Category Archives: Crisis Response

Police Mental Health Training Pays Off

Great to see the Crisis Intervention Training (CIT) being provided to officers in San Mateo County on how to respond to individuals needing mental health assistance is making a difference. In a recent stand off with an individual who was distraught and threatened to harm himself and others, the San Mateo Police worked together with the County’s SMART team (San Mateo County Mental Health Assessment and Referral Team) to prevent the situation from ending in a tragedy.  Kudos to the San Mateo Police for the sensitivity shown in handling a situation that could have easily gone sideways. Read the full story here.

Crisis Collaboration Work Moving Forward

The Behavioral Health & Recovery Services Crisis Collaboration Workgroup met for the third time this past week and a diverse group of service providers within San Mateo County were in attendance. Representatives from:  BHRS, Law Enforcement, School Districts, San Mateo Medical Center, Mills Hospital, V.A., NAMI, Probation, Emergency Medical Services, Mid-Pen Housing, crisis line providers, crisis response non-profits and several others came together with the goal to:  Read more

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 mfullerton@smcgov.org.

Trauma Awareness and Trauma Informed Care

Over the past several weeks and most intensively these past few days, the media has been dominated by the domestic violence perpetrated by NFL football player Ray Rice on his then fiancee (now wife). The first video of him dragging her out of the casino elevator as she lay unconscious on the floor was startling, alarming, and reprehensible. The response of the NFL and his employer the Baltimore Ravens was tepid at best. Then just the other day the second video showing the actual act of violence in the elevator has created a loud and profound outrage. The graphic nature of the video has moved the understanding of domestic violence, for many, from the abstract to the concrete. As an advocate for victim’s rights said this morning on the radio, “most people have never seen domestic violence and this video has changed the way people will now think about and discuss it.”

Janay Rice is a victim and has been traumatized. We all hope that she will get the care and support that she will need into the forseeable future. We also hope that Ray Rice gets the treatment he needs to move forward in his life as well.

Without question the events surrounding Ray and Janay Rice are horrific. We must also remember that trauma is experienced in many different ways and can have profound and lasting consequences if left untreated and the person unsupported.

For the past several years at BHRS we have had a number of “champions” that have advocated strongly for raising awareness of how trauma impacts those with behavioral health challenges and for transforming our services into a trauma informed system of care. Extensive training to our staff and providers has been provided and we are on the cutting edge of some exciting new treatment approaches and technology. In particular the Neurosequential Model of Therapy (NMT). Over the past few years we have had a cohort of clinicians trained and now applying these new therapeutic tools. Some are going on to become trainers so we can sustain and expand this work. Our Board of Supervisors has provided Measure A funding to support alternative treatment methods that can be tailored to the specific needs of clients.

As we continue to develop our individual and collective expertise in trauma informed care we must make it known to all who seek our services that they have come to a safe, welcoming and supportive place where we are understanding of how trauma has intersected in their lives and we are here in support of the recovery.

 

Improving Crisis Response

Over the past several months we have been focusing on a number of efforts to improve how we respond to individuals experiencing a mental health crisis. In July we convened representatives from law enforcement, education, health, behavioral health (staff and providers), family members and others to discuss how we can better coordinate our existing efforts, identify gaps in our system, and figure ways to improve. It was really encouraging to see the high level of motivation among all the participants to continue working on these issues. We are currently collecting information from the participants and will be reconvening in the Fall.

On Monday I will be going, along with two police chiefs, assistant sheriff, deputy county manager, Louise Rogers (deputy chief/health system), Kacy Carr and Paul Sorbo to Monterey County to meet with representatives from law enforcement and behavioral health to learn about what they have been doing over the past 4-5 years to boost their crisis response capacity and improve outcomes. I expect we will hear some very informative and helpful things that we can then consider as we continue to look for ways to improve.

Also, Suzanne Aubrey, Mary Taylor Fullerton with technical assistance from Perneille Gutschick have drafted a “script” and tips for family member if/when they need to call 911 for assistance with a loved one. The intent is to improve communication and minimize any misinterpretations between the caller (family member) and receiver (dispatch) so that the appropriate field response occurs. We will soon be meeting with dispatch to finalize the script. (The script will be interpreted in a number of languages) Once it is finalized we will begin a marketing/outreach effort to get this information to as many people as possible. We will provide the information on easy to post cards, refrigerator magnets etc. Also we will want to make sure that as  part of an intake process we make these materials available. NAMI will also be helpful in the distribution. Please send me ideas you have on how to get this widely distributed.

At the end of the day we need to do everything we can to ensure that those individuals experiencing a mental health crisis will receive the most appropriate response and that they their loved ones, the responders and the community are safe.

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