Abstract
Purpose: The 988 crisis line is new to the mental health system. Since its implementation in 2022, few studies have been conducted to explore the effect on agencies responding to mental health crises. This study explained how the 988 crisis line impacted that first response. It also sought to identify factors in a first response affected by this.
Theoretical Framework: The theoretical framework for this study came from punctuated equilibrium and garbage can theories. Changes occurred in the mental health system as the public applied social pressure for change, resulting in national legislation and policy changes. Punctuated equilibrium theory provides a lens into these changes. Garbage can theory addresses how the 988 crisis line changes the existing local responses to mental health crises.
Methodology: The study employed a qualitative approach. Los Angeles County uses a complex system of fire departments to protect its citizens, structures, and wilderness areas. This study used a survey and direct observations in the Los Angeles City Fire Department and data from the Los Angeles County Fire Department. Publicly available secondary data from the Department of Mental Health and the Didi Hirsch Organization offered a quantitative perspective on volume of mental health service users and allowed a triangulation of investigation.
Findings: Like a majority of the population, the survey of fire personnel revealed the 988 crisis line is unknown. The 988 number is used often but the geographical data for specified regional locations is unavailable. Data from the Los Angeles Department of Mental Health indicated that the number of new patients using services under the Mental Health Services Act is increasing even though the overall number of patients has decreased since the implementation of the 988 crisis line.
Conclusions and Recommendations: The study revealed that more education is needed to inform the public about the 988 crisis line. Fire personnel need autonomy to give resources to patients who are not transported from the scene. Data collected from various agencies must align geographically and with similar variables to identify spurious linkages. Agencies must work together and more research must occur in all areas to spur discussion.