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988 & 911: Strengthening Crisis Response While Managing Risk and Liability

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2025-12
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Substance Abuse and Mental Health Services Administration (SAMHSA)
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Government Document
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Abstract

The 988 Suicide and Crisis Lifeline (988), formerly the National Suicide Prevention Lifeline, is a nationwide network of over 200 local and state-funded crisis centers that provide specialized care by answering calls, chats, and texts from individuals experiencing behavioral health crisis and connecting them with highly trained crisis counselors for immediate assistance. As a nationwide emergency response service, 988 is designed to shift care for behavioral health crisis from the traditional 911 emergency services response systems. For decades, 911 first responders – police, emergency management services, fire fighters – were tasked with responding to any and all crisis situations in communities. However, this system, while pivotal, was not designed to effectively address behavioral health emergencies. With limited resources and specialized capacity, 911 centers often struggle to provide the appropriate support for individuals experiencing behavioral health crises, highlighting the urgent need for a more focused alternative like 988. By establishing collaborations between 988 and 911 call centers, communities will better position themselves to effectively respond to crisis situations using the appropriate resources based on the nature of the crisis. In the Spring of 2024, the 988 Crisis Systems Response Training and Technical Assistance Center (CSR-TTAC) hosted several webinars with partners interested in improving coordination between 988 and 911. In addition to the logistical obstacles that were discussed (e.g., funding and people power), concerns about potential legal risk and liabilities arose. Subsequent conversations in the fall of 2024 with implementors in the field highlighted relationship and trust building between partners as the key strategy to overcome risk and liability obstacles. This document will help partners understand essential definitions, roles, and responsibilities that may reduce concerns around legal risk and liability. Building and enhancing relationships between 988 and 911 increases trust, streamlines communication, improves problem solving, and allows for skills sharing and resource pooling, all of which promote effective collaboration between 988 and 911 services.

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Introduction. ......................................................................................................1 Key Partners and Readiness Assessment.........................................2 Establishing and Maintaining Interorganizational Trust.........4 Contractual Considerations......................................................................6 Liability Concerns...........................................................................................7 Policy and Procedure Considerations................................................9 Jurisdictional Efforts Around Liability. ............................................13 Summary and Calls to Action................................................................15 References........................................................................................................16
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