Georgia’s mental health hotline is a national leader. Some worry about its expansion

Kevin Tanner, Commissioner of the Georgia Department of Behavioral Health and Developmental Disabilities speaks during a town hall discussing the milestones of 988 Suicide & Crisis Lifeline at Georgia State University in Atlanta on Friday, May 19, 2023  (Natrice Miller/natrice.miller@ajc.com)

Credit: Natrice Miller/AJC

Credit: Natrice Miller/AJC

Kevin Tanner, Commissioner of the Georgia Department of Behavioral Health and Developmental Disabilities speaks during a town hall discussing the milestones of 988 Suicide & Crisis Lifeline at Georgia State University in Atlanta on Friday, May 19, 2023 (Natrice Miller/natrice.miller@ajc.com)

Georgia’s new 988 mental health hotline service, which launched last summer, was recognized on Friday as a model for other states. But some Democratic lawmakers in the Legislature say last-minute budget cuts made by the governor’s office could hamper the planned expansion of 988.

At a town hall on Friday to discuss the future of the hotline, national leaders held up Georgia as an example of what’s working. The success with 988, a national hotline for people experiencing a mental health or substance abuse crisis, has been a bright spot for a state that’s traditionally lagged in providing that care.

And yet, as demand for the 988 hotline grows, lawmakers said the state will need more people to staff the phones and further expand the types of services being offered. Amid fears of a looming recession, when Gov. Brian Kemp signed the budget he told agencies to ignore millions of dollars that the Legislature had wanted to include.

The early budget included $2.2 million in funding to expand 988, as well as wage hikes for mental health professionals. Democratic lawmakers are now worried the loss of that money will primarily hurt people in the midst of a mental health crisis.

“What is clear is that the work and focus to improve our mental health services across Georgia have been derailed,” said Rep. Mary Margaret Oliver, a Democrat in the state Legislature.

When it comes to 988 specifically, the results in Georgia are strong. On average, Georgia is answering calls to its hotline in fewer than 10 seconds, and has earned high marks in how it handles the number of callers, even as intake continues to climb. Call volume is up 12% for a nine-month period ending in March 2023, according to the Georgia Department of Behavioral Health and Developmental Disabilities. The hotline model that the state relies on uses best practices: like 24/7 crisis intervention by phone and texting; teams of trained professionals who are responding quickly to people in distress; and places that provide both short- and long-term care.

Experts on the federal, state and local level hold a town hall to discuss the milestones of 988 Suicide & Crisis Lifeline at Georgia State University in Atlanta on Friday, May 19, 2023  (Natrice Miller/natrice.miller@ajc.com)

Credit: Natrice Miller / Natrice.Miller@ajc.com

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Credit: Natrice Miller / Natrice.Miller@ajc.com

“This state is a star, and this state is one that should be lifted up as an example,” said Monica Johnson, a director overseeing the 988 Suicide & Crisis Lifeline at the federal level, said at a town hall event at Georgia State University in Atlanta. Before this, Johnson served as the interim commissioner at DBHDD in Georgia.

Those call numbers are only expected to rise. The 988 number has not been widely promoted yet, but DBHDD Commissioner Kevin Tanner said in an interview that his agency will be working to spread the word in the coming months. The state agency will predict future call volume in Georgia and those estimates will also influence the agency’s budget request for the 2024-25 budget year.

“I am very optimistic,” Tanner said of 988 in Georgia. “We have been able to keep up with demand and improve our answer time.”

Kemp’s instruction for the state to not spend 988 funds was because the money was earmarked for administrative funding to 988 rather than direct response services for those in crisis. So far, call volume has not increased to a level that requires additional support over the existing levels, according to Kemp’s budget instructions.

Another budget cut that some Democratic lawmakers took issue with was millions of dollars in wage hikes for mental health professionals. “These wage increases were going to be targeted to the greatest need,” said Sen. Sally Harrell, a Democrat.

But the budget did include other gains for mental health, including increased overall funding for the department and more money for mobile crisis services — the trained professionals who are dispatched to people who call 988 in distress.

A key advisor to Kemp defended the governor’s decision on Wednesday, as well as his record on mental health: not only has the state been funneling more money into mental health services issue under the governor’s tenure, but Kemp did what he had to do to ensure the state’s fiscal health.

Cody Hall, adviser to Gov. Brian Kemp, said there was about a $200 million hole that the General Assembly choose not to fund in the latest budget, and that the state can only pull so much money from its reserves before the Wall Street credit ratings agencies take notice. The state now has a record $5.2 billion in reserves.

“This year, there was a larger hole than usual,” Hall said on the Georgia Public Broadcasting radio show “Political Rewind.” “What the governor is trying to do is make sure that we are planning our budget process years in advance and that if there is an economic downturn ... we are prepared and we’re not asking agencies to come in and make 5%, 10% or 15% budget cuts.”

Georgia often has ranked towards the bottom of surveys that measure how state’s deliver mental health care. But the governor and lawmakers have made strides in improving access. Last year, lawmakers overwhelmingly passed a 76-page overhaul of the mental health care system, which was a priority of then-House Speaker David Ralston, who died in November. The law aims to ensure that insurance companies cover mental health care the same way physical health care is covered. Lawmakers also greatly increased funding for mental health services.

However, this year’s effort to improve Georgia’s mental health care system stalled in the Senate: House Bill 520 focused on addressing a shortage of mental health providers and streamlining the way agencies share information about patients, including what the bill called “familiar faces” that law enforcement and mental health providers see time and time again.

The bill overwhelmingly passed the House but failed to get a vote in a Senate committee.

As for 988, Tanner said that going forward, the state will need to continue building out the entire mental health system.

”We got a lot of work to do, but we have the team that’s up to the challenge and in a state that’s having serious conversations,” Tanner said. “We are going to continue to be a leader in this area.”

-- Reporter James Salzer contributed to this report.