Wraparound crisis care: The BC Crisis Line Network, 9-8-8 and the integration of the crisis care continuum

Last year, we reported that the Crisis Centre of BC, in partnership with the BC Crisis Line Network, was working to bring about changes to our systems to ensure British Columbians receive the right kind of suicide intervention and mental health crisis care.

This year, we took a crucial step towards providing better access to mental health crisis care for all, with the integration of local centres across the network onto the same phone system, allowing calls to be routed between them.

For years, we have worked to ensure that no call is left unanswered, that nobody is left waiting or met with a voicemail inbox in their moment of need. In September 2023 we onboarded onto the Provincial Health Services Authority’s new call centre, alongside nine other BC crisis centres. Now, if a particular crisis centre is experiencing a high volume of calls, another centre within the network provides seamless backup support. This ensures that people in crisis receive timely help, even during peak hours. The network also fosters knowledge sharing and collaboration between crisis centres, meaning we can continue to improve the quality and appropriateness of support we provide.

In BC, we moved from a 43% answer rate for incoming calls to a 76% answer rate in only six months.

In November 2023, we also onboarded onto the national 9-8-8 platform, joining 40 crisis centres across Canada to provide immediate support to folks dealing with suicidal thoughts or actions. The 9-8-8 service has been receiving 1,000 calls and 450 texts every single day, and we have answered calls from people in distress as close as our neighbourhood and as distant as Newfoundland. The bottom line is, these calls get answered because crisis line responders are available. 

9-8-8 offers bilingual, culturally appropriate support, and an easy-to-remember number, ensuring a broader reach to those who may not have known about previous helplines. 

Building a Stronger Safety Net for Crisis

The launch of the provincial crisis line network and the national 9-8-8 suicide crisis hotline are significant strides towards a more effective crisis response system. However, the road ahead requires further collaboration.

Here in British Columbia, we continue to work towards a more coordinated crisis response continuum, a comprehensive approach that prioritizes early intervention and community-based support. 

A crisis care continuum maximizes the autonomy of the person in crisis by providing alternatives to police and psychiatric intervention, which is often the default for crisis intervention today. We believe in a system that helps the person in crisis decide their next steps in the least restrictive way, and minimizes the trauma inherent in coercive approaches to care.

The ideal continuum includes:

• 24/7 accessible crisis hotlines, chat, and text services: These would offer immediate intervention and serve as the entry point for further support within the continuum.
• Civilian-led mobile crisis response teams: These teams would be equipped to address crises directly in the community; in communities using civilian-led teams, police interventions are almost never necessary.
• Community-based crisis respite facilities: These facilities, separate from hospitals and jails, would provide safe havens for those in crisis; when community-based crisis respite is in place, only 2% of individuals who flow through the crisis care continuum require psychiatric hospitalization.
• Wraparound crisis follow-up and care: This ensures individuals receive ongoing community-based support after a crisis event.

The national suicide crisis line is a step in the right direction. To further streamline crisis care and minimize police involvement in mental health situations, we advocate for:

• Ensuring all BC 9-8-8 calls are answered in BC.
• Clear criteria for directing calls from 9-1-1 and police non-emergency lines to crisis lines, ensuring individuals connect with the most appropriate resources.
• Expanding the use of 310-6789, BC’s crisis line, as a public access point for dispatching mobile crisis teams across the province, as public feedback suggests.

By working together to implement a comprehensive crisis response continuum, we can build a more robust safety net for those in need.