COUNTY OF OSWEGO DEPARTMENT OF SOCIAL SERVICES/ DIVISION OF MENTAL HYGIENE OSWEGO COUNTY BUILDING 100 SPRING STREET, PO BOX 1320 MEXICO, NEW YORK 13114 (315) 963-5361 FAX (315) 963-5530 CRISIS SERVICES SURVEY SUMMARY In attempt to assess the current needs of Oswego County residents for crisis services related to mental health, housing, alcohol or substance abuse issues, the Mental Hygiene Division of the Oswego County Dept of Social Service implemented a community survey to identify needed services or improvements to current services. For the purpose of this anonymous survey, Crisis was defined as an unexpected occurrence or incident related to emotional or psychiatric distress, problematic use/abuse of alcohol or drugs, homelessness, behaviors putting oneself or others at risk of injury. The following is a summary of the results of this survey. Prepared by Nicole Kolmsee, Director of Community Services nkolmsee@oswegocounty.com (315) 963-5361
Table of Contents I. Background Information II. III. IV. Characteristics of Respondents Responses from Law Enforcement and Health Care Providers Responses from Mental Hygiene Providers, school employees, Law enforcement, Health care providers, County leaders, and DSS employees V. Responses from General Community VI. Comments VII. Next Steps 2
I. Background Information The current options available for the Oswego County general community for crisis services related to mental health, housing, alcohol or substance abuse issues include: o Oswego Health: Oswego Hospital Emergency Department (24/7) for immediate observation, and interface with the Oswego Hospital Behavioral Services Division (OHBSD), for Medical or Mental Health evaluation and services including inpatient care. o Oswego Hospital BSD has crisis services available on a walk in basis. Depending on time of day and staff availability, a walk in may need to be seen initially at the Emergency Department. o Oswego Hospital BSD maintains a crisis hotline 24/7 for counseling over the phone. However, this may be a long distance call for some. o County residents can use CONTACT for crisis counseling. However, this may be a long distance call for some. o St. Joseph s Hospital in Syracuse, NY has a Comprehensive Psychiatric Evaluation Program (CPEP) service available to Oswego County residents. o County Residents enrolled in the Oswego Case Management Program have access 24/7 to support from the program. (Limited to the 140 participants enrolled) o County Residents enrolled in the OHBSD Assertive Community Treatment (ACT) Team program have access 24/7 to support from the team. (Limited to the 48 participants enrolled) o SAF services (OCO Inc.) maintain a crisis hotline geared towards domestic violence 24/7. o Homeless Shelters are located in neighboring Onondaga County (The Rescue Mission and The Salvation Army) Formerly, a Mobile Crisis Service was available. This service was discontinued in 2006 due to the ineffectiveness of its design and significantly low utilization. A general awareness exists that what is available is insufficient and is in need of attention. The purpose for collecting information on this topic is to guide the decision making process around how best to proceed. It is unlikely that a vast array of new services will be implemented primarily due to cost. However, there is a commitment to improve upon the current state to better meet local needs. 3
II. Characteristics of Respondents This survey was available for completion on paper on online. The survey was marketed in the local newspaper, on the Oswego County Website, and individually to provider and consumer groups, law enforcement, health care providers, and schools. A total of 284 people completed the survey. The following is a summary breakdown of the largest percentage characteristics reported of the respondents. Age 45 years and up = 51% 27-44 years = 40% up to 26 years = 9% Residence by Zip Code Oswego = 45% Fulton = 24% Mexico = 8% 75% have lived in Oswego County 10 or more years 21% identified themselves as either a recipient of friend/family member of recipient of mental health, substance abuse, or MRDD services. 17% identified themselves as Community Member 17% identified themselves as Mental Hygiene Service Provider/Professional 16% identified themselves as School Employee 11% identified themselves as Health Care Professional 8% identified themselves as Dept of Social Services Employee 7% identified themselves as a member of Law Enforcement III. Responses from Law Enforcement and Health Care Providers Members of Law Enforcement and Health Care providers were asked to report on the frequency of crisis issues they address that are related to specific groups. Alcohol Abuse / Drunkenness Law Enforcement Health Care 2-4 times/month = 48% 1 or more times/week = 100% 1 or more times/week = 32% Daily = 71% Daily = 16% 2-4 times/month = 100% 2-4 times/month = 53% 1 or more times/week = 94% 1 or more times/week = 34% Chemically Addicted Individuals Daily = 47% Daily = 22% Mentally Ill 2-4 times/month = 75% Individuals 1 or more times/week = 100% 1 or more times/week = 37% Daily = 47% Daily = 28% Children w/ 2-4 times/month = 100% 2-4 times/month = 53% Behavioral 1 or more times/week = 88% 1 or more times/week = 41% Problems Daily = 59% Daily = 22% Police comments seem to indicate their perception that community and providers are utilizing a response from law enforcement as a first reaction instead of a last resort. 4
IV. Responses from Mental Hygiene Providers, school employees, Law enforcement, Health care providers, County leaders, and DSS employees This group was asked to rate the level of need for the following services in Oswego County. The rankings for High to Very High Need are in the following table. Psychiatric Emergency Room 84% Overnight Crisis Bed, Hospital Diversion 78% Children s Crisis Respite 77% Housing Shelter 70% Chemical Dependency Detox 66% Counseling Phone Line w/ a professional 62% In-Home Evaluation 62% Suicide Prevention Hotline 59% Sobering Up Bed 57% Peer Phone Line 45% Overwhelmingly, the comments from this group regarding the appropriateness and effectiveness of our current crisis services reflect the belief that services are minimal, ineffective, and often not age or situation appropriate. Responses indicate the need for training related to this topic focus primarily on crisis and suicide intervention skills/de-escalation (specifically for youth), and the need for information on available services and procedures for accessing them. V. Responses from General Community This group was asked to rate the usefulness of various services at a time of crisis. The rankings for those identified as Very Useful by the majority of respondents are in the following table. Support from Family or Friend 64% Sponsor, Mentor, Advocate 52% Overnight Crisis Bed, Hospital Diversion 52% Housing Shelter 51% Psychiatric Emergency Room 49% Children s Crisis Respite 47% 58 respondents indicated that either they or someone they know have been to a Local Emergency Department for psychiatric evaluation. 30% of these individuals reported the level of care was in line with their needs. 14% reported the level of care was either in line with or higher than needed. Another 37% however, reported a negative experience or offered a critical comment regarding the type or quality of service received. It would seem to reason that a general Emergency Department is undoubtedly not best suited for managing behavioral health crisis needs. 5
VI. Comments Respondents offered very extensive comments regarding specific desired services, quality of current services (positive and negative), gaps, and accessibility issues. A large volume of comments related to children and family needs as well access to appropriate clinical services for individual needs. The need for information/descriptions regarding what is available, who is eligible, and how to access the service is also evident. VII. Next Steps A short-term workgroup has been established to review the information collected from this survey. The goals of the workgroup will be to: 1. Identify the greatest need expressed by respondents, and make recommendation(s) for how best to address 2. Make recommendations for meeting training needs reported by respondents 3. Make recommendations for responding to request for resource and access information Workgroup Participants include: Oswego County Director of Community Services Oswego County Mental Health Educator Mental Health Peer Advocate Parent Advocate Representative from Oswego Case Management Services Representatives from Oswego Hospital Behavioral Health Division Representative from Oswego County DSS Child and Family Services Representative from OCO MH Residential Services Representative from OCO Youth Division March 14, 2007 6