If you ask Carroll County law enforcement officials whether they support the county’s relatively new mobile crisis team, they answer will likely be a resounding “yes.”
“I can’t say enough about how well the program has worked,” said Col. Lawrence Suther of the Carroll County Sheriff’s Office. “The only downside is we need another one.”
The mobile crisis team is composed of therapists and peers — people in recovery for mental health or substance use issues — who can respond to people in a crisis and help direct them to resources. And while police are trained to deal with people having, say, a mental health crisis, Suther said it helps police to have focused professionals they can call on to assist them.
“They bring a whole new level of expertise to the table,” he said. “I think it’s saved us in work time, it’s saved us in some trips to the [emergency room] and it’s probably saved us some arrests from people acting out from a mental health issue where they might end up in the jail. These folks are able to get them calm and on a treatment plan.”
The mobile crisis team in Carroll County is available from 9 a.m. until midnight and can be reached by calling 410-952-9552.
From July 1 through Sept. 30, the first three months of fiscal year 2020, the mobile crisis team diverted 29 people from the emergency room to other, less intensive resources, and helped six people who might otherwise have wound up in jail.
The team responded to a total of 140 new cases during that time. That’s according to statistics collected by the Affiliated Sante group, which operates the mobile crisis team on behalf of the Carroll County Health Department.
The team responded to 507 cases in FY19, from July 2018 through June 2019, said Mike Clancy, a therapist with Affiliated Sante and director of the mobile crisis team.
Diverting people to a less intensive venue for treating a behavioral health need than the emergency department at a hospital is one of the key reasons the department pursued a mobile crisis program, according to Veronica Dietz, director of crisis services. Until the mobile crisis team started operating in May 2018, Carroll was one of only a few jurisdictions in Maryland without some form of mobile crisis service, she said.
“As the local behavioral health authority, our job is to ensure Medicaid dollars are spent appropriately and effectively,” Dietz said. “We were seeing a lot of people going into emergency departments and utilizing the emergency department unnecessarily to get their behavioral health needs met. That is not a responsible way of using Medicaid dollars.”
It’s also not the best outcome for the person seeking help, she said — nor is jail for someone who is perhaps best served with treatment for an addiction or mental health issue.
Discussions that began back in 2012 led to Carroll’s Crisis Intervention Training for local law enforcement, training that helped police officers recognize someone in crisis and learn how to de-escalate situations and help connect those people to services, according to Dietz.
“Mobile crisis was the next step for us,” she said. “To create immediate response to people in crisis.”
A “crisis” is purposefully defined loosely and is driven by those who call for help, according to Clancy.
“We don’t really define crisis for people, we let them define it for themselves,” Clancy said. “Where most people think a crisis is someone having suicidal ideation, we can just have somebody who is upset with their parent or their significant other; that’s a crisis.”
Whether a family dispute, someone upset that they lost a job, or something more physical such as an overdose or a reaction to or lack of medication, the process is the same, according to Clancy: to intervene in the crisis and try to link people to services — and to follow up to make sure that happens, even if it takes a while.
“Everyone that we see we try to do a 24-hour follow-up,” he said. “Our average length of working with someone is about nine days, minimum is about six and then maximum is about 26. Usually if it’s longer it’s because we’re waiting for someone to get linked to care somewhere.”
And that ability to stick with someone and follow up over the longer term is one of the things that makes a big difference between the crisis team and the police, according to Suther.
“Before we had them, it was one and done. We tried to get them referred to resources and things like that and it didn’t always work out," he said. “With the mobile crisis team, they can do that.”
The people on his team know which agencies or treatment programs are taking referrals, and can follow up until someone gets to where they need to go, Clancy said, though he noted at the same time that the vast majority of people the team helps are treated in their home environment and do not need to go elsewhere.
It’s also important to note that working with the mobile crisis team is up to the individual; they will not forcibly take someone to a treatment program or even interact without their consent.
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“It’s absolutely voluntary. They have to consent to let us see them. If they don’t, we don’t see them,” Clancy said. “It’s usually because they really don’t want to see anyone. A third-party person called about them and they are saying, ‘I don’t know why that person said that.’ ”
It is an intense job, according to Clancy, and they are always looking for therapists interested in working in a crisis setting. Calls can take them from Westminster to Sykesville to New Windsor, to Manchester and Sykesville, he said. “There are days when we’ve had five, up to six back-to-back dispatches, which is really hard in an 8-hour time frame, because you are constantly running.”
And because the mobile crisis team will take as long as it needs on the scene to help someone in crisis, a single call can mean other calls have to wait if they come in too shortly after a dispatch.
“If they have a 30-minute drive to get somewhere, an hour, an hour and a half on scene, and a 30 minute drive back, essentially the team is out of service for two to three hours per shot,” Clancy said. “A lot of the times we have to say we can’t respond right now, we suggest you do this. If it’s an emergency call the police.”
And while the police are glad to respond, Suther said, he hopes they will be able to expand the mobile crisis team so they can take more calls. The team currently has two shifts, and could add a third.
“They have been very responsible and available to our needs; it’s a good marriage, if you will, a good combination of resources. The only drawback is we need more,” he said. “We have facilitated them getting radios, and we are looking at a way to get them a car if they add this third unit. That’s all in preliminary stages.”