crisis receives the right services at the right time and provides a detailed roadmap for lawmakers.

"Our real goal here is to help create a very visual, easy to understand tool that lets them understand how they can be that champion," Kimball emphasized. "That helps ensure that no one's worst day keeps them from living their best life."

Another objective for Kimball is to spark conversations about what is achievable. For instance, the report showcased Oklahoma's RideCare program, which offers non-law enforcement transportation to urgent recovery centers. Oklahoma also distributed nearly 30,000 iPads equipped with crisis de-escalation tools to first responders and others.

Georgia provides "Peer2Peer Warm Lines" offering 24-hour support from trained specialists to people facing challenges who may not require emergency response.

Wyoming ranked highest in the nation for suicide rates four consecutive years through 2021, according to the Centers for Disease Control and Prevention, and the state is funding more crisis response.

About 90% of calls to Wyoming's 988 crisis response line get an in-state answer, according to a new report. Calls used to be routed elsewhere, but the state has been working to localize responses.

Two Wyoming call centers opened in 2020 to offer 24/7 support and now average about 500 in-state calls per month, according to the Wyoming Department of Health.

Kim Deti, public information officer for the department, said the state is currently working to house the helpline's text and online chat options in-state too, and a local connection is important.

"We believe that people within Wyoming, whether they're calling, texting or chatting, they may feel more able to connect and relate to someone from their area," Deti explained.

A 2023 state law created a trust fund for the program but failed to add money to pay for it. This year, a proposed $40 million allocation was reduced to $10 million in the final state budget. Federal funds are also available through July 2025.

If you or someone you know is in crisis, help is available by calling or texting 988.

The nonprofit Inseparable published a report this month to improve crisis response systems. It encourages states to pursue policies to develop system infrastructure, accountability, workforce capacity and sustainable funding.

Angela Kimball, chief advocacy officer for the mental health advocacy organization Inseparable, said in terms of payment, response to mental health emergencies should look like the response to other emergencies.

"Police come. They don't ask whether or not there's an insurance card or a payer first. And the same is true for mental health, substance use, and suicidal crises," Kimball urged. "We want there to be a response regardless."

Kimball argued there should be funds for mental health crises beyond Medicaid.