U.S. Sen. Catherine Cortez Masto on Thursday took a tour of the Crisis Call Center of Nevada in Reno, which coincided with the introduction of her bipartisan Behavioral Health Crisis Services Expansion Act.
Cortez Masto’s legislation seeks to set national standards for behavioral health crisis services across the country and would direct the U.S. Department of Health and Human Services to define the core regional and community-based components of the continuum of care to address mental health crises.
The bill would expand coverage for behavioral health services to everyone, no matter where they get their health insurance, or if they have it, and would provide for reimbursement of providers whose patients are enrolled in Medicare, Medicaid, Affordable Care Act plans, employer-sponsored plans, Veterans Affairs plans, TRICARE and the Federal Employee Health Benefits Program.
The bill would also direct new Mental Health Block Grant funding for crisis services and establish a panel of experts to provide guidance to states, tribes, territories and communities as they seek to improve training and protocols for coordination between 911 dispatcher and 988 crisis hotline call centers.
The 988 crisis hotline is a federally assigned number for people in distress to call. It is being implemented in Nevada following the passage of Senate Bill 390 last session to give those in crisis an easier way to reach out than calling the 10-digit number for the suicide hotline.
Rachelle Pellissier, executive director of the Crisis Call Center of Nevada, spoke with Cortez Masto about the call center and how her legislation would aid in its operations.
The Crisis Call Center of Nevada has been in operation since 1966. It’s also one of nine national call centers, and calls from other states are routed to it when there’s a high volume. It’s staffed 24/7 by more than 50 employees, 50 volunteers and a cadre of University of Nevada, Reno, student interns studying in relevant fields who take calls from people in mental crisis, those struggling with substance abuse, and people reporting child abuse in Nevada’s rural counties.
“Any kind of crisis line you can think of pretty much comes into here,” Pellissier said.
The call center has also, for more than four decades, been responsible for sexual assault advocacy in northern Nevada. When a rape is reported, the center sends a forensic nurse to attend the sexual assault medical exam and assigns an advocate to work with the victim until they’re ready to file a police report and be directed to additional resources.
Pellissier said the main job of staff in the crisis call center is to de-escalate the situation when someone calls.
“And we help them through the crisis,” she said. “We now have case managers on both day shift and swing shift, that, once we get them de-escalated, we’ll have them do a follow up and get them out to even more services.”
“We know that the best suicide prevention is to help people before they get into that emergency.”
Staff members at the center go through an intensive, 73-hour training to learn the ropes.
“We go through everything you can think of that might get a person in trauma,” Pellissier said. “We learn about mental health. We learn about veteran culture. We learn about all sorts of diverse cultures and how to handle those calls.”
The center fielded more than 83,000 calls during 2020. Of those, 20,000 were from Nevadans. The pandemic influenced work at the call center, though it did not greatly increase the number of calls received.
“We did see an increase [because of the pandemic] but in the acuity of the calls,” Pellissier said. “By that I mean they were much higher mental health issues and much closer to an imminent risk thing. So that means even though we didn’t have more calls, the time on the phone to get them de-escalated so we can then refer them to the appropriate services was that much longer.”
Pellissier said Cortez Masto’s bill would provide the resources the call center needs to expand its services and be prepared for the implementation of the 988 mental crisis call line. She said the center would use the funding to set up systems similar to those of 911 operators’, which allow for GPS tracking of callers to help identify the location of those who need in-person assistance.
The funding set out in the bill would also allow the center to create mobile crisis response units composed of clinicians and staff to respond to the average of 2% of calls during which staff is unable to de-escalate a situation. Currently, if staff are unable to de-escalate, they must call 911 to see if police think a response is necessary.
The mother of 18-year-old Miciah Lee, who was killed in January 2020 by Sparks Police officers after she’d made a 911 call from a restaurant parking lot saying he was suicidal and armed, told Nevada legislators during the 2021 session that her son might be alive if other resources had been available to respond that day.
“It’s so important that we have behavioral health—that we treat people in a behavioral health situation the same way we treat people in a physical health situation,” Pellissier said.
Cortez Masto said that is the point of her new legislation.
“There should be no distinction,” she said. “That’s what we call parity when it comes to funding these services. The parity is not there yet, so we’ve got to bring it—and that’s part of what we’re doing with my bill as well.”
Cortez Masto pointed out that the American Rescue Plan has already created funding for behavioral health services, including money for the creation of mobile crisis response units. It will also direct $1 billion to education in Nevada, some of which Cortez Masto hopes will be used to address mental health crises in children.
Pellissier is hopeful for the passage of Cortez Masto’s legislation.
“It’s going to help us expand our services. We know that the best suicide prevention is to help people before they get into that emergency … and having enough resources that they can call us when they’re feeling anxious or when they’re feeling depressed, and not have to wait until their pain is so great that suicide feels like the only way to get out of that pain,” she said.
“So, as we expand these services, this vital funding the senator is bringing forward will absolutely help us to get more resources to more Nevadans so they don’t get to that crisis stage—but, when they do, it will give us the services to send out to them and get them to the right resources that they need,” she added.
