Funder Perspective: Philanthropy’s Unique Opportunity to Support 988 and Crisis Reform
Rick Kellar, MBA, President, Peg’s Foundation
Alicia D. Smith, MHA, Director of Policy and Implementation, Peg’s Foundation
Kristen Ward, MPH, Director of Programs and Knowledge, Mindful Philanthropy
With the national 988 mental health crisis hotline soon launching on July 16th, Peg’s Foundation and Mindful Philanthropy share our insights on why funders should support crisis reform and how to meet this unique moment for lasting impact.
Why Mental Health Crisis Reform?
Each year, over 2 million people with severe mental illness are booked into jail. On top of that, over 20,000 people in mental health or substance use disorder crisis land in emergency rooms daily. Hospitals and jails across the U.S. are shouldering the burden of these crises, as people struggle to break the cycle of incarceration and hospitalization. The new three-digit, national 988 crisis line is a key jumping off point to improve the behavioral health care continuum. Improved knowledge about and access to a crisis hotline is important, but a crisis line ought to be measured by how well the crisis is addressed during as well as after the call, and beyond.
Last month, Mindful Philanthropy released our latest guidance, A Call for Hope: How Philanthropy Can Support 988 and Mental Health Crisis Care, for funders to support 988 implementation within a broader crisis response system.
Peg’s Foundation, based in Ohio, is one funder who has long led the way in this important work. Had it not been for the love and determination of his mother, Peg Morgan, founder of Peg’s Foundation, and the advocacy of the Ohio NAMI leadership, her son would have been another statistic of mental illness criminalization. Sadly, this story is too common, and the outcomes for the person struggling are often much worse. Driven by this experience, Peg decided to make serious mental illness a core priority of the Foundation. Peg’s Foundation’s work in crisis reform began by applying the Sequential Intercept Model (SIM) to early grantmaking with the help of a local partner and co-architect of the model. The SIM explains how individuals with mental and substance use disorders come into contact with and move through the criminal justice system.
For 17 years, Peg’s Foundation has invested in ways to reduce criminal justice interactions, and get people like our founder’s son the help they need sooner. Along the way, each element of our work grew into a systems approach that has informed national best practices. In 2020, Peg’s launched Clear Pathways, an initiative in partnership with local and state partners to improve crisis response in select communities. By applying the “Someone to Call, Someone to Come if needed, and Somewhere to Become Safe” framework, Peg’s aims to disrupt the cycle of jail, emergency department visits, and homelessness, enabling all people to thrive in relationships and their community. Our hope is that this model that can be applied across Ohio and beyond.
Our Advice to Other Funders
The COVID-19 pandemic has improved the public perceptions of behavioral health challenges, significantly reducing stigma in just a few short years. For funders who want to help, 988 and behavioral health crisis response reform is a key starting point to help families across the country find answers. Yet these funders often do not know where to start. Or, they may be hesitant to dip their toe in. Here is our advice:
Get in the game! Make your first grant in this space and learn from there. Do not let perfect be the enemy of good. This is an especially great time for funders in adjacent areas such as housing, justice reform, or education to get involved. Consider how you might address the many risk factors that contribute to mental health challenges, such as homelessness or childhood trauma. Look for opportunities to help streamline the implementation of 988 and fund infrastructure and services that build a robust for crisis response and care.
Leverage philanthropy’s “power of convening” to invite diverse stakeholders to the table. Peg’s Foundation discovered early on the power of bringing people together to share learnings and collaborate. By setting the table, philanthropy can build and nurture relationships with leaders, experts, providers, and most importantly decision-makers to inform smart solutions. For example, in Ohio, Peg’s Foundation has built deep relationships with state leaders, providers, associations, payers, advocacy groups, and legislators to activate smart ideas and policies for the mental health system in the state. Having credibility with these decision makers and stakeholders, built by learning together over time, has made systems change more possible.
Be willing to collaborate with other funders. We can make the most impact when we work together and learn from each other. We need to emulate what we expect of the systems around us. Peg’s Foundation has partnered with Pew Charitable Trusts and the Sozosei Foundation on Clear Pathways to elevate smart solutions organically within local communities and the state. By being the neutral eye and ears for national scale, funders also improve their ability to invest at the state and local level.
Be patient and stay the course. Systems change can take years. Fortunately, philanthropy has the unique ability to play the long game. The July 16th date is not a deadline but rather a starting point. We expect that there will be a lot of frustration about inconsistent delivery of 988 in its early implementation. If we consider 911 as a comparison, we know that this system needs continuous improvement even after 40+ years since implementation. Similarly, 988 is one of many steps to achieve an equitable and effective crisis response system. Foundations have the ability to bring longevity to the solution-making.
Learn from other states and localities. Philanthropy also has a unique ability to highlight and uplift learnings from certain states and localities and adapt them to other settings. For example, in Ohio, the Peg’s Foundation has helped the state learn from and adapt Arizona’s crisis care model. The approach offers three core components of the crisis continuum and allows law enforcement to bypass emergency rooms and take individuals in mental health crises directly to crisis centers, reducing psychiatric inpatient care and personnel costs. With local insights, funders can help scale, replicate, and adapt this or similar models to other states and localities by assessing their infrastructure and funding services through partnerships with local stakeholders.
To learn more about how funders can support 988 implementation within a broader crisis response system, including more information on Clear Pathways and the Arizona model, download Mindful Philanthropy’s latest guidance, A Call for Hope: How Philanthropy Can Support 988 and Mental Health Crisis Care. See our blog for more in this series on 988 and crisis reform.
