the current crisis

of the current crisis The system emphasizes a “flawless door” approach where people in a mental health crisis can call an emergency number or go to a crisis facility to get help. This approach also includes close cooperation between emergency dispatches, mobile crisis response teams and psychiatric facilities.

Since 2016, some residents have called for more crisis resolution without law enforcement. Two Santa Cruz County residents They were killed by law enforcement officers during another mental health crisis.

The Crisis Now program “will save lives and alleviate suffering,” said Jeffrey Alt, whose son was shot dead by Santa Cruz police during a mental health crisis. But the approved program is “just a starting point,” he said. “It will take 10 to 20 years for the dedication and focus of behavioral health services to become an ideal crisis management system.”

In Maricopa County, Arizona, the Crisis Now system has reduced psychiatric hospitalizations, reduced emergency room visits due to mental health crises, and reduced law enforcement time for mental health calls, the report says. Report from Crisis Now Academy. the current crisis is a program led by the National Association of Mental Health Program Directors, Mental Health Programs RI International, and others.

Santa Cruz County leaders plan to partner with RI International as a consultant to develop a similar system. The plan includes upgrades to mental health crisis response lines, agile crisis response, and short-term crisis treatment facilities.

The plan also calls for an increase in personnel for the county’s agile crisis response. Santa Cruz County is now 2 non-enforcement teams Responses to mental health crises: mobile emergency response team (MERT) and Mobile Emergency Response Teams for Youth (Marty). Both teams have qualified mental health workers, such as therapists and social workers, and unqualified crisis managers to respond to psychiatric crises.

Both teams are currently on call Monday through Friday from 8am to 5pm. Within three years, a crisis response team will be available for him around the clock.

County leaders plan to partner with nonprofits to staff crisis response systems. The nonprofit, which has not yet been selected, plans to employ 12 to 24 certified piercing specialists and paramedics and train them to work alongside county-licensed mental health clinicians. The mobile crisis system is expected to include her three levels of response:

• For low-level crises, the team includes two piercing specialists, or one piercing specialist and one paramedic.
• For crises that may require involuntary psychiatric restraint, the team includes a licensed mental health clinician along with a piercing specialist or paramedic. Patients are detained in crisis and stable facilities for up to 72 hours if mental health workers determine that they are a danger to themselves or others.
• For situations involving safety concerns, our Crisis Management Team will work with law enforcement.

A new dispatch system is planned to be introduced to simplify crisis response. People in a mental health crisis can call:

The new system will allow dispatchers to dispatch mobile crisis response teams as needed, regardless of what number people call. James Russell, county senior behavioral health manager, said the improved dispatch system will also include increased cooperation between dispatchers, mobile response teams and psychiatric facilities.

The Crisis Now plan is also expected to improve organization and operations. Crisis Stabilization Program. The program is now available for up to 24 hours for her 12 clients in crisis. Santa Cruz County has a contract with Telecare to operate the facility, which admits about 100 people a month. About half of the hospitalized patients are people who were forcibly brought into psychiatric hospitals by law enforcement agencies.

according to Report from Crisis Now Academy, the nonprofit helps make patient admissions and discharges more efficient so facilities can serve more people. It also plans to train staff to work with people who have experienced trauma and reduce suicide risk.

fundraising

Most of the funding for Crisis Now will come from the Mental Health Services Act, a state tax on billionaires that accounts for about 19% of the county’s behavioral health budget. The county can spend his 5% of that money on “innovation projects” to strengthen mental health services. Crisis Now will be fully funded for three years as an innovation project, but long-term funding for the project has not yet been secured.

The recent expansion of Medi-Cal reimbursement could also help fund Crisis Now.a national program Behavioral health programs like Crisis Now will be able to bill Medi-Cal for mobile crisis response. Russell said in the future counties may be able to bill private insurance for crisis response.

Shortage of mental health staff

The new plan comes at a time when the county’s Department of Behavioral Health is in a “very difficult situation,” said Health Services Commissioner Monica Morales.

Morales said continued staffing shortages are limiting the county’s ability to help those in crisis amid growing calls for a response to the mental health crisis.

At a meeting on Tuesday, Behavioral Health Deputy Director Karen Kahn said more than 7,000 people were treated at mental health clinics in the county in 2019. “It’s now down to about 5,500,” she says.

a Santa Cruz County Civil Grand Jury Report Issued This Month He elaborated on persistent understaffing in behavioral health departments in both counties. As of March, 31% of the county’s crisis positions were vacant, according to the report.

Staffing shortages are also affecting the crisis stabilization program run by Telecare, according to the report. county official report. The program is designed to hold people for up to 24 hours before they are released or transferred to another facility, but understaffing is prolonging the length of detention, according to the report. From July 2022 he by December about half of the adults were enrolled in the Crisis Stabilization Program. stayed longer than 24 hours. 7% stayed longer than 72 hours.

Graph shows percentage of minors and adults denied from Santa Cruz County’s Crisis Stabilization Program. People are often directed to emergency rooms when all spaces are full or the facility does not have enough staff. (Santa Cruz County)

Shortages also keep people who seek help away from crisis stabilization programs, often sending them to emergency rooms at Dominican hospitals and Watsonville community hospitals. In May, the program rejected 19% of adults and 43% of adolescents under the age of 18, according to a staff report.

Khan said the county is working with Telecare to address staffing shortages and staffing has improved in recent months. A new crisis management facility for youth will open in 2024.

MERT and MERTY teams are also struggling to recruit and retain staff, the report said. Therapist Kevin Cisneros is the sole licensed clinician on the MERT team, Cisneros said during the meeting.

Cisneros and five other county officials urged county leaders to address the shortage and increase funding across the county’s mental health programs.

Social worker Kirsten Jewell said licensed mental health doctors earn significantly less than in surrounding counties. “If we really want to solve this problem of having so many job openings in our county, we need to offer competitive wages,” she said. He also recommended more part-time positions for qualified clinicians.

Morales said the county is considering raising salaries for some jobs and identifying other possible incentives for applicants. But it could take up to five years to address staffing issues, she said.

“We can’t afford to keep this model until we have a full staff,” Morales said. “We have to go after both at the same time.”

Morales said the new program is expected to address the staffing shortage by adding more unlicensed crisis response staff. The Crisis Now program will require some newly licensed clinicians, but many of the new staff will be unlicensed peer responders. Those positions are much easier to hire, she says.

Santa Cruz County Superintendent Justin Cummings said resolving the staffing program should be one of the county’s “top priorities.” “There are a lot of great programs that we want to put in place, but if we don’t have the workers here to actually provide those services, we won’t be able to reach our goals.”

Local stories related to Santa Cruz