Alabama's crisis response needs some improvements to expand its coverage and effectiveness, according to a new report.

The mental health policy group Inseparable looked at 988 crisis lifeline responses by state and suggested ways to enhance them.

In Alabama, it said the 988 call centers have received more than 54,000 calls, just since March but the state's call capacity is only at 75%, below the target of 90%.

Kim Boswell, commissioner of the Alabama Department of Mental Health, said efforts are underway to boost the resource.

"The good news is that the Opioid Commission appropriated $3 million to help us with the call center capacity," Boswell pointed out. "I feel like with the $3 million, we will get to our 90% goal of calls being answered in-state."

She noted the crisis system has improved access to care since its launch. It has diverted more than 1,600 people to mental health resources rather than sending them to jail and diverted 6,700 from emergency departments. It's also helped over 9400 people receive mental health evaluations at crisis centers.

The report also called attention to the state's need to increase the number of mobile crisis response teams and crisis center beds. Boswell acknowledged the legislature has supported the expansion of mobile teams. There are 14 teams to address both adult and child crises, with plans for further expansion.

"We would love to have a mobile crisis team in every county, or at least coverage for every county, especially some of our more rural counties," Boswell emphasized. "Because as you know, a big barrier to care is transportation."

She added more funding has also been allocated to increase residential substance use treatment beds, which had not been expanded since the 1970s. And efforts are ongoing to ensure access to care for both Medicaid-eligible people and those without insurance.

Angela Kimball, chief advocacy officer for Inseparable, said to enhance services and extend its reach across the state, the report asks state legislatures to focus on sustainable funding sources and accountability measures for the crisis response system.

"By having these accountability pieces, this allows legislators to oversee the system over the long haul," Kimball stressed. "And to set up the structures for continuous learning, continuous system improvement."

She explained data collection, annual reporting and coordination between the 988 and 911 systems are ways states can make them more accountable.

Budding flowers, warmer temperatures and longer days are welcome signs to many after the long, dark months of winter. Some people might believe warmer weather improves mental health after seasonal depression in the winter months, but that's not always the case. Many people experience increased mental-health struggles as spring rolls around.

When people's feeling in the springtime doesn't meet their expectations, said Cynthia Cubbage, director of family and post-adopt service for the Barker Adoption Foundation, it can make mental-health issues worse.

"When people are looking forward to spring because it's a time of renewal, and those expectations don't happen, and then nothing gets better for them because it's deeper than that," she said, "then they get really stressed and depression can really set in. And it's because of the expectations."

Suicide rates rise in the spring and not winter, according to Johns Hopkins Medicine. Researchers find that seasonal allergies play a role. A person with rhinitis, which causes allergy symptoms, is more than 40% more likely to be depressed.

Cubbage said there are many ways people can combat those feelings: Get outdoors as much as possible and get out socially as well. But she reminded folks that sleep is vital.

"Definitely prioritize sleep, even though we're having more daylight," she said. "It makes people want to stay up longer - that they should be doing things - and to remember that's a big transition for your body. They should still prioritize their sleep. If they were still going to sleep at eight or they were putting their kids down at eight, that should continue."

Cubbage added that, if you continue to feel depressed or down even after trying those suggestions, it's best to seek out professional mental-health help.

A bill headed to the Montana governor's desk would qualify post-traumatic stress disorder under workers' compensation for the state's first responders.

PTSD is a mental-health condition that someone may develop after a traumatic event. It can result in a range of symptoms from a negative mood and reactivity to flashbacks and difficulty sleeping. First responders report experiencing PTSD at about five times the rate of the general population, according to Relief Mental Health.

George Richards, who serves as president of both the Montana State Firefighters' Association and the Montana State Council of Professional Firefighters, said suicide is one of the top two leading causes of death among firefighters.

"Firefighters, police officers, paramedics, EMTs, experience - working on a gunshot victim or a fatality wreck or a kid death - major trauma-critical calls that really affect the brain," he said.

Richards said the bill had bipartisan support, although some opponents were concerned with the costs. The bill passed a House vote Friday, just before today's observance of Workers Memorial Day.

Until now, Montana was one of roughly a dozen states without a PTSD-related workers comp policy for first responders. Richards said treatment for PTSD will also help with worker retention.

"We want it recognized so they can get the treatment and return to work as a healthy individual with a clear mind," he said.

Treatment can take different forms, Richards noted, from peer-to-peer support to residential treatment programs.


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A new report finds that Maryland has made progress in providing school mental health services to its students but work still remains. The report by the national mental health advocacy organization, Inseparable, measures states based on 13 policy targets.

Maryland has improved its ratio of social workers to students. There is one social worker for every 620 students - a decline from more than 2,300 students in previous years. But the state has not implemented, or only partially implemented, five policies, such as expanding Medicaid coverage to include school-based mental health services.

Caitlin Hochul, vice president of public policy with Inseparable, said providing mental health services in schools has major impacts on students and parents alike.

"You're reducing the financial strain on parents," she explained. "You're reducing the need for reliable transportation. You don't need to be taking a lot of time off of school to go travel to an appointment, so it really helps give kids the resources and tools they need to get back in the classroom and learn."

Maryland also lacks mental health screenings of students, a tool that advocates say is critical to identify potential mental health issues.

The Maryland state legislature recently passed laws geared toward bolstering the behavioral health workforce. One law made school mental health professionals eligible for the state's loan repayment plan, and another created a state workforce development program for mental health professionals.

Sen. Malcolm Augustine, D-Prince George's County, said a focus of the state legislature has been working to bring - and keep - mental health professionals in the state.

"It's challenging right now for us to attract and retain these folks," he said. "It's a global issue, so we are trying to do our very best to create opportunities for them to have their loans repaid, opportunities for them to grow professionally, in the hopes that we'll be able to retain and grow our own."

Maryland lawmakers also passed laws requiring education and health agencies to provide guidelines for student telehealth appointments on school days.