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Maryland lawmakers may spend $12M to improve mental health crisis hotline, if bill moves forward

The Maryland Senate Chamber is decorated with the colors of the Maryland state flag.
Matt Bush
The Maryland Senate Chamber is decorated with the colors of the Maryland state flag.

The Maryland state Senate is likely to take up a bill that will fund the 988 suicide and crisis prevention hotline by $12 million in 2025.

While the federal government doled out more than $280 million nationwide, state officials have been overwhelmed by the need for such services. In Maryland, one state senator who represents a part of Prince George’s County wants to convince other lawmakers and eventually Gov. Wes Moore that spending $12 million more in Maryland from state coffers is worth it for taxpayers.

The proposed bill, sponsored by State Sen. Malcom Augustine, a Democrat who represents District 47, would allocate state money into existing crisis call centers, mobile crisis teams, crisis stabilization centers and other behavioral health services.

The federal Department of Health and Human Services, through its Substance Abuse and Mental Health Services Administration, established 988 last year as an easy-to-remember number that anyone nationwide can call in an emergency instead of dialing 911.

While the federal government gave states $105 million to staff the crisis call centers and spent $177 to strengthen and build the infrastructure, Augustine and advocates alike say that’s not enough.

The 200 centers across the nation have been inundated with calls, signaling that some states need to increase their 988 capacity. The federal government also wants states to eventually take over their own hotlines.

“It takes money, it’s a good commitment of money,” Augustine told WYPR. “We want to make sure that we would reduce the amount of time that people would have to wait for the calls.”

Maryland has a call center with 140 agents, as of July 2022.

In November 2022, the hotline was contacted more than 400,000 times nationwide by call, text or chat, according to the federal Substance Abuse and Mental Health Services Administration.

Compared to November 2021, the hotline saw a 38% increase in calls, 289% increase in chats and a 1,227% increase in texts.

Last year, Maryland set up a 988 trust fund to ensure that the program would have a funding stream. Maryland legislators approved $5 million for the first year of the program and another $5.5 million for 2024.

Dan Rabbitt, the policy director for Behavioral Health System Baltimore, told the Senate Budget and Taxation Committee this week that, if anything, the $12 million for 2025 is an underestimation of what the state needs to provide 988 services.

“We got the $12 million from a February 2021 SAMHSA estimate of what the state of Maryland needed to have an adequate 988 lifeline network,” he said. “That analysis said Maryland would need $10 million to $18 million in the first year. We're halfway through the first year. We felt that the $12 million was squarely in line with that. We think that this is a good investment.”

Maryland, like the rest of the nation, is facing a mental health crisis according to health experts.

About 13% of young adults had serious thoughts about suicide from 2017 to 2019, that’s double the amount from 10 years before, according to SAMHSA’s Center for Substance Abuse Treatment and Mental Health Services, the most recent report on Maryland.

More than 190,000 adults in Maryland said they has serious thoughts of suicide in the past year. In 2021, more than 48,000 people died by suicide nationwide.

However, much of Maryland’s mental health statistics still have not taken into account the lingering coronavirus pandemic which has stretched over nearly three years. Organizations like the National Alliance on Mental Health say the situation is much worse.

One statistic that sheds light on the reality of the mental health crisis in Maryland is the frequency of emergency room visits.

In 2018, mental health accounted for 11.5% of emergency room visits statewide, according to the Maryland Department of Health. That number ballooned to nearly 48% in 2021.

Some argue that the state is ahead of many of its peers when it comes to funding and expanding the crisis hotline.

Only 11 states have established a trust fund and five have implemented small fees like the ones paid for 911 to pay for 988 call centers.

Both the Maryland Hospital Association, an advocacy group that represents the interest of its hospital membership, and insurance giant Kaiser Permanente spoke in favor of Augustine’s bill at the hearing.

But opponents to the bill said they were afraid that call operators working with emergency services may escalate mental health situations by sending police instead of behavioral health experts or expose undocumented residents when police question them about their immigration status during a routine visit.

Augustine, the state senator, said most crises are solved at the call level and do not move to the need for physical intervention.

“We know that as we get people more engaged with 988, it should and will provide some relief to our 911 system,” he said. “we're getting people who are dealing with behavioral health crises directly to the right resources.”

Scott is the Health Reporter for WYPR. @smaucionewypr
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