There should be “no wrong door” for accessing mental health care in Fairbanks and across Alaska, says Mike Sanders, who is on a mission to make sure support is more readily available for people in crisis.
Sanders is coordinator of a Fairbanks program called Crisis Now that launched Oct. 4. Similar crisis response initiatives are underway in Anchorage and the Mat-Su area.
“The best practice is for a mobile crisis team to divert a lot of the cases that are not criminal and not someone who is a danger to self or others,” Sanders said. “Then it is not a cop car sitting out in the driveway. It is not traumatic for the person in crisis.”
Crisis Now seeks to respond to people in the community experiencing a psychiatric crisis by sending out a mobile intervention team. The goal is to provide outreach, support and resources before people need more intensive help.
The Alaska Mental Health Trust Authority, the Department of Health and Social Services and other partners have been reviewing existing crisis care services to implement promising models like Crisis Now.
“It is about meeting people where they are at. Changing how we respond to individuals experiencing a behavioral health crisis can improve outcomes for that individual,” said Allison Biastock, chief communications officer for the Mental Health Trust Authority.
Currently, there are few crisis services available in Fairbanks or anywhere else in Alaska for stabilizing people outside of a hospital before problems escalate and require the police or other authorities to intervene.
Typically, local police or emergency medical technicians have responded to these calls, but personnel often lack the resources or training to effectively stabilize a person. Depending on the situation, the individual may wind up in a hospital emergency room or in jail.
“In our experience that is the wrong way to handle the vast majority of crisis experiences,” Sanders said. “We have learned a lot about better systems, and we and others are moving to take advantage of what we have learned.”
Science and data point to community-based models that send help to people where they are, whether at home or on the street. With Crisis Now, an on-call team responds to situations as the impacted individuals, their families or others reach out for help.
“Maybe someone is talking about suicide and is really depressed,” Sanders said. “If the [crisis hotline] is not able to resolve the problem over the phone, the mobile team is dispatched.”
“The clinician arrives on the scene, and the peer support specialist starts de-escalating the problem. We try to resolve the problem on the scene,” he said.
On call, 24 hours a day
Once fully staffed in Fairbanks, the crisis mobilization team, which consists of a clinician and peer support specialist, will be on call 24 hours a day.
In the first week of November, a start-up crisis mobilization team in Fairbanks responded to 15 calls. Organizers expect the number to increase as more people learn about the service.
The mobile crisis team talks to the individual, assesses his or her needs, and provides next-day appointments with providers who can prescribe medication or other services.
In the future, the team will be able to refer individuals to community stabilization programs. The trust authority is working to engage potential operators in Fairbanks to offer short-term care that may run for several hours to a few days.
Three components of Crisis Now
“Crisis Now is a continuum of three components that are working in many communities to prevent suicide, reduce wait times in emergency rooms and correctional settings, and provide the best supports for individuals in crisis,” Biastock said.
The three components of Crisis Now are:
• A regional or statewide call center that responds to and coordinates care. Fairbanks already has an established call center called the Care Line (1-877-266-HELP). People may also phone 911. “CareLine is there for somebody to talk to,” Sanders said. “Anyone in any sort of crisis can connect with help.”
• Centrally deployed, 24/7 mobile crisis teams are being organized to respond to people who need immediate help. A clinician and peer support specialist spend an average of 45 minutes at the location, said Linda Setterberg, operations director at the Bridge, an agency that provides peer support. “They really do get connected,” she said.
• Stabilization resources under development will offer a safe, supportive and appropriate place for people in crisis. These will be locations separate from hospitals, where no one is turned away for services. “They are staffed by clinicians and peers, and are a place where individuals can be in a safe and stable environment with access to the clinical resources they need,” Biastock said. “They get the time and space to decompress.”
Raising awareness about crisis support
The Mental Health Trust Authority grants about $25 million a year to providers, nonprofits, state agencies, local governments and tribal organizations to support its mission.
“Trust grants are often prioritized to serve as catalytic funding that can help our partners do things like bring on new lines of service, access training for innovative ways to serve beneficiaries, and help implement system-level improvements,” Biastock said.
In Fairbanks, the trust authority has funded partner agencies to form the crisis mobilization teams and help assure a continuum of care.
“Part of the Crisis Now model is to raise awareness so that the public can understand that there is no wrong door approach to getting care,” Sanders said. “We want people to be able to connect and reach out. ”