3C SESSION 

SAMHSA’s 988 Crisis Systems Response Training and

Technical Assistance Center: Crisis Community Collaboration 

November 28, 2023 
Crisis Systems Response TTAC 

The Substance Abuse and Mental Health Services Administration (SAMHSA) 

has selected Altarum to provide training and technical assistance support 

to states, territories, tribal nations and organizations, and community partners 

across the 988 Suicide and Crisis Lifeline and crisis continuum of care. Along 

with our partners, W2 Consulting Corporation and Change Matrix, LLC, who 

have extensive experience with crisis services, technical assistance, and health 

equity, the Crisis Systems Response Training and Technical Assistance Center 

(TTAC) was formed to support the continued growth of 988 Lifeline and build a 

more robust crisis care system. 
 

Agenda 

• Welcome 

• Introductions 

• 988 & Behavioral Health Crisis Coordinating Office 

Priorities 

• Discussion of SAMHSA and key partner roles 

• Office updates 

• Overview of the TTAC and goals, including how training 

and TA differs across the crisis TTAC, SAMHSA GPOs, 

and the Lifeline administrator 

• “Thought Exchange” session

• Moderated Question & Answer session related to the 

information shared 

• Time for reflections about webinars and activities within 

the last month 

• Preview of activities to come 
SAMHSA 988 & BHCCO Leads 

Monica Johnson, M.A., 

LPC 

Director of the 988 & 

Behavioral Health Crisis 

Coordinating Office 

John Palmieri, M.D., 

M.H.A. 

Deputy Director of the 988 & 

Behavioral Health Crisis 

Coordinating Office 

Charissa Pallas 

Division Director of 

Communications for the 988 

& Behavioral Health Crisis 

Coordinating Office 

Jill D. Mays, M.S., LPC 

Division Director of Crisis 

System Transformation for 

the 988 & Behavioral Health 

Crisis Coordinating Office 
Equity

Trauma-Informed Approaches

Commitment to Data and Evidence

Recovery 

Preventing Substance 

Use and 

Overdose

Promoting Resilience 

and Emotional Health 

for Children, Youth,

and Families

Enhancing Access to 

Suicide Prevention 

and Mental Health 

Services

Integrating Behavioral 

and Physical

Healthcare

Strengthening the 

Behavioral Health 

Workforce

SAMHSA’s Priorities

Equity 

Trauma-Informed Approaches 

Commitment to Data and Evidence 

Recovery 

SAMHSA’s

Priorities 

Preventing Substance 

Use and 

Overdose 

Promoting Resilience 

and Emotional Health 

for Children, Youth, 

and Families 

Enhancing Access to 

Suicide Prevention 

and Mental Health 

Services 

Integrating Behavioral 

and Physical 

Healthcare 

Strengthening the 

Behavioral Health 

Workforce 
The Role of SAMHSA: 

The 988 Lifeline and Behavioral Health Crisis Services Transformation 

Serve as lead federal organization 

of the 988 Suicide & Crisis Lifeline 

Serve as lead federal organization 

for behavioral health crisis services 

transformation 

• Manage cooperative agreement with the 988 

Lifeline network administrator 

• Provide funding to help administrator, states, 

territories, and tribes strengthen 988 Lifeline 

services 

• Align and coordinate 988 Lifeline communication 

with external partners and network administrator 

• Lead awareness building and behavior change 

campaigns 

• Articulate long-term vision for crisis services 

• Coordinate federal action within SAMHSA, 

across HHS, and with federal partners 

• Drive strategic partnerships with states, 

territories, tribes, and external partners 

• Disseminate data and quality standards 

• Monitor, evaluate, and communicate 

effectiveness 
988 & Behavioral Health Crisis Coordinating Office 
988 Implementation & The Impact on States’ Crisis Continuums

Overview 

• Rapid development of crisis continuum of care 

• Role responsibility changes within the system 

o SAMHSA/HHS and Federal Partners 

o Vibrant Emotional Health, The 988 Network Administrator 

o State Behavioral Health Authorities & Government Leaders 

o Crisis Contact Centers 
988 Grant Programs and Collaborations 

SAMHSA 

Vibrant 

Emotional 

Health 

Crisis 

Centers 

State, 

Territory, 

Tribe 

SAMHSA 

Cooperative 

Agreement 

Lifeline 

Network 

Agreement 

Contract 

(State/Territory) 

