In our work within the behavioral health community, we are confronted with a stark and undeniable reality: our systems often fail the very people they are meant to serve. Those in crisis frequently encounter environments that punish rather than support, and these experiences can leave deep scars—both emotional and physical.
This crisis of care inspired us to embark on creating a global consensus document on values for crisis care. The cornerstone of this effort is dignity. Not as an abstract or lofty ideal, but as a real, actionable commitment to the humanity of every person in crisis. Dignity must become a universal standard—a guiding light for all crisis response systems worldwide.
The Crisis of Dignity
Every day, tens of thousands of individuals in crisis face dehumanizing treatment. Too often, they are met not with compassion, but with cold, procedural responses:
- Detainment in sterile, isolating emergency rooms for days.
- Transport in patrol cars with heads pressed down, wrists shackled.
- Encounters that amplify trauma instead of fostering healing.
These experiences don’t just erode trust—they strip away humanity and perpetuate cycles of harm. And the consequences are not just tragic—they are often fatal.
A recent study from Allegheny County, Pennsylvania, revealed that up to 20% of individuals involuntarily hospitalized for psychiatric care die within five years. To put this in context, this mortality rate exceeds that of individuals exiting jail, enrolling in homeless shelters, or even those diagnosed with severe mental illness.
This isn’t an isolated finding. A meta-analysis in BMJ Open found that suicide rates in the first week after psychiatric discharge are alarmingly high—3,000 per 100,000 person-years. These numbers dwarf the global average suicide rate of 9 per 100,000. Despite these grim statistics, behavioral health systems still lack comprehensive mortality reporting, underscoring the urgent need for reform.
A Crisis of Life and Death
These data points paint a clear picture: this is more than a crisis of dignity. It’s a crisis of life and death. Yet, amidst these challenges, we find hope and opportunity.
The launch of 988 represents a paradigm shift. This three-digit lifeline is more than a phone number—it is a symbol of compassion, accessibility, and connection. For countless individuals, it is a beacon of hope in their darkest moments.
But we cannot stop there. 988 must be a foundation, not the finish line. Dignity must flow through every facet of our behavioral health systems. From policies and protocols to individual interactions, every decision must begin and end with respect for the humanity of the person in crisis.
The Path Forward
The Substance Abuse and Mental Health Services Administration (SAMHSA) has opened the door for public comment on revised national guidelines for crisis care. This is a pivotal moment to embrace transformational change.
Back in 2017, when the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) began working with SAMHSA, we were challenged to provide a “candid and sober assessment” of the state of crisis care. That challenge remains. We must dig deep, ask hard questions, and pursue bold solutions that honor the inherent worth of every individual who turns to us in their time of need.
A Call to Action
This is our moment to move beyond outdated, punitive responses and embrace the transformative power of dignity. Every life we touch is an opportunity to restore hope and healing. Together, we can build systems that save lives while honoring the humanity of those we serve.
Let’s make dignity not just a value, but a standard—a promise we uphold in every interaction. Because at the heart of every crisis is a person, and every person deserves respect, compassion, and care.
Monica, your leadership at SAMHSA has been instrumental in advancing this vision. Your dedication inspires us to push forward. Let us rise to meet this challenge, creating systems that don’t just respond to crises but transform lives for the better.
The time to act is now. Let dignity lead the way.
David Covington is the Managing Partner & Co-Founder of Behavioral Health Link
Join us on Lifelines with David and John, a 988 Podcast, where we delve into the fascinating world of crisis intervention and explore the inception and growth of the transformative 988 lifeline. Since its launch on July 16, 2022, 988 has become a beacon of hope and innovation in suicide and crisis prevention. David, the visionary behind the Atlanta crisis center, and Dr. John, a key figure in post-9/11 mental health disaster response, have played crucial roles in shaping the National Suicide Prevention Lifeline and the emergence of 988.
Lifelines with David & John: The 988 Podcast is not just a podcast; it’s a movement towards a future where every call for help is met with understanding, and every individual in crisis finds a beacon of hope.