GiveBetter x California

Didi Hirsch Mental Health Services

Mental health treatment, crisis lines, post-discharge follow-up and substance-use care

Research time: 14 min on GPT-6 Astra Light
  • Research — reviewed programs, finances and impact evidence.

Updated: 2026-09-14

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Summary

What do they do? Didi Hirsch provides outpatient, residential, substance-use and crisis mental-health services, including 988 and Teen Line. Its California clinical services coexist with national and international crisis-line activity. The estimate prices a depression-treatment component at full recipient cost, not the whole portfolio.

Why we’re interested in this organization:

  • A current service report identifies a concrete outpatient population and diagnosis mix.

  • The organization delivers clinical therapy, medication support and post-discharge coordination, not only awareness.

  • Original returns and Schedule D reconcile donated services and separately netted event costs.

Our main reservations:

  • The depression illustration omits much of the recipient's potentially important crisis, severe-illness and child-care value.

  • Eligibility, treatment intensity, funding response and California residence are subjective scenario inputs rather than observed marginal outcomes.

  • Crisis-contact improvement is not a demonstrated mortality effect, and other funded centers may substitute.

What do you get for your dollar? $221.4M per better life: ten additional quality-adjusted life years in California. Conditional depression-treatment QALYs at full recipient cost; not whole-portfolio effectiveness..

5498 outpatient clients * .6 adult-compatible * .32 depression * .5 eligibility * .5 clinical transfer * .25 funding response =65.976 reference-effect-equivalent offers; *.057*.99/1.03=3.614588038835 California QALYs. All intermediate fractions except reported diagnosis share are judgments.

1. What do they do?

This report covers the entire Didi Hirsch Psychiatric Service recipient, EIN 95-1816023, operating as Didi Hirsch Mental Health Services. Its ordinary donation route does not guarantee that the next gift supports only its strongest suicide-prevention activity. Ordinary donation route

Current services include 988, counseling, hospital referrals and support groups. Attempt-survivor groups are for California residents, while bereavement groups are available nationwide. Broad health care and substance-use work also belong in the recipient scope. Current suicide prevention, follow-up and support services

The 2025 annual report records 246,098 988 calls, chats and texts; 97% were resolved without emergency services and 69% of contacts with suicidal intent improved by the interaction's end. These are contact-level reported outcomes, not distinct lives saved. Teen Line receives international contacts, so headquarters location does not establish the geographic impact numerator. 2025 Annual Report, including current services and financial summary

2. Monitoring and information sharing

A direct study of the UCLA–Didi Hirsch partnership describes outreach within 24–72 hours after discharge, safety planning, emotional support and linkage to care. It involved focus groups with 18 providers/counselors, not a controlled patient-outcome comparison. Participants identified referral and communication gaps, making successful engagement—not referrals sent—the meaningful delivery metric. Qualitative evaluation of UCLA–Didi Hirsch post-discharge follow-up partnership

The organization's SOSA research enrolled 92 attempt survivors in an eight-week group and assessed pre/post self-reported symptoms and resilience. Without a comparison group, improvement can reflect treatment elsewhere, natural recovery and selective completion; it does not identify mortality effects. Open-label evaluation of Survivors of Suicide Attempts groups

ED-SAFE provides stronger external evidence for a bundle of ED resources and follow-up calls. In sequential phases, one-year attempt risk was 23% with usual care versus 18% with the intervention; screening alone did not show the same improvement. This was not random assignment to Didi Hirsch, and reduced attempts must not be relabeled an equal proportional reduction in deaths. ED-SAFE sequential-phase suicide prevention trial

Request unique-patient engagement, repeat contacts, alternative care received, symptoms over time, attempted self-harm and mortality linkage with an appropriate comparison. Include uncontactable referrals and dropout. A same-person repeated crisis should not receive a fresh lifetime survival credit each time.

The outpatient branch separately uses 5,498 reported clients and a 32% depression share in the adult narrative. Adult-compatible share and clinical eligibility remain assumptions; ask for unique adult depression patients and therapy offered rather than treating all outpatient clients alike.

3. Qualitative assessment

The CoBalT randomized trial enrolled 469 UK adults with depression despite antidepressants. It compared an offer of 12–18 CBT sessions plus usual care with usual care, yielding an estimated 0.057 additional QALY over 12 months. This is an intention-to-treat offer effect, not an effect per completed session. The economic methods use baseline-adjusted EQ-5D area under the curve; the model does not multiply it by another year or transplant the UK treatment price.

