Mobile Crisis Response: A Service offered by Family & Children Services Contracted by: Kalamazoo Community Mental Health and Substance Abuse Services
Why was there a need for crisis response? KCMHSAS requested proposals to meet the needs of children and families in Kalamazoo County There had been no program with staff specially trained to work with children and families that provided immediate crisis intervention 24 hours a day
What is Mobile Crisis Response (MCR) 24-hour response team Respond to any youth in Kalamazoo County (regardless of insurance) that is experiencing a mental health or substance use crisis Offer crisis intervention to work through the current crisis situation to prevent hospitalization or placement of the child outside of the home when possible Complete assessment and screening for Crisis Residential, Partial Hospitalization, and Inpatient Hospitalization for Medicaid and no insurance youth Provide follow-up services until on-going services are obtained and assist with linking to on-going services Program started in January 2000
When would you access MCR? The family defines the crisis The family or professional feels that they need assistance in resolving a crisis For professional consultation (i.e., schools, law enforcement, primary care physicians, emergency departments) Professionals may call for assistance in creating crisis safety plans If it is not the parent contacting MCR, parental permission must be obtained unless the child is14 years of age or older
How to access MCR. Call 1-269-373-6000 or 1-888-373-6200 KCMHSAS Access staff or Gryphon Place staff will triage the call and determine if MCR should be contacted.
What can you expect from MCR? Contact the person requesting the service within 20 minutes of our receipt of the call Triage the situation with the caller and determine what the next step will be If a face-to-face response is requested, complete a brief risk assessment and respond within 45 minutes if possible (Multiple calls can delay response time) Respond in teams of two
What to expect continued Complete consents for services as well as additional required documentation Complete a brief clinical assessment We may talk to family members separately Determine appropriate disposition
What to expect continued Develop a crisis safety plan with the family Arrange any appropriate follow-up services
Risk and Safety Assessment Assess for the following: Willingness of others in the home to have someone come into the home Intoxication of members present in the home Animals in the home Weapons in the home History of violence Pest infestation
Crisis Model Comparisons Initial development of program and how program is structured now look differently Not based on any particular model
Staffing and Team 2 Full-time staff working M-F days After-hours, weekends, holidays on-call staff Supervisor/Program Manager Manager on-call for placement approval and back-up for overflow calls Assistance from Supervisors in other F&CS Behavioral Health programs Assistance from Clinicians in other F&CS Behavioral Health programs Recent addition of a 3 rd Responder for Crisis Residential Services
Training of Staff Initial training of staff begins with orientation to the program and agency They receive training on the electronic medical record Shadow shifts are scheduled 2 nd responder then 1 st responder Monthly team meetings 24 hours of clinical training in the area of youth
Program Budget Revenue Daily rate from KCMHSAS Engaged rate - averaged for a three year period Expenses On-call pay Engaged pay Salary staff Mileage Training IT equipment Marketing
Call volume and trends Program data is collected each month and reviewed for current trends and possible outreach needs Data is able to help guide training needs Data is able to help in identifying staffing needs Call volume has varied over the years with increases and decreases
Data Data is tracked in multiple areas each month, quarter and yearly Time of call Location Referral source Age Current services Diagnosis Presenting problem Interesting trends Typical calls Repeat callers
Marketing Primary marketing times are in the Fall, Winter and Summer Marketing has focused on mental health providers, physicians, Emergency Departments, schools, and law enforcement Marketing plan for the Summer of 2016 includes religious organizations and providers that have not received information in the past three years Marketing log is maintained each year
Success The program quickly met and exceeded expectations Development of relationships with the local ED s, community mental health, primary care physicians, and schools Reputation of the program and staff Acceptance by the community Able to facilitate direct admissions with Borgess Adolescent unit Opportunity to work with law enforcement
Challenges Unpredictable call volume Obtaining SS# and Medicaid # COFR cases Relay system from Access or Gryphon Receiving alerts or updates from on-going service providers More collaboration with law enforcement Hiring staff Misinformation quickly spreads