MOU (Tribe) 

SAMHSA 

Cooperative 

Agreement 

New Grants: 

• 988 State/Territory Cohort 2

• 988 Tribal Response cohort 2

• 988 Crisis Center Follow Up (10 cooperative

agreements)

• All awarded states, territories, tribes, and

crisis centers can be found at:

www.samhsa.gov/grants
Snapshot of 988 Lifeline Federal Funding: 2007–2023 

 

 

 

800 Federal Funding to Lifeline ($, millions) 

Not exhaustive – highlights select funding years and does not include all supplemental funding awards 

$502M*** 

700 

600 

500 $432M** 

$152M sent to states and 400 

territories and $17M sent to 

300 tribes to build staffing across 

states’ local crisis call centers 

through grants. 200 

100 

$23M* $2.9M $3.7M $6.2M $6.6M 0 

FY 2007 FY 2012 FY 2015 FY 2018 FY 2021 FY 2022 FY 2023 

*$23M includes the President’s FY 2021 budget allocation (excludes 3–year COVID supplement of $32M) 

**$432M includes the President’s FY 2022 budget allocation of $102M, $180M from the American Rescue Plan, and $150M from the Bipartisan Safer 

Communities Act 

***$502M includes the FY 2023 Omnibus Appropriations for the Lifeline allocation of $502M and an additional $200M 

funding for states, territories, and tribes to build local capacity 
The Role of Vibrant as Network Administrator 

SAMHSA funds Vibrant Emotional Health, a national non-profit, to manage, 

enhance, and strengthen the Lifeline. The Lifeline routes individuals in the 

United States to a network of more than 200 certified crisis centers, which link 

to local emergency, mental health, and social services resources. Vibrant 

must maintain the current Lifeline infrastructure, activities, and network of 

crisis centers including, but not limited to, all telephone, chat, and text-based 

services. 

Challenges/Opportunities 

• Scope & Role Clarification 

• Relationship w/Crisis Contact Centers 

• Rapid internal growth 

• Navigating state government systems 

• Data Discrepancies 
States & Territories Crisis Systems Development Challenges 

Progressive/Advanced Systems 

• Mature crisis continuum in place (crisis contact center(s), an array of intensive outpatient services, crisis 

stabilization, centralized dispatch for mobile crisis, mobile crisis and co-responder teams, preferred points of entry, 

utilization of peer services, co-occurring MH/SU/IDD expertise, covers age span and specialized populations, etc.) 

• Leverages technology for coordination of the system 

• Clear provisions for expectations (e.g., standards and key performance indicators; monitoring system) 

• Clear lines of authority/accountability 

• Strong stakeholder collaborations, legislative support, and leverages multiple funding streams 

Adequate/Competent Systems 

• Fundamentals in place to leverage 988 and new funding opportunities to advance to progressive model 

• Crisis Contact Centers are experienced but may not have direct oversight by the state; less accountability 

• Has components of intensive outpatient services and crisis services but not 100% coordinated 

• Strengthening existing partnerships for innovative approaches to crisis care and has local buy in for enhanced 

funding 

Novice Systems 

• Limited to no coordinated continuum; may have parts of the service system but each part operates separately with 

limited to no accountability 

• Lack of coordination, oversight, accountability, poor relationships with contact system 

• Limited statewide crisis or intensive outpatient services and fragmented continuum 

• Lack of local support for funding and legislation 
 

The Role Of State Behavioral Health Authorities & Government 

• Ensure local capacity to answer 988 contacts 24/7 

• Build local capacity to ensure availability of crisis services and access to 

care 

• Secure funding, legislation, or appropriations for crisis services continuum 

• Lead coordination efforts between crisis contact centers, provider network, 

local stakeholders, advocacy, and federal government 

• Lead innovation efforts to advance states’ access to crisis continuum 

services 

• Provide oversight and accountability of funding, services, outcomes, 

performance and health of the crisis network 
State 988 Legislation 

National Alliance on Mental Illness (NAMI). “988 Crisis Response 

State Legislation Map.” https://reimaginecrisis.org/map/. 
States & Territories Crisis Systems Development Challenges. 