Transport is limited: the trial excluded psychosis, bipolar disorder, major substance misuse and patients already receiving psychotherapy or secondary depression care. Didi Hirsch treats a more complex population. A separate eligibility factor and 50% effect-transfer factor are explicit judgments, not empirically fitted adjustments. The clinical bridge is useful for a subset, but cannot establish a portfolio average.

For suicide prevention, ED-SAFE supports a bundled emergency-department and follow-up intervention, with a roughly five-percentage-point difference in one-year attempt risk. It does not identify deaths prevented by Didi Hirsch alone. Hotline relief, severe-illness care, child development, substance-use treatment and avoided coercive responses may have substantial value, but no unsupported lifetime or per-call credit is added.

California scope is evaluated independently of the LA report. The current clinical locations are in California, so g_CA=.99 is a high but not certain resident-share judgment for this outpatient component; .95–1 is tested. It is not the geographic share of national 988 or international Teen Line benefit.

4. What do you get for your dollar?

Full recognized recipient resources for FY2025 are $80,043,834: $79,340,574 Form 990 expense, plus $482,866 of donated services excluded from that return total, plus $220,394 of event costs netted against revenue. The corresponding totals are $90,068,699 for FY2024 and $78,394,883 for FY2023; their mean is $82,835,805.33. Original Schedule D reconciles the annual report's $79,823,440 FY2025 expense to Form 990 before restoring event costs. The audit download was blocked; this is a filed reconciliation, not an independently reopened audit. FY2025 return and schedules

Excluding donated services, gross Form 990 expenses are $79,560,968, $89,400,520 and $77,256,644 respectively. These are accrual expenses, not cash flows. No rental, gaming or inventory expense addback was shown in the original returns. FY2024 FY2023

The conditional depression component yields 3.614588 California QALYs, or $221.45 million per 10, at full recognized recipient cost. Only California clinical benefit is counted. Positive joint cases are sensitivity judgments, not confidence bounds; zero and adverse outcomes remain possible. Major crisis, severe-illness and youth pathways are unpriced, not zero-valued. Outside clinical and patient resources add societal cost.

Model, assumptions and sensitivity

Full annual recipient recognized resources, including donated services and restored event costs. The health numerator is only a depression-treatment component, not the complete portfolio. No program-only denominator or public-contract subtraction.

g_CA=.99 is a California resident-share judgment for the clinical outpatient subset, informed by current California clinics. .95–1 stress range. Not the national crisis-line share and not automatically copied from LA g=.95.

QCA=N*s*p*e*q*t*b*gCA/(1+d)-H; N=5498,s=.6,p=.32,e=.5,q=.057,t=.5,b=.25,gCA=.99,d=.03,H=0. q is a complete 12-month offer effect; no repeated-year multiplication. Price10=10*80043834/QCA. Other portfolio health remains unpriced.

C
80043834 USD annual full recognized recipient resources (observed). FY2025 Part IX 79,340,574 + donated services 482,866 + event costs 220,394. [99025] [schedule25]
N
5498 reported annual outpatient clients (observed). 2025 annual report, printed page 9; not crisis contacts. [annual25]
s
0.6 adult-compatible share of outpatient total (judgment). Adult denominator not separately supplied. .6 central, .3–.8 joint stress tests; not an observed age distribution. [annual25]
p
0.32 depression diagnosis share (observed). Reported in adult outpatient narrative; transport to eligible count conditional on s. [annual25]
e
0.5 eligible depression-treatment offer fraction (judgment). Excludes clients unlike CoBalT, including major psychosis/bipolar/substance-use overlap and already-equivalent therapy; test .1–.8. [cobalt]
q
0.057 additional QALYs per randomized CBT offer over 12 months (observed). External CoBalT intention-to-treat estimate; not per completed course or per year indefinitely. [cobalt-economic]
t
0.5 clinical effect transfer fraction (judgment). Different intensity and clinical system; .1–1 joint tests. Not a local empirical rate. [treatment] [cobalt]
b
0.25 proportional funding responsiveness (judgment). New ordinary support changes one-quarter of proportional clinical delivery after replacement funding; .05–.75 stress tests. [99025] [case-support]
g
0.99 California resident share of clinical component (judgment). Current California clinics support concentration; patient residence unobserved. .95–1 independent CA stress range. [locations]
d
0.03 one-year delivery discount (judgment). q already measures one-year health area; discount once for future delivery, not again for duration.
H
0 component harm QALYs in positive illustration (judgment). Zero only in positive illustrative scenarios; negative stress test retained.
Q_other_CA
null additional non-overlapping California portfolio QALYs (unknown). 988, severe mental illness, youth, residential and substance-use benefits and harms require separate models.

