Behavioral Health Response Presentation
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Behavioral Health Response City Council Work Session January 27, 2022 4:00 p.m. Arizona Regional Behavioral Health Care System • Most AHCCCS (Arizona’s Medicaid system) members receive behavioral health care services through their chosen health care plan instead of from a Regional Behavioral Health Authority (RBHA). • The RBHA serves persons who are Title 19 eligible or in crisis. This includes: • Foster children enrolled in CMDP, including those CMDP members who have a CRS condition • Members enrolled with DES/DDD • Individuals determined to have a Serious Mental Illness. • RBHA services include but are not limited to: • Mental health counseling • Psychiatric and psychologist services • Opioid Use Disorder and Treatment Effects on Chandler Departments • Increased law enforcement contacts • Increased calls for emergency services • Increased resident concerns about ability to use public facilities such as parks, libraries, parking garages, bus shelters and transit centers • Challenges cleaning and maintaining public facilities where people without shelter are camping • Increased requests for blight removal and environmental clean-up related to homeless encampments • Increased justice court involvement Chandler Fire Department Behavioral Health Response Chandler Fire Department CR288 24/7 Deployable resource through Phx 911- Auto Dispatch or Special Call by FD or PD On Scene response by Masters Level Mental Health Professionals - 2 Person response team • Social Workers, Counselors or Behavioral Health Practitioners • 3 Full Time Staff including Coordinator • 8 PT Staff • University Interns 2-6 per semester • Trained Crisis Response Volunteers 20+ CR288 Program Established in 2004, 1 unit • Over 17-year history of providing evidenced based and Trauma Informed compassionate stabilization, verbal de-escalation and intervention for all types of crisis situations within our community Chandler Fire Department Complete Crisis Care Prevention Activities • Community Outreach/Events • Quarterly Training CIT- Local, Regional, State-Wide, National and Internationally. *CFD has a Credentialed CIT Coordinator • Regular Training CST- Curriculum Development and Implantation with accredited University and Community partnerships. *Taught nearly 6,000 First responders around the country to date. Included in AZ Fire School Intervention Services • Immediate Response through 911 System- 1,700-1,900 calls annually *Part of an Automatic/Mutual Aid System • Treat and Refer Behavioral Protocol- ED Diversion • Transport- BH facilities, Advocacy Centers, Shelters, Schools, Churches, etc. Postvention Care/Follow up- • Resource/Referral- In Person, Phone, Mail • Short Term Case Management • Debriefings/Defusing/Community Meetings Chandler Fire Department CR288 unit strives to: Provide immediate crisis intervention and on-scene victim assistance. Provide emotional support, information and referrals to clients. Facilitate communication between clients and the Fire and/or Police Departments. CR288 is part of a larger system of Urgent and Emergent Crisis Care CR288 Mental Health Workflow •911callers •Chandler Fire Units •Chandler Police Patrol Units •CPD VSU- Advocacy Center •Out of City Public Safety •City of Chandler Neighborhood Resources •Public Libraries •CUSD schools •Family members of clients experiencing symptoms •Faith Based Organizations •AZCEND/I-Help •Non-Profit Organizations •Private Business Owners •Behavioral health Providers •Members of the Community • Regional Tribal Services Referral Sources •Assessment and referral for treatment for the person experiencing a mental health crisis / symptoms •Support and guidance for family members and loved ones •Resource Connection 300+ tangible on the response vehicle CR288 Crisis Response Unit •Client is not deemed DTS/DTO, resources provided to stabilize in the community. •Existing coping skills •Youth Specialists / school supports •Community clinics / community mental health services •Family / Natural support system •Counseling referrals •Outpatient program options Client (adult or <18) not DTS/DTO •Clients who express or exhibit SI, but who are not in need of medical attention, are taken by CR288 to a BHC for a higher level of care / formal evaluation Client (adult or <15) DTS/DTO CFD Treat and Refer Behavioral Protocol •Clients expressing SI who are voluntary for treatment are referred to a local BHC •Age of patient and insurance coverage are considered when selecting facility DTS/DTO Voluntary Treatment Outcomes •Clients expressing SI who are resistant to treatment or unable to give consent to treat can be petitioned by CR288 / CPD / CPR/Witness /Family •Children / adolescents do not need to be petitioned, parental consent for treatment is sufficient for an evaluation. CR288 to Transport DTS / DTO Involuntary Treatment Outcomes *DTO = Danger to Others *DTS = Danger to Self *SI = Suicidal Ideations *BHC= Behavioral Health Center Prosecutor’s Office and Municipal Court Behavioral Health Response Treatment Courts Flow Chart The Chandler Municipal Court has three treatment courts. We are a part of the East Valley Veterans’ Court which serves several cities. We have our own Mental Health Court, as well as the Support Court. The Support Court is our newest treatment court, which was authorized by this City Council. Defendants are identified as a person who will benefit from one of the three treatment courts. Defendants are identified as a person who will benefit from one of the three treatment courts. •Defendants are identified by the prosecutor, defense attorney, mental health liaisons, homeless navigators and/or VA staff. The defendant is given the choice to stay in the regular court, set the matter for trial or move to the treatment court. The defendant is given the choice to stay in the regular court, set the matter for trial or move to the treatment court. •Defendants are offered a more favorable plea offer as an incentive to move to the treatment courts. If they choose the treatment court, they are given an individualized directive. If they choose the