Yesterday at the NYAPRS Conference, Commissioner Sullivan highlighted the fact that there has been over one hundred million dollars annualized that has transitioned to the community from the closing of hospital beds through reinvestment. A shining example of utilizing that funding for the community is through the great work of our MHA of Southern Tier and their mobile crisis team.
MHAST’s mobile crisis team is changing how police handle mental health cases. Here’s how.
With over 20 years in law enforcement, Police Sergeant Anthony Diles, the Crisis Intervention Coordinator for the Binghamton Police Department, recalls his time in the academy at the beginning of his career, when mental health training was scarce.
“There certainly wasn’t any ongoing training that happened throughout your career after you went through your initial [training],” Diles said.
But, with increased efforts in training, education and community partnerships, local law enforcement agencies have worked over the past decade or so to improve responses to those experiencing a mental health crisis.
“Our policies focus on a more compassionate approach, realizing that mental health isn’t a crime,” Diles said.
The mobile crisis team formed around 2016, with the goal of assisting local law enforcement agencies and healthcare facilities with mental health crises.
Michael Hatch, a former lieutenant with the Johnson City Police Department, is MHAST’s Director of Crisis Services and is tasked with leading Crisis Intervention Team (CIT) training for local police agencies. He also oversees the mobile crisis team, and is in the process of growing staff and expanding the program.
In January, MHAST’s Mobile Crisis Services moved from the organization’s headquarters on 47 Broad Avenue in Binghamton into an office space inside Johnson City’s Oakdale Mall, next door to Arby’s, that previously housed other MHAST services.
The office is now centrally located so the team can easily hop on the highway and jet to Endicott, Binghamton or elsewhere. This is ideal for the Mobile Crisis Services, which does not host walk-in hours or expect patients to visit them for services.
Instead, the team goes right to where the needs are.
The team makes face-to-face visits with those experiencing a mental health crisis, and is often dispatched by 9-1-1, or called directly by a police officer or other community providers.
Impact of the mobile crisis team
According to Hatch, last year’s mobile crisis team responded to over 200 calls. The team’s success rate is about 70%, measured by whether they are able to stabilize the individual without needing to visit a hospital.
The goal is to take the burden off of law enforcement, allowing them to tend to criminal calls, and reduce the use of avoidable inpatient admissions, emergency room visits and readmission by Medicaid recipients.
“Unfortunately, they [law enforcement] get bogged down and tied up with mental health calls that they are not necessarily equipped to handle, nor should they,” Hatch said. “So, it should really fall on the doctors and nurses and clinicians. It’s an illness. It’s not a crime.”
By stabilizing the individual in the field, the team is also working to decrease hospital wait times and help to ease the stress put on already overwhelmed medical facilities including the UHS Comprehensive Psychiatric Emergency Program (CPEP). This cuts down on medical expenditures and medicaid costs.
Mobile Crisis Services falls under Care Compass’ Crisis Stabilization Project, which is managed by Lauren Greco and is part of the network’s 11 projects that promote collaboration between hospital systems and community-based partners. The Care Compass Network is one of 25 entities in New York State working on Medicaid payment reform, and has the main goal of preventing emergency room visits for those who don’t need them.
There is a mobile crisis team in all nine of the counties the network serves, including Broome, Tioga, Tompkins, Chemung and Steuben. The Broome team is working on a sustainability model where the program itself can bill Medicaid for field visits and follow-up appointments.
“The partnership between the mental health agency, who is often providing the services, and the police is key,” Greco said.
While the number of calls the mobile crisis team responds to varies from week to week, Hatch said it can be as many as seven or eight in a day, or as low as one or two.
Incidents may range from someone having thoughts of suicide, to delusions and hallucinations as a result of schizophrenia.
“If a person’s in crisis and it’s not involving a criminal nature, the team can go,” Hatch said.
The hours vary; however, the mobile crisis team typically works 11 a.m to 7 p.m. Monday through Friday.
During their shift, the team carries a police radio and listens to police calls. They’ll then go to the scene if requested by police or if they think they’re needed.
If the incident is non-criminal and a person doesn’t fit the criteria to go to the hospital as an emergency situation, officers can call clinicians to the scene to deescalate and stabilize the person on site.
“The nice thing about this team, is that they can respond as needed to pretty much any incident,” Hatch said. “It could be a situation where somebody’s in crisis because they just have cumulative stress and cumulative trauma that’s added up on them and it’s just put them to the verge of having a breakdown.”
If the situation is stabilized, the clinician can remain on the scene and allow the officers to resume responding to other calls.
For a month after the call, the clinician and peer support person will follow-up with the person to assure that they have rides to appointments and other resources they may need.
Those in need are not limited to calling 9-1-1, and can reach the clinicians through a direct line by calling 766-1369. If there is no response, callers can leave a voicemail.
The team is also available to assist primary care doctors, schools, or whoever may need their services.
“We don’t always have to go through police,” Hatch said. “And that’s kind of our hope, is that with education and the community of this program, we can perhaps move away from that and not have to involve the police, and allow them to do their job and put bad guys in jail.”
Expanding the reach
Due to high demand, Hatch is seeking more staffing for the mobile crisis team and is in the process of hiring a second clinician.
“It’s hard to find people that want to do this type of work, because it can be messy,” Hatch said. “You’re out in the field, you’re in the streets, you’re going into some difficult places and situations to deal with.”
As staff is added, Hatch hopes to expand the team’s hours. He also plans to add part-time positions that would be scheduled weekly and per diem staff to work weekend and on-call/overnight hours.
“If they’re available and they answer, they’ll come right to you,” Hatch said.
Those who apply to the team should be either a licensed mental health social worker, licensed clinical social worker or a licensed mental health counselor with at least six years of clinical experience. Applicants with less than six years of clinical experience are still encouraged to apply.
“We’re looking for staff to fill a need that the community has shown us,” Hatch said.
Hatch envisions a team that operates 24/7, seven days a week.
“It’s a big reach to do that, but our hope is that some day that’s what we can do,” Hatch said.