Conditional depression component, not whole portfolio: Cost: $80.0M; California QALYs: 3.6145880388349516; all-population QALYs: 3.6510990291262138. N=5498,s=.6,p=.32,e=.5,q=.057,t=.5,b=.25,gCA=.99,d=.03,H=0. A continuation-scale proportional funding model, not a claim that all existing patients depend on a new gift.

Weak component delivery and funding response: Cost: $80.0M; California QALYs: 0.013874176310679609; all-population QALYs: 0.014604396116504853. s=.3,e=.1,t=.1,b=.05,gCA=.95; other positive-case inputs unchanged.

Favorable component assumptions: Cost: $80.0M; California QALYs: 46.73406757281555; all-population QALYs: 46.73406757281555. s=.8,e=.8,t=1,b=.75,gCA=1; not a confidence bound.

Component excluding donated-service valuation: Cost: $79.6M; California QALYs: 3.6145880388349516; all-population QALYs: 3.6510990291262138. Same clinical assumptions; use gross Form 990 accrual expense, not cash flows.

No additional component health: Cost: $80.0M; California QALYs: 0; all-population QALYs: 0. b=0 or t=0,H=0; other portfolio value is not implied zero.

Illustrative adverse component: Cost: $80.0M; California QALYs: -1; all-population QALYs: -1. No benefit and H=1 California QALY; magnitude is a stress test, not an empirical harm estimate.

Whole-portfolio health remains unestimated: Cost: $80.0M; California QALYs: unknown; all-population QALYs: unknown. Q_other_CA is unknown; do not substitute the component price for a full-recipient ranking.

Counterfactual: Usual medication and clinical care continue; public contracts, alternative providers and reserves replace some capacity. CoBalT already compares with usual care, so no extra generic usual-care discount is applied. b only concerns whether added recipient funding changes clinical capacity.

Attribution: The clinical transfer t covers differences in delivered therapy, setting and case mix after eligibility e. No separate coalition multiplier is added. Count each client once in this component, and do not add overlapping symptom gains from crisis or substance-use services. q is per offer, so trial noncompletion must not be discounted a second time.

This is a conditional component illustration, not an expected whole-portfolio return, lower bound or confidence interval. Adult share, eligibility, transfer, funding and residence are explicit subjective inputs. Major other pathways are unpriced; zero or adverse net effect is possible.

Sensitivity

  • At the full-recipient $1 million/10 target, required annual California health is 800.43834 QALYs; $100,000/10 requires 8004.3834.
  • Halving the adult share, clinical eligibility, transfer or funding responsiveness doubles the positive component price.
  • The 0.057 QALY includes the trial's entire 12-month utility trajectory. No lifetime extrapolation, per-session multiplier or duplicated completion discount is applied.
  • Applying the depression effect to schizophrenia, bipolar disorder, all children or crisis callers would materially overstate the evidence.
  • Other portfolio value may dominate the depression component; omission is not proof of low overall effectiveness.

Unresolved inputs

  • Unique adult depression denominator and clinical eligibility, including existing psychotherapy and comorbidity.
  • Delivered treatment intensity, local utility trajectories and causal comparison with current alternatives.
  • Current unrestricted funding gap after the June 2026 fundraising deadline and public renewals.
  • Patient residence and outcome overlap across clinics, crisis services and substance-use treatment.
  • Independent cost-to-clinical-outcome models for the unpriced majority of services.

5. Funding and previous grants

The corrected recognized-resource series and event/donated-service reconciliation are disclosed in the cost section.

For 2025, the return assigns $65,368,624 to programs, $12,236,469 to administration and $1,735,481 to fundraising. Revenue includes $67,042,157 government grants and $8,829,632 contract fees. Net assets are $40,203,725, of which $3,180,468 is restricted. These data demonstrate a large contracted provider, not an identified unrestricted funding gap. The revised cost model restores those direct event costs and recognized donated services. Original Form 990 for fiscal year ending June 2025

The annual report separately presents $79,823,440 FY2024–25 expense, now reconciled through original Schedule D and restored event costs in the revised resource series. It identifies existing government crisis-service funders and a two-year $1 million Red Cross disaster-care award; neither confirms that every useful activity is funded. 2025 Annual Report, including current services and financial summary

The May 2026 Assembly review documents rising demand, an 85.5% in-state call answer rate in early 2026 and substantially weaker text/chat response. It also describes public appropriations and funding requests. These are dated system findings, not a verified current Didi Hirsch cash gap. Contacts flowing to national backup are not necessarily unanswered, and local service may add coordination quality rather than create all of the call's benefit. May 2026 AB 988 implementation outcomes review

September 2026 HHS announcements include $252 million for crisis and suicide-prevention services nationally. This review did not establish what portion, if any, reaches this recipient. Neither a national announcement nor an earlier shortage statement establishes today's marginal opportunity. September 2026 federal behavioral-health and crisis-service awards

Annual expenses

Organization-level spending, including programs, administration and fundraising. The research list averages three comparable, consecutive full fiscal years when available.

