For over two hours and 40 minutes, Jose Olivera, a member of Santa Barbara County’s Behavioral Wellness mobile crisis team, talked through a patient’s front door to try to convince them to seek out the medical and mental health care they urgently needed.
Law enforcement and paramedics had visited the patient the day before, but were unable to convince them to get help.
After the patient’s sibling called the mobile crisis access line the next day, Olivera and his partner, along with paramedics, convinced the patient to leave their home and get medical treatment.
Hours later the patient had a heart attack. Because the mobile crisis team was able to get him to the hospital, he got the care he needed.
The mobile crisis teams have been around for nearly 10 years, but they recently expanded. Staff now go out in pairs when responding to mental health-related calls.
More Services, More Calls After Expansion
Before services were expanded, teams would go out primarily to determine if a patient needed to be involuntarily detained for a 72-hour psychiatric hospitalization, known as a 5150 hold.
Now, in teams of two, they can help de-escalate situations, do crisis assessment and help hand-offs to support services. The teams are available 24/7 in Santa Barbara, Lompoc and Santa Maria.
The state recently made mobile crisis services reimbursable for MediCal beneficiaries, but anyone can still call the service at any time. The reason behind the reimbursement is to reduce use of law enforcement and emergency rooms for mental health-related emergency calls.
Olivera said things have been going well since they expanded services and that they noticed an increase of calls through the 24/7 access line.
“You get to brainstorm what ways to better support the patient; it gives you another person to collaborate with if it’s a complicated case,” Olivera said. “I think having two people gives more assurance to people in the community.”
Olivera said he and his partner will respond to calls themselves, and with law enforcement. They deal with situations in the community, jails and hospitals.
“We’ve been able to convince the patient to re-engage in treatment and take their prescribed medications,” Olivera said.
John Winckler, Behavioral Wellness’ branch chief over specialty programs, said that teams are usually able to respond to calls within 30 minutes.
“We’re able to get there when the crisis is happening, so that we can see what’s going on and effectively evaluate and get the person the help that they need,” Winckler said.
Lynne Gibbs, an advocate for mental health services, said having more people on the crisis teams helps to ensure timely responses to those in need.
Gibbs said law enforcement and mental health clinicians complement each other in the work they do.
“As partners, they can de-escalate potentially dangerous situations,” Gibbs said. “They’ve described to us that sometimes someone in crisis will bond more closely with the clinician, sometimes they bond more closely with the law enforcement officer, they really do work as an experienced team.”
Funding Needed to Expand Co-Response Teams
Gibbs is also public policy chair for the Santa Barbara County chapter of the National Alliance on Mental Illness. One thing she’d like to see in crisis services is 24/7 co-response teams.
While mobile crisis services are available 24/7, co-response teams, which pair a mental health crisis worker with a member of law enforcement, have varying hours of availability depending where they are in the county.
Suzanne Grimmesey, chief of strategy and community engagement for Behavioral Wellness, said while ideally they would expand services, doing so would require more funding.
The county-wide teams are funded by the county, city of Santa Barbara and city of Santa Maria. Behavioral Wellness uses funds from the Mental Health Services Act (MHSA) to support the clinicians on these teams; but because of Proposition 1, which California voters approved earlier this year in the presidential primary election, that may be changing.
The proposition requires counties to use 30% of the income they receive from MHSA on housing instead of services. Because of this, and other funding changes, funding for the co-response teams is shrinking, according to Grimmesey.
Impact of Co-Response Teams
While the future of the co-response teams is uncertain, staff are seeing the benefits the program has in the community.
Susanne Newman has been a co-response team member for a year, working alongside a Santa Maria police officer. Newman has seen how the teams provide a more discrete care while also freeing up law enforcement.
“Having a mental health person go out with law enforcement is a little gentler than having five cop cars showing up to your house when you’re just calling for help and all of a sudden all the neighbors are looking out the window,” Newman said.
Newman said being paired up with law enforcement is beneficial in unsafe situations or when a patient is refusing to go to the hospital.
“If I place someone on a hold and tell them they’re going to the hospital, a lot of times they’ll say, ‘No, I’m not going.’ So law enforcement assists with being able to convince them,” Newman said. “Whereas, if it’s just two mobile crisis people, it’s very difficult to get somebody to go that doesn’t want to go.”
Newman worked in mobile crisis for five years before joining co-response. She said she enjoys being on a co-response team because she likes being out in the field as opposed to the jails and hospitals.
Having worked in the mental health field in North County, Newman has seen an increase in unhoused individuals suffering from mental illness and has seen the full cycle of substance abuse impact people and their families.
“Working in drug and alcohol and mental health for the last 25 years, the people that you worked with 25 years ago, you start to see their kids come in with mental health issues, so you see the generational aspect of that,” Newman said.
She’s also seen some things get better, such as the research around drug use and mental health and the collaboration between the two systems.
“There’s the flip side of it, where you see people you worked with 20 years ago, and you see them getting clean and sober and taking care of their mental health issues and really being productive members of society,” Newman said. “The difference is we have more resources today than we did back then.”
Newman said the most rewarding part of her job is helping people get the care they need and seeing them recover.
“To have people come back and have a life, that’s amazing,” Newman said. “To watch people come up from nothing, that’s huge, and to just be a small part of that, that’s big.”
To access mobile crisis or co-response teams, Santa Barbara County residents can call the 24/7 access line at 888-868-1649. If there is an immediate risk of someone hurting themselves or others, call 9-1-1.
link