FR 2024-28136

In this Federal Register notice, the Substance Abuse and Mental Health Services Administration (SAMHSA) has proposed an information collection plan to evaluate the 988 Suicide & Crisis Lifeline and associated Crisis Services Program. This document sets out the framework for gathering data aimed at assessing the implementation, outcomes, and impacts of the 988 Lifeline, which has been pivotal in providing crisis support services across the United States. The evaluation encompasses various levels, from systemic to individual client assessments, and examines the efficacy of these services in delivering timely and effective support to those experiencing mental health crises.

Summary and Overview

The 988 Lifeline serves as a crucial tool in connecting individuals in crisis with necessary behavioral health services. SAMHSA aims to collect data to evaluate how well the Lifeline meets its objectives. This involves examining the infrastructure, collaborations, and utilization of crisis services both nationally and within specific states, territories, and tribal jurisdictions. Feedback from stakeholders and grantees will shape the ongoing efforts to enhance the program. With an eye on improving service performance and crisis care quality, SAMHSA is opening a comment period for public input on this proposed data collection, due by January 31, 2025.

Significant Issues and Concerns

One primary concern is the complexity and technical nature of the document, which may be challenging for general readers to fully understand. The descriptions of the various evaluation levels—system, client, and impact—are dense and could benefit from simplification or additional context to ensure broader comprehensibility.

Moreover, the document does not explicitly describe how the quality and utility of the collected information will be improved. There is an absence of specific criteria for success, which could lead to ambiguity about the ultimate goals of this evaluation effort.

Another significant issue pertains to the projected burdens on respondents—a broad estimation of time and effort required for data collection. Detailed plans on how these burdens will be minimized would be prudent to demonstrate the feasibility of this undertaking.

Additionally, while the document outlines substantial funding dedicated to the initiative, questions arise about whether the allocation is sufficient given the scope and intended depth of the evaluation.

Impact on the Public

Broadly, the success of this evaluation will significantly impact the public by potentially enhancing the efficacy and responsiveness of mental health crisis services. The 988 Lifeline aims to decrease instances of suicide, overdose, and other mental health crises by connecting individuals to necessary services promptly.

Impact on Specific Stakeholders

Stakeholders such as crisis centers, healthcare professionals, and beneficiaries of mental health services will feel the direct effects of this initiative. Positively, the findings from this data collection could support increased funding and resources for understaffed or underfunded centers, leading to improved service delivery and outcomes for individuals in crisis.

Conversely, the document may concern these stakeholders about the potential administrative burdens or funding sufficiency relative to the expected improvements. The lack of detailed strategies for minimizing data collection burdens and the need for clear success metrics could amplify these concerns.

In conclusion, SAMHSA's proposed evaluation highlights the federal government's commitment to advancing mental health crisis intervention. However, clearer communication and planning are necessary to address stakeholder concerns and maximize the beneficial outcomes of this ambitious effort.

In reviewing the financial references within this Federal Register document, there are noteworthy points concerning appropriations and funding allocations that require attention.

Summary of Financial Allocations

In the fiscal year 2024, the Biden-Harris administration dedicated nearly $500 million to support the 988 Suicide & Crisis Lifeline and related programs. This funding is intended for various stakeholders including the 988 Lifeline Administrator, state territories, Tribal entities, and other center levels. The allocation is part of an overarching effort to enhance crisis care across the United States. Such a substantial financial commitment signifies the federal government's dedication to addressing mental health and crisis response infrastructures.

Relation to Identified Issues

A significant aspect of the document is its discussion on funding without corresponding details on how effectively or adequately these funds will be utilized. The appropriated $500 million is intended to support various components of the 988 Lifeline and associated evaluations, yet there is a noted potential concern regarding whether this amount sufficiently covers the wide-ranging evaluation and implementation goals outlined in the document. The document elaborates on diverse levels and types of evaluations, such as system-level, client-level, and impact evaluations, all of which require significant resources. However, without precise breakdowns or measures of financial adequacy, stakeholders might question whether the funding matches the scope of proposed activities and evaluations.

Moreover, although there is a clear mention of the financial support, the document lacks transparency regarding how this funding contributes to enhancing the quality, utility, and clarity of information collected through the evaluation process. Without this clarity, there may be ambiguity in understanding whether financial resources are effectively directed towards addressing the identified needs and challenges within the crisis care system.

In addition, while an estimate of the burden on respondents is provided, this does not extend to a detailed explanation of how financial resources will help manage or minimize these burdens. Providing such details could alleviate concerns about the feasibility of the evaluation efforts given the allocated budget.

Overall, while the $500 million funding represents a substantial investment in national crisis care, the document could further benefit from additional transparency and detail regarding financial allocations to specific programmatic elements and the anticipated effectiveness of such spending.