Examples of Common Issues: 

• Data discrepancies 

• Miscommunication 

• Challenges with building complex systems within states 

• Lack of relationships between crisis contact center & state authorities 

• Authority and oversight gaps/challenges 

• Local political climates 

• Role clarity 
States & Territories Crisis Systems Development Challenges.. 

Actions/Opportunities 

• Providing educational and technical assistance support for individual states related 

to data discrepancies and other issues raised 

• Actively working on improving communication and visibility of existing mechanism 

for information exchange (grantee meeting, office hours, 988 TTAC, site visits, 

convenings, etc.) 

• Leveraging 988 TTAC for support and training for complexity with crisis 

transformation and 988 implementation challenges. (e.g., policy academies) 

• Encouraging states and contact centers to develop meaningful relationships and 

collaborations 

• Leveraging trade associations, e.g., National Association for State Mental Health 

Program Directors (NASMHPD) for communication 

• Underscoring existing mechanisms for official communication channels 
988 Partner Communication Efforts 

Goal: Coordinated and Aligned Communication About 988 

Driving a Common Narrative 

We recognize the need to speak 

with one voice to ensure there is 

a clear understanding about what 

the 988 Lifeline is and how it 

works. 

Role of Partners Across the Country 

We encourage building on the SAMHSA 

messages and FAQs with your state, 

local, territory, tribal, or community 

coalitions, to meet the needs of your 

specific audiences. 
SAMHSA 988 Webpage 

One-Stop-Shop for 988 Lifeline 

Resources 

• URL: www.samhsa.gov/988 

• About 988 

• Partner Toolkit 

• Performance Metrics 

• Lifeline History 

• Funding Notice 

• Jobs: www.samhsa.gov/988jobs 
SAMHSA 988 Partner Toolkit 

 

 

PARTNER TOOLKIT ASSETS IN ENGLISH AND SPANISH 

• Key Messages 

• FAQs 

• Logos & Brand Guidance 

• Social Media Shareables 

• Print Materials 

• End Cards For Media 

• Sample Radio PSA Scripts 

• Branded Photos 

Visit www.samhsa.gov/find-help/988/partnertoolkit to access materials and to sign up for the 

latest 988 Lifeline news. 
 

988 Communications Research 

Establish body of formative research on KABs among populations at higher risk of/disproportionately impacted by suicide about: suicide 

prevention and mental health, use of 988/other help-seeking behaviors, motivating factors and barriers to help-seeking, as well as identifying 

influencers and trusted messengers. 

• Coordinating Partners: Action Alliance, SPRC, and Ad Council Research Institute

• Target Publication Date: Fall 2023, publish audience-specific research findings and toolkits

• Methodologies: 

• SME interviews (6 total) – complete

• Qualitative research – In-depth interviews (61 – 10/each audience group) – complete

• Quantitative research (of 8 audience groups) – online surveys (~5,000) – complete 

• Populations at Higher Risk of/Disproportionately Impacted by Suicide: 

• American Indian and Alaska Native youth and young adults (ages 13 –34)

• Black youth and young adults (ages 13–34)

• Hispanic youth and young adults (ages 13–34) 

• People who attempted suicide/experienced serious thoughts of suicide in their lifetime (ages 18+)

• LGBTQI+ youth and adults (ages 13–49) 

• Rural older men (ages 49+)

• People with disabilities (ages 13+) 

• AANHPI (ages 13–34) 

• Trusted messengers/influencers for the above populations 

• Target publication date: early 2024 

• Mothers/primary caregivers; siblings; friends; spouses/partners 
Serve as Lead Federal Organization for Behavioral Health Crisis Services 

Transformation 

Improve five core system outcomes related to behavioral health crisis services 

ACCESS 

People in crisis have 

timely and equitable 

access (by race, 

ethnicity, 

geography) to crisis 

services 

EXPERIENCE 

People in crisis & 

crisis providers 

report seamless, 

trauma-informed 

care experience 

COST AND 

PAYMENT

Local crisis systems 

have efficient and 

sustainable crisis 

services in place 

AWARENESS 

& UTILIZATION 

People in crisis and 

crisis providers are 

aware of and utilize 

appropriate crisis 

resources 

QUALITY 

People in crisis

experience highquality, evidence 

informed,

effective care

across the crisis

continuum
988 & Crisis System Evaluation 

Contractor: Aptive, ICF (subcontractor) 

Period of Performance: 5-year award, 9/15/23 to 9/14/28 

Purpose: To assess utilization of the 988 Lifeline & various aspects of the crisis services 

continuum, as well as clinical, service, and impact outcomes, w/ particular attention to 

inequities that may exist across these outcome measures. 

