The recent article, “Some patients crowd ERs” (April 22), describes how hospitals struggle to handle mental health and substance use cases. We agree, as most everyone interviewed in this article does, that yes, Maryland has a problem. We know that there are many committees, task forces, legislation, a command center, as well as state and city activities going on to address these issues. The question is how are all these entities aligning themselves within the larger system? The emergency rooms can’t do it alone. It’s clear, as one reads The Sun’s investigation, that the system is fragmented. We, as advocates, can attest to our own fatigue every day of just trying to navigate our families through this maze.
We would like to recommend a few interventions that might lift the load in the meantime, until the day comes when all our stars are aligned:
- The state should immediately designate some financial resources from the current budget and federal money to beef up the existing Assertive Community Treatment or ACT teams and add more of them to help remove some pressure from the ERs and emergency first responders. These ACT teams are evidence-based and are equipped with fidelity measures. Any behavioral health providers who implement ACT teams will receive a financial incentive based on how well they meet the measures.
- The same should happen with our mobile crisis teams or MCTs. Our current MCT’s vary from jurisdiction to jurisdiction and don’t even exist in some counties. We would recommend immediately implementing MCTs in all jurisdictions and increasing them where they currently exist.
- All of Maryland’s subdivisions should look to Anne Arundel County Safe Stations as a best practice and implement this model throughout the state.
- Finally, technical assistance for emergency departments to respond to addiction is being offered for free from the Addiction Policy Forum. We urge all ERs to participate in this free service.
Additionally, while implementing the above, the state should simultaneously be working on identifying its current treatment capacity. If we don’t know what we have then how do we know what we need? We support more funding for treatment, but we are taxpayers and would not like to see money thrown at an accidental system of care to be wasted, notwithstanding that our families are not getting the treatment that will get them to a higher level of wellness.
Patricia Bayly Miedusiewski, Timonium
The writer represents Maryland Heroin Awareness Advocates along with co-signers Carin Miller of Frederick County, Beth Schmidt of Carroll County, Ginger Rosella of Calvert County, Lynn Miller of Harford County, Traci Boylston of St. Mary’s County, Linnea Sandkuhler of Baltimore City, Rob Zellner of Washington County and Debbie Fling of Washington County.
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