  • FY 2023: $78.4M; Didi Hirsch Psychiatric Service, EIN 95-1816023, 12-month period, June-ending accrual full recognized recipient expense: Form 990 Part IX plus Schedule D donated services and Part VIII direct event costs.. Source
  • FY 2024: $90.1M; Didi Hirsch Psychiatric Service, EIN 95-1816023, 12-month period, June-ending accrual full recognized recipient expense: Form 990 Part IX plus Schedule D donated services and Part VIII direct event costs.. Source
  • FY 2025: $80.0M; Didi Hirsch Psychiatric Service, EIN 95-1816023, 12-month period, June-ending accrual full recognized recipient expense: Form 990 Part IX plus Schedule D donated services and Part VIII direct event costs.. Source

6. Sources

  1. Current suicide prevention, follow-up and support services. Didi Hirsch. Published: not stated; retrieved: 2026-09-13.
  2. Ordinary donation route. Didi Hirsch. Published: not stated; retrieved: 2026-09-13.
  3. 2025 Annual Report, including current services and financial summary. Didi Hirsch. Published: not stated; retrieved: 2026-09-13.
  4. Original Form 990 for fiscal year ending June 2025. Didi Hirsch / IRS via ProPublica. Published: 2026-03-30; retrieved: 2026-09-13.
  5. Original Form 990 for fiscal year ending June 2024 with 2023 comparative totals. Didi Hirsch / IRS via ProPublica. Published: 2025-03-24; retrieved: 2026-09-13.
  6. Qualitative evaluation of UCLA–Didi Hirsch post-discharge follow-up partnership. Soderlund et al., BMC Health Services Research. Published: 2023-11-17; retrieved: 2026-09-13.
  7. Open-label evaluation of Survivors of Suicide Attempts groups. Hom et al., Psychological Services. Published: not stated; retrieved: 2026-09-13.
  8. ED-SAFE sequential-phase suicide prevention trial. Miller et al., JAMA Psychiatry. Published: 2017-06-01; retrieved: 2026-09-13.
  9. May 2026 AB 988 implementation outcomes review. California Assembly Health Committee. Published: 2026-05-12; retrieved: 2026-09-13.
  10. September 2026 federal behavioral-health and crisis-service awards. US HHS. Published: 2026-09-08; retrieved: 2026-09-13.
  11. Population suicide mortality following national 988 launch. Patel, Liu and Jena, JAMA. Published: 2026-04-22; retrieved: 2026-09-13.
  12. Authors' response on national 988 mortality findings. Patel, Liu and Jena, JAMA. Published: 2026-08-17; retrieved: 2026-09-13.
  13. Original FY2023 Form 990 and Schedule D. Didi Hirsch / IRS via ProPublica. Published: 2024-05-15; retrieved: 2026-09-14.
  14. Original FY2025 Schedule D expense reconciliation. Didi Hirsch / IRS via ProPublica. Published: 2026-03-30; retrieved: 2026-09-14.
  15. Original FY2024 Schedule D expense reconciliation. Didi Hirsch / IRS via ProPublica. Published: 2025-03-24; retrieved: 2026-09-14.
  16. Original FY2023 Schedule D expense reconciliation. Didi Hirsch / IRS via ProPublica. Published: 2024-05-15; retrieved: 2026-09-14.
  17. Current treatment portfolio. Didi Hirsch. Published: not stated; retrieved: 2026-09-14.
  18. Current clinic geography. Didi Hirsch. Published: not stated; retrieved: 2026-09-14.
  19. CoBalT original randomized trial. Wiles et al.; NIHR Health Technology Assessment. Published: not stated; retrieved: 2026-09-14.
  20. CoBalT economic evaluation methods and results. Wiles et al.; NIHR Journals Library. Published: not stated; retrieved: 2026-09-14.
  21. Case for support; internal date August 8, 2025. Didi Hirsch. Published: not stated; retrieved: 2026-09-14.
  22. 2026–27 clinical internship handbook. Didi Hirsch. Published: not stated; retrieved: 2026-09-14.