Mass. set up a mental health hotline. 6,000 people called in the first 3 months

Massachusetts health officials are taking steps meant to improve access to mental health care. One pillar of their ambitious effort is a new helpline to assist people seeking treatment. It promises to connect callers with mental health services — 24 hours a day — and it's free.

The Massachusetts Behavioral Health Help Line can be reached by calling or texting 833-773-2445. It is staffed by clinicians, maintains confidentiality and has an online chat function.

When someone contacts the helpline, a referral specialist will assess the situation, determine if the person needs immediate help and locate the appropriate services. That could involve scheduling an appointment at a clinic or mental health provider's office, or reconnecting the person with a previous provider. It also might mean finding treatment for a substance use disorder, locating a bed in a psychiatric facility or sending out an emergency mobile mental health team. The help is offered regardless of the caller's insurance.

"Think of the helpline as quite literally that front door into the network of treatment," said Massachusetts Department of Mental Health Commissioner Brooke Doyle. The helpline is part of the state's "Roadmap for Behavioral Health Reform," a comprehensive plan put in motion by former Gov. Charlie Baker's administration to improve behavioral health care.

During a recent training call for helpline staffers, workers listened to a simulated call involving a common request  —  getting a mental health appointment right away.

Helpline resource and referral specialist Ashley Decoteau spoke with a colleague pretending to be the caller.

"I really am in need of some help, and I'm hoping that I can be seen today," the simulated caller told Decoteau, explaining that she was hearing voices and has had thoughts of harming herself.

Decoteau asked some questions to assess the caller's state of mind.

"Have you had any thoughts of wanting to harm or kill anyone else?" Decoteau asked.

"No," the woman told her.

Decoteau asked other questions designed to determine whether the caller was experiencing domestic violence or was in immediate danger. She reassured the caller that their conversation was confidential, but told her that if the helpline learns of serious risk or harm, she may be legally required to disclose that information.

In emergency situations, helpline workers are trained to contact 911.

After confirming the patient's safety, Decoteau asked if she could connect the caller  with a Community Behavioral Health Center for a mental health evaluation that same day — either at the center or at the caller's home. Decoteau stayed on the line and made sure the caller got an appointment.

"This is a typical type of call for someone who is calling for themselves in an urgent situation," said Heather Towers, a manager with the Massachusetts Behavioral Health Partnership, which oversees the helpline.

A Community Behavioral Health Center, or CBHC, is a treatment center that provides flexible scheduling, with appointments outside of typical business hours, and has interdisciplinary teams of clinicians. Statewide, 25 of these centers started operating this year as part of the "Roadmap" policy to improve mental health care. Many of the centers provide outpatient, inpatient and emergency services.

Some of the state's private insurers will cover visits to Community Behavioral Health Centers, depending on the type of visit. But some insurers place limits on coverage for urgent and emergency care.

The helpline also sends patients to some private providers who have the flexibility to see patients right away.

The end of a call is not the end of the staff's engagement with patients. "We will also call back to make sure they received the services they need," said Sharon Hanson, CEO of the Massachusetts Behavioral Health Partnership.

The helpline is staffed by more than 60 people who work remotely. The staff includes resource and referral specialists, such as Decoteau, as well as clinicians and certified peer specialists, or people who have personal experience with mental health treatment.

Since it began operating in January, the helpline has fielded more than 6,000 calls, according to state data. More than a quarter of calls in March resulted in referrals to outpatient mental health services. Another 28% percent were for general information about behavioral health care. Just 3% of callers refused the helpline referral.

Anyone can contact the helpline, which operates in 200 languages. It is separate from the national 988 emergency mental health and suicide prevention hotline that began operating last July.

The state expects start-up costs for the helpline of $13.6 million, and its annual operating costs will be $18.5 million.

Doyle, the state's mental health commissioner, said the initiative aims to prevent mental health issues from becoming a crisis. She added that by helping people navigate the mental health treatment system, the state also is hoping to ease pressure on hospital emergency departments.

"All too often people were going to emergency departments as first line responses when they needed help getting into treatment," Doyle said. "And what we also saw is that because outpatient, community-based treatment options were confusing and hard to enter, that sometimes people waited too long to seek help."

Many mental health advocates praised the launch of the helpline, but questioned whether there are enough mental health professionals to take helpline referrals — amid a nationwide shortage of behavioral health care workers.

"The reality is that work force is a huge, huge issue," said Pam Sager, executive director of the Parent Professional Advocacy League, a group that works toward improving mental health care for children and families.

Sager said the helpline is well-designed, but based on her clients' experiences, "they're still struggling to really make good connections for families, and families are waiting a long time to get therapists and other providers." Sager said she hopes state officials will reach out to a broad group of providers to ensure there is enough treatment.

The Massachusetts Association for Behavioral Health Care, which advocates for mental health and substance use providers and represents most of the new Community Behavioral Health Centers, said the helpline is the first step in what will likely be a lengthy journey to improve mental health care.

"It's important to to view the 'Roadmap' as a long game," said the group's president and CEO, Lydia Conley, "What's really great about this is we put a stake in the ground and said we're tired of doing the same old business as usual. Hopefully, these initiatives will be part of a multi-year strategy of investment in behavioral health treatment services and the workforce."