Q&A: Adrienne Breidenstine, Baltimore Behavioral Health System on 988 Deployment – Status of Reform

Adrienne BreidenstineMSW, is the vice president of policy and communications for the Behavioral Health System of Baltimore (BHSB), a non-profit organization that operates the city of Baltimore’s health care system for people with addictions and mental health issues. .

In this Q&A, Breidenstine discusses the recent launch of the 988 Suicide and Crisis Lifeline on July 16, and how BHSB plans to expand its services to meet the unique needs of the City of Baltimore and surrounding county residents.

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State of the reform: How does BHSB specifically address the behavioral health needs of Baltimore City residents, and how has the recent launch of 988 affected your operations?

Adrienne Breidenstine: “The type of population varies in our state and it is certainly something that we have looked at and have more experience in, just through the diversity and variation in the ways we provide crisis services outside of an urban setting. Part of that is through the [Greater Baltimore Regional Integrated Crisis System] partnership in which we are also involved. This is a regional project that includes the City of Baltimore, Baltimore County, Carroll County, and Howard County, where we are looking to expand services.

One of the things we’re doing is actually regionalizing the 988 hotlines. We know we have to consider different types of populations in different geographic regions. We have cities, suburbs, and when you start to get into Carroll County, you get more rural. We are setting up 988 hotlines to be able to respond to anyone with any type of concern that they might call.

These crisis hotlines have been around in our communities for decades, more than 20 years in fact. 988 is simply just the phone number change. He changes that number to 988 for the National Suicide Prevention Lifeline. The Lifeline has been supported by local call centers for decades. So the call centers that sought to regionalize in this intergovernmental region have been around and have been doing this work for a very long time. With 988 to come and more [state] resulting resources, we are increasing the capacity of our call center in order to have more people to answer the phone.

OR: The answers have varied on each state’s readiness to implement 988, but it appears that Maryland already has this infrastructure in place.

A B: “There are 8 call centers in our state that were part of this national call center network. We, at least regionally in Baltimore City, Baltimore County, Carroll County, have been planning this [transition] for 2 years. So the minute the Federal Communications Commission made that designation, we started planning. So we feel we are ready and we are doing what we can to recruit staff to be ready to respond to calls. No one really knows what the expected call volume will be, but we expect it to increase over time.

OR: According to you, what is your average call volume at the moment or before the introduction of 988?

A B: “It’s only been a week, but we’ve been tracking call volume and have seen a slight increase. It’s hard to tell if this is the result of 988, as our call volume fluctuates from day to day. From what happened over the course of the year, in Baltimore City, we received over 40,000 calls to our call centers As we seek to regionalize call center services for these 4 jurisdictions, we believe that we could receive 124,000 calls per year in the first year alone, so that is what we are considering.

OR: There has been an ongoing shortage of healthcare workers in Maryland during the pandemic – how is BHSB continuing to overcome the resulting challenges?

A B: “It’s definitely a challenge. Our field is not unique in that we also face this challenge. Our call centers have gotten creative, one of the things they’ve learned during the pandemic is that the people who work as our call center operators who are professional advisers, we can work from home. Through technology and routing, we can ensure that people working from home always answer calls. So that’s definitely something that our call centers have used to really support and show the advantage and use that for recruiting.

OR: As for the next few months, what do you hope to accomplish? Are there ways the state can better support call centers as they adapt to the implementation of 988?

A B: “Over the next few months, what we hope to achieve is to monitor call volume very closely. We hope it will gradually increase. One of the things that we also started a year or two ago is trying to figure out the best way to market 988 locally. So we did two years of market research and community engagement. We now have a fairly solid

“Call 988” helpline brand. One of the things we’ve done with our many, many partners over the past few months has been to raise awareness of this resource. It’s a great resource that’s been around for decades again, but the previous issue wasn’t easy to remember. One of the things we’ve learned from our community involvement is that 988 is useful for a lot more people because it’s an easy number to remember. The feedback we’ve received is “Yes, I’ll remember that, that should lower the barrier”. People were really happy to hear that when they call they get immediate help to connect with a professional counsellor.

This interview has been edited for clarity and length.

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