988 and the Hope Institute

The National Suicide Prevention Lifeline (1-800-273-8255) connects millions of callers experiencing suicidal distress or mental health crises with local crisis call centers every year.

Everyone knows they can quickly reach emergency services through 911. But the 911 system was not developed to respond to people experiencing suicidal distress. Law enforcement officers are not trained to respond to individuals with acute suicidal crises and the medical continuum of care is not designed to quickly and effectively manage a person’s thoughts of suicide.

Too often, individuals who call 911 spend hours or days in Emergency Departments, are needlessly hospitalized where they receive little or no treatment, or wait weeks, sometime months, for an appointment at their local Community Mental Health Center.

How do we combine the strengths of the National Suicide Prevention Lifeline with the reach of 911? The answer is 988.

The Federal Communications Commission (FCC) designated the “988” three-digit number as the suicide and mental health parallel system to 911. It will revolutionize how individuals living with suicidal thoughts connect to life-saving resources in the United States. 988 is now live.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has created resources to help states, territories, tribes, mental health and substance use disorder professionals, and others looking for information on understanding the background, history, funding opportunities, and implementation resources for strengthening suicide prevention and mental health crisis services.

SAMHSA has designed a 988 crisis response system for people who are an immediate danger to themselves. While it is imperative that these systems are implemented, most people with serious thoughts of suicide do not need or want to be picked up by a Mobile Crisis Team and taken to a Crisis Facility.

There is an effective alternative to bridge the gap between Mobile Crisis Teams and waiting for months to be seen by a Community Mental Health Center; The Hope Institute.

• The SAMHSA model is designed for Emergent Care – The Hope Institute stabilizes these high risk cases before they are referred to a Certified Community Behavioral Health Center – typically less than 10% of callers
• Urgent – a Crisis Team completes a Safety Plan and schedules a Next Day Appointment with The Hope Institute – 45% of callers
• Routine – The Crisis Call Specialist completes A Safety Plan and schedules a Next Day Appointment with The Hope Institute – 45% of callers

According to Vibrant Emotional Health, the ideal system in behavioral healthcare makes individuals feel supported, respected, and in control of their own care.

A crisis line specialist should be capable of providing a Safety Plan and a Next Day Appointment to a caller for:

1. Evidence-based treatment
2. That specifically address thoughts of suicide
3. In an outpatient or telehealth setting

Fortunately, resources to facilitate these best practices in suicidal referral and treatment exist today in the form of the Hope Institute.

The Hope Institute integrates the best practices of a modern crisis care continuum with next day appointments, taking referrals from emergency rooms and hospitals and relieving the strain of suicidal distress on schools, colleges, jails, sheriff’s offices, and first responders. Treatment begins within 24 business hours of referral.

Hope Institutes provide clients with a combination of two evidence-based, suicide-focused treatments, the Collaborative Assessment and Management of Suicidality (CAMS) and group skills in Dialectic Behavioral Therapy (DBT).

Clients can visit the center or opt to be treated via telehealth, sometimes multiple times per week based on need. Hope Institutes are small, calm, and stigma free, staffed by clinicians motivated to work with clients and trained to treat the “drivers” that make the person want to end their life.

The team of clinicians at The Hope Institute focus exclusively on suicide cases. Their clients are stabilized in an average of 6 weeks, adolescents in an average of 5 weeks.

The Hope Institute will work with you to select a location that makes sense and our Team does the rest – hiring clinicians, training, scheduling, implementing systems, negotiating reimbursement rates with private insurers and Medicaid, certifying the center runs with fidelity to evidence based treatment and, most importantly, ensuring that clients have a life worth living.

Hope Institutes are cost effective and rapidly become self-funded by taking referrals from:

• Crisis lines
• Schools
• Colleges
• Sherrifs, first responders and jails
• EDs
• Hospitals
• Community mental health centers
• Churches

A Hope Institute can be open in 90 days and an 18 clinician center can treat over 3,000 clients each year.

EXAMPLE: Between November of 2021 and May 2022, The Hope Institute in Perrysburg, Ohio has stabilized 312 patients ages 8 and older. Adults are averaging 6 weeks, while the child and adolescent population is averaging 5.2 weeks. Roughly 13% of those individuals did not need ongoing services. These numbers are prior to any marketing of these services or referrals from crisis resources.

If you are interested in bringing the Hope Institute to your community, contact our team today: Derek Lee or Andrew Evans.

The Hope Institute One Pager (PDF)