Credit: (AP Photo/Jenny Kane)

For Juliet Hyndman of Warren County, the need for a better system to respond to mental health emergencies is an issue that hits close to home.

A family member lives with bipolar disorder and has been hospitalized 13 times over a 20-year span since the original diagnosis.

“I’m advocating that the state is committed to, at the onset, at least one mobile crisis team per county,” said Hyndman, who is president of the Warren County affiliate of the National Alliance on Mental Illness.

“As a rural county, Warren County has historically been dismissed and not received needed funding support, due to cultural bias on the parts of our leaders and the lack of understanding of the unique and equally pressing needs of its residents,” she said.

Hyndman was one of nearly a dozen advocates who gave feedback at two public sessions hosted by the state Department of Human Services last week about how the state should design mobile outreach teams sent to assist callers to the 988 Suicide and Crisis Lifeline. The number has been in use nationwide since July. Using either the 988 number or the original 11-digit number will get people to the same services, according to the Substance Abuse and Mental Health Services Administration. And the state is creating a broader response system that will add additional mobile crisis response teams throughout New Jersey, according to Susan Loughery, the associate executive director of Catholic Charities in Trenton.

The official approach seems to be in line with Hyndman’s. The teams will be placed in all 21 counties with a plan to provide round-the-clock services, according to Eva Loayza-McBride, the deputy communications director at the human services department, with the exact number of teams to be determined by county and regional population and taking into account the specific  needs of rural communities, she said.

Existing resources

New Jersey already has multiple mobile crisis response systems in place, including one for children and their families that is funded through the Department of Children and Families, according to Loughery. Additionally, the state funds early-intervention support services programs that provide short-term mental health assistance to people in need of immediate help. And Catholic Charities currently runs a program that provides mobile outreach services, according to Loughery.

As well as developing a network of mobile response teams, the human services department is developing a request for proposals for a single organization to manage the 988 Suicide and Crisis Lifeline in New Jersey. That organization will be responsible for monitoring referrals made by 988 contact centers to ensure connections are made to treatment, providing training to 988 Lifeline centers and dispatching mobile crisis response teams. The request for proposals from the state Division of Mental Health and Addiction Services calls for $2 million in annual state funding to the organization that will manage the 988 hotline.

More than  26,850 calls have been received through the 988 hotline in New Jersey since July, when the number went live, according to Tom Hester, spokesperson for the human services department. Additionally, 988 calls in New Jersey resulted in 240 emergency rescues during the same period.

Currently, calls come into the national 988 Lifeline crisis center network from across the country and are routed to independently operated call centers based on the caller’s area code. New Jersey has five Lifeline centers that respond to calls, texts or chats from the 988 number. Each is independently managed and all are approved by Vibrant Emotional Health, which manages the 988 number nationally, according to Loayza-McBride. All the New Jersey call centers are also contracted with the state Division of Mental Health and Addiction Services.

So far, data indicates that 988 calls answered in New Jersey have been lagging answer-rate goals set by Vibrant Emotional Health.

The most recent data for June through October 2022 showed that the in-state answer rate was 70% in June and increased to 78% in October, according to the Division of Mental Health and Addiction Services. The goal established by Vibrant for in-state answer rates is 90%.

Personal experience

The state is considering mobile crisis response teams that include people who themselves are in recovery from mental health issues, along with a counselor, according to Valerie Mielke, the assistant commissioner for the Division of Mental Health and Addiction Services.

Community advocates at the public listening sessions stressed the need for oversight of the response teams.

“We need to have a task force that’s monitoring and making sure that whatever we [are] putting in place, whatever you hear today, whatever we’re asking you to do and if you decide to do it, that it’s being done,” said Cassandra Dock, a community advocate from Essex County. “Because a lot of times, we’ll have these sessions, we’ll listen, but we won’t do anything.”

Others said there is a need for a connection between the 988 call system and schools. Because schools must call emergency medical technicians, many times children are referred to hospitals and to crisis centers that aren’t necessarily equipped for young people, said Donna Jackson, who is also a community advocate from Essex County.

“We have lost several children in the city of Newark to suicide,” said Jackson. “Our school systems are inundated across this state with our children … acting out in terms of committing suicide. It’s almost to the point in our school system where … it’s almost glorified.”

Hyndman, of Warren County, suggested that the state should allow each county to determine which mobile crisis response model would best serve their needs. She pointed to a mobile crisis response team in Eugene, Oregon called Crisis Assistance Helping Out On The Streets, or CAHOOTS. It offers crisis counseling and suicide prevention that’s an alternative to police responses in nonviolent crises.

“I’m here to share my perspective in hopes that as a state, we can create a more excellent system for mental illness crisis response,” she said. ”(One) that will reverse the current trend of incarceration for those who live with mental illness and increase the efficiency by which people who experience mental illness symptoms and their families and loved ones can receive the support and recovery services when they’re needed and where they’re needed.”

The third and final public listening session will be held in person today at 1 p.m. at Camden County College in Blackwood.