treatment court, they are given an individualized directive. •If the defendants successfully complete their directive, they graduate from the program. East Valley Regional Veterans’ Court Veterans’ Court is a collaborative process that includes the prosecutor, defense counsel, Judge, the Department of Veteran Affairs and other community-based support organizations. The goal of Veteran’s Court is to rehabilitate and restore veterans as active, contributing members of their community. East Valley Regional Veterans’ Court • Veterans’ Justice Outreach Social Workers (VJO’s) are the backbone of this program. • VJO’s connect Veterans with all of the services they qualify for through the VA. • The prosecutor, defense attorney, judge and VJO work together to come up with a treatment plan designed to help the Veteran overcome service-related issues. East Valley Regional Veterans’ Court • The plan can include substance abuse counseling, job training, medications, group therapy, individual therapy, mental health counseling, inpatient services, and help with housing. • VJO’s also help Defendants sign up for and make the most of their VA benefits. • When Defendants graduate they receive a Challenge Coin from the VA to commemorate the challenge they faced and overcame. Mental Health Court • The purpose of the Chandler Mental Health Court (MHC) is to connect defendants who are severely mentally ill (SMI) with mental health services with the goal of reducing recidivism within this vulnerable segment of the population. • An average of 40 defendants are participating in the program at any given time. Mental Health Court • Defendants each have a case manager with Mercy Maricopa. • The prosecutor, defense attorney, case manager and judge work together to develop a treatment plan for the Defendant. • The plan may include substance abuse counseling, job training, medications, group therapy, individual therapy, mental health counseling, inpatient services, and help with finding housing and employment. Support Court • Launched December 2021 • Similar to Mental Health Court but includes Homeless Defendants who are not SMI. • The prosecutor, defense attorney, homeless navigator and the judge work together to develop a treatment plan for the Defendant. • The plan can include substance abuse counseling and help with housing and finding work. Neighborhood Resources Department Behavioral Health Response NRD Programs Serving Persons with Mental and Behavioral Health Concerns Chandler Connect Operation Open Door Support Court Tenant Based Rental Assistance (TBRA) Emergency Housing Vouchers (EHV) Staff Qualifications, Training, Associations • Peer Support Certification • Behavioral Health Technician • Non-Violent Crisis Intervention Training (CPI) • Casii Psychiatric Assessment • American Society of Addiction Medicine • Harm Reduction • Motivational Interviewing • Suicide Prevention How We Serve Persons with Behavioral Health Concerns • Person Centered Engagement • Trauma Informed Care • Connection to Mental Health and Recovery Services • Harm Reduction and Motivational Interviewing • Ongoing Coordination with Community-Based Providers FY 2020-21 Program Data 52 17 29 5 Operation Open Door: 44% Self-Reported Mental Health Disability Assisted with Mental Health Services Self Reported Substance Abuse Assisted with Substance Abuse 89 15 77 21 Chandler Connect: 95% Self-Reported Mental Health Disability Assisted with Mental Health Services Self Reported Substance Abuse Assisted with Substance Abuse Chandler Police Department Behavioral Health Response Crisis Intervention Team (CIT) Program CIT training is a specialized 40-hour police curriculum that aims to reduce the risk of serious injury or death during an emergency interaction between persons with mental illness and police officers CIT improves communication, identifies mental health resources for those in crisis and helps ensure officer and community safety CIT programs create connections between law enforcement, mental health providers, hospital emergency services and individuals with mental illness and their families CIT in Chandler Taught regionally in the Phoenix metro area since 2004 Program expanded significantly in 2014 with the creation of the East Valley CIT Program Collaboration (Chandler FD CR, Mesa FD CR, Mesa PD, Scottsdale PD, Gilbert PD, ASU PD, Mercy Care Maricopa County) CIT trained officers receive 8 hours of continuing education training a year CIT related training provided to all Chandler police officers annually Chandler 911 Communication Center Response to Persons Affected by Mental Illness or in Crisis Adjusted dispatching guidelines and implemented call triage protocols in August 2021 Prior to August 2021, police officers would be dispatched to all mental illness or crisis related calls for service Effective August 2021, persons affected by mental illness or in crisis (suicidal or depressed) who call police and are not reporting a criminal incident, not involved in a criminal situation, not acting violent (no weapons), and do not need medical attention may be referred to Solari crisis call service Officers will continue to be dispatched on all reports of situations involving persons who display symptoms of serious mental illness or in crisis and/or are a danger to themselves or others due to the unpredictable nature of those involved. Recommendations/Next Steps • As resources allow, consider offering other behavioral health resources within City’s purview which enhance provision of core services to residents: • Behavioral Health Navigator • Police Department Behavioral Health Unit • Embedded Solari crisis counselors in CPD’s 911 Communications Center • Increase the types of behavioral health service calls diverted to Solari’s network, rather than Police • Includes training for officers and call-takers on how the call diversion program will operate • Identify training resources for City employees on signs of suicide • Partnering with CUSD and Compass Church on “BREAKTHROUGH,” a free, community- wide mental health conference focused on adolescents (February 25 and 26, 2022) • Continue exploring community partnerships Questions?