Crisis System Collaboration-A Work in Progress

About a year ago, the State issued a request for proposals to counties designed to improve local capacity to respond to people in crisis that in large part is due to their mental illness. One of the requirements of the proposal was to catalogue existing crisis response efforts within the county. Going through that exercise was illuminating. While here in San Mateo County we do have considerable resources devoted to preventing crises and responding to them, it was clear we have not organized the resources within a collaborative/partnering framework that would enhance leveraging our resources, identifying and filling gaps, and building future capacity.

In July, BHRS convened a meeting with representatives from law enforcement, hospitals, emergency medical services, NAMI, office of emergency services, education, community based organizations, probation, and the county managers office. We wanted to bring this group together to see if there was agreement in working toward building a collaborative that would focus on improving prevention of and responding to crises. The participants strongly affirmed such an interest and they were willing to devote their time to make this work.

A survey was developed to find out from the 70 participants how we they would rate our current effectiveness in the following areas: crisis prevention; client and family supports; crisis response; post response; and data/evaluation. Here are some of the findings:

  • Prevention: approximately 57% felt we have effective services, while 14% disagreed and 27% were neutral
  •  Client and Family Supports: 45% agreed, 15% disagreed and 27% neutral
  •  Crisis Response: 54% agreed, 11% disagreed and 32% neutral
  •  Post Response: 26% agreed, 11% disagreed and 32% neutral
  •  Data and Evaluation: 0% agreed, 31% disagreed and 69% neutral

For each of the items there was a large percentage of neutral responses which at this point we are interpreting that the respondents did not have enough information and/or they felt there is room for improvement (see a summary of the Crisis Service Collaboration survey results). The group reconvened in September to review the results of the survey and to start identifying potential areas to focus on including but not limited to the following: linking people to services prior to a crisis, a place for people to go voluntarily, mobile crisis, enhanced language capacity, follow up after a Psychiatric Emergency Service or hospitalization stay, information sharing across agencies, and develop an evaluation tool to determine how well we are doing.

We are excited about the strong interest and enthusiasm for developing a strong and effective collaboration. We will be meeting again in January to continue our work.

If you are interested in participating please contact Mary Taylor-Fullerton at