“988,” the three-digit, easy-to-remember behavioral health version of 911, launched this month – connecting individuals via call, text, or chat to regional crisis centers through the existing National Suicide Prevention Lifeline. With the switch expecting to raise awareness and call volume, Bamboo Health is kicking off a 988 Q&A Series to provide an overview of the current crisis management landscape, where the nation stands, and how we’re partnering with states through our technology solutions.

In our inaugural Q&A, we sit down with Gina Gibson, senior director of behavioral health solutions, to discuss the upcoming launch of the 988 National Suicide Prevention Lifeline, infrastructure readiness at the state level, and how Bamboo Health (partnered with its affiliate, OpenBeds Inc.) is well-positioned to support interoperability preparation for this groundbreaking behavioral health initiative.

Let’s start off talking about your position at Bamboo Health. What are your primary roles and responsibilities? What about the job most excites you?

At Bamboo Health, I serve as the crisis subject matter expert, partnering with states to design their crisis management systems and matching their need to the most appropriate Bamboo Health solution. What excites me the most about my role is that I get to work cross functionally across the enterprise, consult with states, and provide tangible solutions to real-world problems that directly impact individuals daily.

You bring extensive boots on the ground experience to Bamboo Health having served as chief operating officer of the contractor for the Georgia Crisis and Access Line. Can you talk a bit more about that experience and what it taught you about behavioral health resources needs?

I’ve worked in the behavioral health crisis management space for the past 11 years, most recently as chief operating officer of the contractor operating the statewide crisis call center hub in Georgia (GCAL) prior to joining Bamboo Health. As the COO, I oversaw the non-clinical administrative and program operations for GCAL (part of the NSPL network) and for blended mobile crisis response services serving roughly 2/3 of the state. I also had the opportunity to work with an Administrative Services Organization (ASO) partner and the state on 988 service delivery plans for both programs. It was during this time that I got to experience first-hand not only how great the need for behavioral health treatment resources truly is, but also the many obstacles that prevent or delay individuals from getting the help they needed in a timely fashion. For context, during my tenure at the center we had a staff of around 100 at any given time and averaged a volume of around 250,000 calls annually. The State of Georgia has funded this statewide call center since 2006 and, together with the entire crisis continuum structure, today serves as a model for other states seeking to build a similar model.

In your previous role, what did you see as the biggest obstacles when it came to connecting individuals in need with available behavioral health resources?

I think we can all agree that having enough staff in place to support behavioral health resource demand has been and will continue to be the number one obstacle we face when we look to address the escalating behavioral health crisis. Barriers to care such as lack of transportation or simply not knowing which resources are available and how to access them present challenges as well.

The good news is that technology, such as Bamboo Health’s Crisis Management System exists and is well-positioned to help 988 crisis centers, and others, to quickly identify available resources and facilitate individuals access to the treatment they need. This can free up staff to take even more calls or expedite coordination where someone needs more intensive treatment.

988 is positioned as a huge step forward towards addressing our nation’s behavioral health crisis. What about the initiative are your most enthusiastic about?

The National Suicide Prevention Lifeline network is an amazing initiative. What may surprise you is that this resource has been available for some time, launching in 2005. Since then, calls grew from 50,000 in the first year to over 2.3 million in 2020. The goal for 988 is to make it easier for more people to access a lifeline center. When people call, text, or chat 988, they will be connected to trained staff that are part of the existing National Suicide Prevention Lifeline network.

The challenge that we see now, and will continue to see now that 988 has launched, is finding the workforce and making sure states have the adequate number of providers to support that network. At a minimum, someone needs to be there to answer the phone as 75-80% of incoming calls can be deescalated by call center representatives. For the rest of incoming calls, crisis call center personnel need access to additional resources such as the ability to dispatch mobile response teams to address individual needs, ensuring that callers get connected with the right level of care when and where they need it the most. Other callers may benefit from a referral to an inpatient or outpatient treatment facility and call centers need the ability to easily identify these resources and connect callers appropriately.

