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Mobile Crisis Response Team Program To Expand County Wide By The Summer

 March 10, 2021 at 10:20 AM PST

Speaker 1: 00:00 People with mental illness are 16 times more likely to be killed in an encounter with police than those without mental illness that jarring statistic has moved the County to look for better ways to help people experiencing a psychiatric crisis. Officials are now looking at the pros and cons of a pilot program that dispatches teams of behavioral health experts to some calls instead of law enforcement County board of supervisors, chair, Nathan Fletcher joins us with more on the mobile crisis response teams. Chairman Fletcher. Welcome. Thank you for having me. So these teams do not include members of law enforcement like PERT, the psychiatric emergency response teams do, how do they differ from the counties se Speaker 2: 00:43 It's just having a non-law enforcement response for what is a non law enforcement situation. If an individual is not a danger to themselves or anyone else, then we want trained clinicians to respond. These are individuals who have the training, the expertise, the compassion, the empathy, the time, uh, to try and help these individuals that are in distress and get them on a better path, a better way forward. And we're encouraged by the results of the pilot program. And we're looking forward to taking this project county-wide, uh, beginning of the summer. Speaker 1: 01:13 I mean, what prompted the decision not to include law enforcement on these teams? Speaker 2: 01:17 Well, I think that there's been a long recognition that that mental health and drug treatment issues are some of the only issues that automatically gets you a law enforcement response. If someone is having a heart attack, they don't respond to law enforcement and 59,000 times a year on enforcement response to these calls. And in some instances they need to go because there is a danger that the health and safety of San Diego, but the vast majority of them they don't need to. And the presence of law enforcement can escalate the situation. They're also not trained and equipped to be experts in mental health issues and drug treatment and issues. So we want to get the right care to the right person at the right time. And that's where mobile crisis response teams, non law enforcement ones. Um, we believe kit can make a significant positive impact on getting better outcomes for these individuals. Speaker 1: 02:04 Right? And so tell me who specifically makes up the new mobile crisis response. Speaker 2: 02:08 So it will be a series of, of, of trained clinicians. Uh, it will be individuals that are equipped, uh, that, that really know the ins and outs and how to talk some more down how to deescalate, how to build a relationship. Uh, they'll often be paired with someone in the team who has lived experience. There's tremendous value in someone who has lived experience, who has gone through some of these challenges with substance abuses or mental health illness, um, and, and really began to build that relationship with the individual in distress and also be able to assess them about what is the proper treat, how, how can we get them to the right place? Maybe it's a crisis stabilization unit. Maybe they need to go to the emergency room. Maybe they need a different level of care and treatment, but then begin the process of a continuum of care. And what we're trying to do is break the cycle of addiction, poverty, incarceration, emergency level care that itself over and over and over. Let's get these folks into sustained ongoing care. They can improve their quality of life. Speaker 1: 03:05 San Diego County, behavioral health services, assistant directors, Cicely Thornton, Stearns spoke during a press conference on Monday about the program. Here's a clip from her Speaker 3: 03:15 During the last fiscal year per provided over 12,000 crisis contacts. Approximately one third of those were to repeat individuals through the history of the PERT program. We've come to learn that not all situations require the presence of law enforcement. Speaker 1: 03:32 How will it be decided then whether law enforcement PERT or these teams respond to a call? Speaker 2: 03:37 Well, ideally that Joyce would be used, send a mobile crisis response team, or do you send law enforcement with a Curt, a psychiatric emergency response team embedded with them? And the ultimate decision is, is the individual in distress? Are they a danger to themselves or someone else? And if the answer to that is yes, then it needs to be a law enforcement response, ideally with a clinician, if they're not a danger to themselves, and they're not a danger to anyone else, that's when you would send the mobile crisis response team. Speaker 1: 04:05 And what exactly will these teams do when they respond to a call? Speaker 2: 04:09 Well, that's where they'll begin the assessment. They'll begin talking to the individual, assessing what is going on in their life, and then be able to determine what is the best option. There were already a array of services for folks experiencing mental health issues or substance abuse issues. But traditionally with law enforcement, it is you either leave them where they are. You take them to jail, or you take them to the emergency room. Well, these mobile crisis response teams will have the expertise to be able to better assess. Uh, and third Avenue at Hillcrest, we're building our regional behavioral health hub. That'll be one site that will have an array of services in that one location. That's an ideal place where teams can take them. Uh, but again, these teams will know best and be able to make the best assessment about how do we get this individual connected into ongoing services and how do we get them connected into ongoing case management and care coordination, uh, to really try and break those vicious cycles, uh, that we see over and over again. Speaker 1: 05:04 And, and these mental health response teams have been responding to emergencies in North County since January. How has their effectiveness being measured? Speaker 2: 05:12 Well, we've seen tremendous success. I mean, we, we have seen, uh, exactly what it was designed to be exist. A story we recently shared was a family member of the family couldn't deal with them. Uh, it was really getting into a bad place. The mobile crisis response team got there, assess the situation, work with the individual, got them in a crisis stabilization unit. Adam's stable, got them on an outpatient system, uh, and, and was able to help turn it around. The difference is the pilot program has not included diversions from nine one. One to make the system truly work. We need to be able to divert calls from nine one one. And so as we prepare to go county-wide in summer, uh, we are working with multiple jurisdiction city of San Diego, city of Chula Vista national city, and the Sheriff's department to design those and processes. So the nine one, one calls can be diverted to the mobile crisis response team, uh, to try and help get them to the right place. Speaker 1: 06:06 And there's a shortage of mental health treatment options in the County. Will people referred by these mobile response crisis teams have priority for available services? Speaker 2: 06:16 Well, this is a huge issue. What we're doing on mobile crisis response teams is one piece of about a dozen different pieces. We're working on that all have to come together to truly provide the promise of a better way for behavioral health services. And a key part of that is, as you rightly identify, gives this shortage of, of community care. These are or mental health or drug treatment services that are of lower acuity, lower level than an emergency room visit. And this is where we launched our behavioral health impact fund just a year ago, $25 million to increase capacity for these. And so we simultaneously have to build out those levels of care that are below in emergency room type situation to make sure that we have a place to take folks. Speaker 1: 06:59 And there are currently more than 70 per teams, which include members of law enforcement and they aren't able to respond to all nine one, one calls involving a mental health emergency. How will this pilot program meet the demand for service? Speaker 2: 07:13 Well, I, I think there's, there's going to be a great intersection between the mobile crisis response team and the per teams. Uh, ideally anyone who's in mental distress would either get a mobile crisis response team, or if it needs to be a law enforcement response, there's a fear of safety. Then it would be a law enforcement response who is paired with a per clinician. And so we think that this can really enhance and augment the ability of part, uh, to be on scene when there needs to be a law enforcement response. And then when there doesn't need to be, then we have the mobile crisis response teams who can take over. So we think this can increase the effectiveness of our teams. Speaker 1: 07:49 I've been speaking with County board of supervisors, chair, Nathan Fletcher, Nathan Fletcher. Thank you so much for joining us. Speaker 2: 07:55 Thank you for allowing me to join you today.

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The program, which began in January, is intended to help people experiencing mental health or substance use crises by dispatching behavioral health experts to emergency calls instead of law enforcement when appropriate.
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