With the 988 Suicide & Crisis Lifeline approaching its fourth anniversary and states expanding crisis response infrastructure, healthcare leaders are increasingly focused on building systems that can provide specialized care while easing pressure on hospitals, law enforcement and psychiatric facilities.
Chris Santarsiero, vice president of government affairs at Phoenix-based Connections Health Solutions, joined Becker’s “Behavioral Healthcare Podcast” to discuss the policy changes, care models and community partnerships shaping the future of behavioral health crisis response.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Could you tell us more about your role at Connections Health Solutions and the work your organization is doing to transform behavioral health crisis care across the country?
Chris Santarsiero: At Connections Health Solutions I focus on advancing policy, market access and payment mechanisms that expand access to emergency behavioral health crisis care. At Connections, we partner with counties, state governments and payers to serve as the hub of a modern emergency crisis system, meeting individuals where they are and delivering care in the safest, least restrictive setting possible. Today, we operate in six states with crisis response centers and mobile response teams, with more in development, that are improving access to care, elevating quality and clinical excellence, and reducing costs across behavioral health, public safety and criminal justice systems.
Q: You’ve spent more than two decades working at this intersection of healthcare policy and care delivery. As you look at the behavioral health landscape today, what do you see as the most significant challenges communities are facing in meeting the growing demand for services?
CS: In far too many communities today, when someone is in a behavioral health crisis, the default option is the emergency department or even jail. Neither of those settings is designed to deliver the kind of specialized care that our friends, family and community members need. Delivering behavioral health care in emergency departments or jails leads to high costs, poor outcomes, while adding significant strain to our systems that are already overwhelmed.
When you see that gap in higher-acuity situations, when someone presents with suicidal ideation, acute agitation or substance intoxication, appropriate care is critical. Without the right level of support in place, those individuals often cycle right back through emergency departments, hospitals and then ultimately the criminal justice system.
That’s exactly the problem we’re trying to solve at Connections. Our model is designed to complete the emergency response continuum by bringing intensive medical, nursing and peer-focused capabilities directly into the behavioral health crisis setting. This allows us to properly treat high-acuity patients in a way that’s both clinically appropriate and far less restrictive. What keeps me energized in this work is seeing what happens when communities finally have that missing piece in place — we’re starting to see better outcomes, lower costs and, most importantly, people getting a real chance at recovery and long-term well-being.
At its core, the Connections model really changes how behavioral health and legal systems interact. We just opened a new center in Prince William County, Va., that is already alleviating system-wide pressures, easing persistent bottlenecks across the county, and significantly reducing the demand on Virginia’s psychiatric hospitals. In just the first six months, we’ve seen significant community impact. Since opening, we’ve saved over 5,433 law enforcement hours, avoided 1,580 emergency department days and also avoided 9,489 psychiatric inpatient bed days. These measures prove the Connections model creates a true diversionary pathway and gives people access to immediate, targeted care when they need it most, and that’s incredibly meaningful work.
Q: What trends in behavioral health are you watching most closely, and what gives you optimism about where the field is headed over the next several years?
CS: In many ways, the 988 crisis lifeline has been a catalyst for innovation in behavioral health care public policy, and what we’re seeing now is the next phase — building a truly comprehensive, connective crisis continuum that can support people not just in the moment but throughout their recovery. July marks the four-year anniversary of 988, and it is normalizing help-seeking behavior and addressing stigma by making support more visible and accessible.
The launch of the three-digit number fundamentally shifted how states and communities think about crisis response, and almost immediately created urgency and momentum for policymakers to build a more complete, coordinated system across the country at all levels of government.
This simple, easy-to-remember number, just like 911, 988 sends a very clear message: mental health issues are real health issues. That alone helps reframe help-seeking as something proactive and appropriate rather than something people only do as a last resort. That’s a major shift. People can call, text or chat, so they can choose what feels most comfortable, and the support itself is provided at no cost to individuals, is confidential and judgment-free, which really addresses some of the biggest fears people have, especially our youth.
In its first 18 months, our new mobile crisis services center, in partnership with Dauphin, Cumberland and Perry counties in Pennsylvania, has driven a more than 20% reduction in civil commitment petitions in those counties. This demonstrates that these services work as a preventive tool and relieve pressure across entire systems.
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