There is a lot of chatter about state preparation for 988. As someone who has worked at a behavioral health crisis center, what do you think states need to consider in order to make 988 work well?

My biggest piece of advice to states is that they shouldn’t try to do everything all at once. The top priority needs to be having staff ready and prepared to answer the phone when it rings. If enough licensed clinicians aren’t available, non-clinical paraprofessionals and/or volunteers can be trained and clinically supervised to do the work. These individuals need to have the passion to help. Sometimes a caller just wants someone on the other end to listen so they can tell their story.

Growing the provider network, incentivizing providers for performance and expanding/enhancing service delivery; as well as securing a continuous funding stream beyond time-limited grants are critical as well.

Having the right technology infrastructure in place seems like a critical step in the implementation process of 988. Why do you think some states are more prepared than others?

When it comes to 988, preparedness is not going to happen overnight. Some states already have a well-defined statewide “no wrong door” behavioral health system, while others are diligently working to identify and add the missing complement of service providers. Regardless of the state’s level of readiness, it’s essential that the technology used to support this initiative be a compliment and not a hinderance to users. When call agents can assign individuals to appropriate care quickly and accurately, clinical efficiency and patient outcomes improve.

Technology can help connect those dots threading the response process together. This is why interoperability is so important. For example, a crisis center employee should not have to go into multiple systems or gather extensive demographic data to help a patient access care. Instead, a native electronic health record system should be able to interface with a technology system. This is why states should seek interoperable solutions such as OpenBeds® for a bed registry and closed loop referral system and, built off the OpenBeds platform, the Crisis Management System for digital intake and assessment, as well as the ability to dispatch mobile crisis teams using GPS-enabled technology to get situational awareness about the availability of treatment resources using digital networks – all within one system.

It’s also worth highlighting that digitizing the crisis care continuum enables us to track how we are doing at connecting people to definitive assessment and treatment in order to drive improvements to the care delivery system. Nobody has a clear-eyed view of the system today, but technology tools are well-poised to help hold all stakeholders accountable to meeting the goals of the 988 initiative. This includes connecting people to definitive behavioral health assessments and treatments and keeping people out of the medical and criminal justice systems. Technology will also help us prevent people from re-entering the crisis care system.

In your opinion, how is Bamboo Health and OpenBeds helping states in terms of 988 readiness?

Bamboo Health has deep experience delivering behavioral health solutions at the state level for over a decade (and working with states in general for over 20 years). With the OpenBeds and Crisis Management solutions specifically, we have launched or are about to launch complementary clinician and public-facing portals to connect providers/consumers to SUD and mental health treatment in 14 states, working with approximately 1,000 treatment providers and several hundred hospitals across these states.

As a result of being deeply embedded in the delivery of behavioral health services at the local level, Bamboo Health and OpenBeds understand firsthand that there is no one-size-fits-all approach to address these community needs. What is unique about our team is that we can help evaluate our customers’ and partners’ pain points. Then, we match technology solutions to not only address their needs but also assist and aid users to make the most informed decisions possible across the individual’s care continuum.

That’s why we are well-positioned to serve as a valuable technology partner to states during their 988 roll out. For starters, we have demonstrable behavioral health experience, and we understand the space from both a physical and mental health perspective. This is evident in our technology offerings and more specifically with our Crisis Management System capabilities, which leverage the foundational OpenBeds platform where referring providers can communicate with receiving providers, see bed availability in real-time, and refer patients to the appropriate level of care.

We have partnered with state government leaders to help them develop plans and infrastructure to support their communities’ adoption of 988 services, along with expert guidance around securing federal funding, to ensure a smooth launch. We also offer ongoing support across a state’s entire 988 ecosystem.

For Additional Information

If you would like to learn more about 988 or how Bamboo Health can help support infrastructure development efforts for the national behavioral health lifeline, please check out our crisis management playbook.