Mobile Crisis Response Unit

Program Description

Our system was broken. Consumers landing in higher and more restrictive levels of care, while incurring exuberant healthcare costs. Community players disjointed. Behavioral health teams directing clients in need of crisis response to the Emergency Room, or many were taken to jail for holding. Law-enforcement having no options but to jail minor offenses due to lack of community services. Sound familiar? Just one year ago, 100% of the crisis response in our rural geographic service area happened in one of 2 places: emergency room or jail. We knew we had to do something, so we did. We created Mobile Crisis Response Unit. Our front line team developed a program that has revolutionized the care of clients in our county. And guess what? We did it without additional expense. There are two 2-person teams on call 24/7, each person strategically located within our geographic service area to allow for the most rapid response. We partnered with existing 24 hour crisis response line as dispatcher.

Creativity

Community mental health, law-enforcement, emergency medical services, and crisis stabilization services united under a common goal: to provide non-restrictive, patient-centered, cost-effective crisis response. With curiosity and an open mind, we didn’t presume to know what was best for our partners, rather we approached them asking what they needed. We then put out a call to action to all existing clinical staff imploring them to help solve. We needed to dispatch crisis teams to a large, rural geographic service area. We needed team structure, dispatch means, 24/7 coverage, and quick response times. Through staff-driven brainstorming sessions, we developed a pilot program. Initially it was intended to respond in real time with law enforcement. We agreed to move forward and improve processes for the first 90 days. Due to its success, after the first 30 days, fire, emergency medical services, and the greater community were requesting inclusion.

Leadership

Staff, officers, EMS, corrections, consumers, and Emergency Room personnel were engaged around a common-ground vision. The decisions for change were pushed down as close to the operational level as possible. The team brainstormed and networked how to operationally change the way crisis services are delivered. The momentum and impact is rewarding and truly contagious. This was a very resourceful leadership strategy – rather than imposing our own ideas around crisis response, we accessed the existing knowledge and expertise within our own community to build a program. Information is disseminated in many ways. Internal crisis services meet weekly, all stakeholders continue to meet every 2 months to review cases, statistics and to improve processes. This model has been presented at Arizona State University’s Summer Institute of Behavioral Health Summit, Medicaid forums, executive collaboration meetings, Regional Behavioral Health Authority meetings, county board of supervisors, in addition to local coalition and advocacy groups.

Sustainability

This model utilized existing staff and network resources, and incurred nominal additional cost. Community stakeholders are committed to the continuation of this program, seeing the benefit and immediate cost-savings to the taxpayers and the improved long-term outcomes for all involved.

Replicability

Mobile Crisis Response Unit is replicable, wherever there are vested community stakeholders interested in partnering with Behavioral Health providers to provide wrap-around crisis services to communities. The following steps are transferable: -Identification of community crisis support needs, and current system breakdowns (for clients, Behavioral Health providers, Emergency Medical personnel, Emergency Rooms, Jails, and police forces). A curiosity for learning is paramount in this stage, developing and nurturing partnerships. – Identification of in-house champions, in addition to staff being permitted the opportunity to help develop solutions. – 90 day pilot study and commitment from staff and community partners – Outcome monitoring – Constant evaluation and face-to-face teaming of cases and processes – Continuation with program

Results/Outcomes

2/1/2016-2/1/2017 Average response time of 28 min Direct crisis activation calls from Law Enforcement: – Community stabilized 60% of the dispatched calls – 29% needed a higher level of care, relating to a physical need or were identified to need inpatient psychiatric care – 9% cancelled, due to voluntary refusal, or by arrival clients had left the scene – 2% of time the client was jailed Direct crisis activation calls from community members: – Community stabilized 61% of the dispatched calls – 38% needed a higher level of care, relating to a physical need or were identified to need inpatient psychiatric care – 1% client canceled – None were jailed http://m.verdenews.com/news/2016/sep/12/spectrum-healthcares-mobile-crisis-team-partnersh/?templates=mobile