3 Evaluation Types: 

• System-Level Evaluation: designed to capture the ways in which the crisis system works

together to respond to the needs of those experiencing behavioral health crisis, as well as

gauge overall changes in service utilization, care costs, and key clinical and functional

outcomes that result from 988

• Client-Level Evaluation: measures the influence of 988 on individual outcomes and

service utilization over time

• Impact Evaluation: highlights changes in suicide- and overdose-related morbidity and

mortality that result from 988
Crisis Systems Response Training and Technical Assistance Center 

988 Training and Technical Assistance Center 

Provide training and technical assistance support to federal grantees, states, territories, tribal 

nations, tribal organizations, urban Indian health organizations, crisis centers, behavioral health 

provider organizations, health systems, and first responder partners in the following domains: 

• Implementation of crisis services in line with the SAMHSA 2020 National Guidelines for Behavioral Health Crisis Care 

Best Practices Toolkit; 

• Utilization and integration of evidence-based and evidence-informed practices, including services that are culturally 

responsive across the lifespan and that address suicide prevention and the integration of mental health and substance 

use crisis service needs; 

• Sustainability and alignment of practices that address key drivers of crisis system advancement, including workforce, 

financing, technology, and data exchange; and 

• Applying an equity frame in the design and evaluation of crisis systems of care. 
Training and Technical Assistance Landscape 

Grants Project Officers 

Crisis Systems 

Response National 

Training and Technical 

Assistance Center 

Vibrant Network 

Resource Center and 

Center Engagement 

and Training 

Local, state/territory, 

Tribal TA 

Other SAMHSA and 

Federal partner TA 

and Centers of 

Excellence 

https://www.samhsa.gov/practitioner-training 
Thought Exchange Process 

1) The first step is to share your thoughts to the following question: 

What would effective communication and collaboration look like between systems on Federal, State, 

Lifeline, and Local levels for crisis response systems? 

2) The second step is to star the thoughts of others. 

Ideally you will star 30 thoughts strongly disagree strongly agree 

Share as many thoughts as you would like and know that you will remain anonymous. 

As thoughts are shared and starred, they will be organized by theme. The data will show thoughts that 

were offered by the most people and thoughts that rated highly. This gives us thoughts that are shared 

less, but very important. 
Thought Exchange Question 

What would 

effective communication and 

collaboration look like between 

systems on Federal, State, 

Lifeline, and Local levels for 

crisis response systems? 
Mindful Minute 
Upcoming Events: 

Webinars: 

Connecting to Serve: Promising Practices for 988 & 911 Collaboration Webinar Series 

Session 2: Engaging with Your State on 988 & 911 Coordination 

December 14 @ 1:00-2:00 PM EST 

• Office Hour immediately following from 2:00-3:00 PM EST 

• To include a Q&A session and an opportunity for individualized TA 

• Registration Link: 

https://us06web.zoom.us/webinar/register/WN_pMEnKhfHQSOicps9P9Nfng#/registration 

Current Crisis System Implementation: Successes and Challenges 

January 10 @ 1:00-2:00 PM EST 

• Registration Link: 

https://us06web.zoom.us/webinar/register/WN_YWw8sP7VSG2zw5xzpJX4gg#/registration 

Next 3C December 20 @ 1:00-2:00 PM EST 

Session: 
 

 

Contact Information 

SAMHSA’s 988 CSR TTAC Subscribe to the CSR-TTAC contact list to get the 

latest 988 news and invitations to our events, or • support@988crisisttac.org use the QR code to the left: 

• 844-464-8338 (toll free) https://lp.constantcontactpages.com/sl/aUMAyq2 

Crisis Systems Response Training and Technical Assistance | SAMHSA 

This project is supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. The Crisis 

Systems Response Training & Technical Assistance Center works in conjunction with the 988 Suicide & Crisis Lifeline. In 2020, Congress designated the new 988 dialing code to be operated through the existing National Suicide Prevention Lifeline. SAMHSA sees 988 as a 

first step towards a transformed crisis care system in America. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of SAMHSA or the 988 Suicide & Crisis Lifeline.