Mobile Crisis Outreach Follow-Up Program

Program Description

Mobile Crisis Outreach responds within one hour to individuals experiencing emotional distress or mental health crisis 24-hours a day, 7 days a week. Mobile crisis goes to the location of the event and aims to provide services such that a person can move through a crisis in the least restrictive environment. So long as someone is willing to speak with team members, anyone can request mobile crisis. Mobile crisis teams are staffed by mental health professionals, peer support specialists, and crisis counselors with training in crisis intervention. All teams consist of at least one master’s level provider. The Crisis Center’s Mobile Crisis program is unique in that it includes a substantial follow-up process. Crisis is generally conceptualized as a period of intensity and risk during which typical coping is compromised and additional supports are needed. The follow-up program is designed to address this period of risk when it extends beyond the initial crisis contact and responds rapidly and flexibly, providing interim counseling and care coordination services while bridging clients to ongoing providers. Follow-up services are provided by a master’s level mental health professional, are flexible and client-centered, and focus on providing support while working to connect clients to ongoing services.

Creativity

Unlike most mobile crisis programs, we recognize that a crisis doesn’t end once a person is stabilized. That’s why we provide follow-ups that go above and beyond the standard phone call within 24 hours of a response. Follow-ups are provided by a master’s level mental health professional. In some cases, all that is needed is a phone call to check in with the client on the safety plan developed during the initial contact. However, in many cases, clients require additional supports. Our mobile crisis team facilitates continuity of care while clients are connecting with longer-term resources. In these cases follow-up may consist of numerous in person meetings, assistance with applications for mental health, housing or other services. In many cases, the follow up counselor will accompany a client to an initial appointment to introduce the client to their primary provider, a practice known as a “warm transfer.”

Leadership

The Crisis Center is a trusted expert in crisis intervention services in our community. Our staff is highly trained and provides training on crisis intervention techniques. In addition to a 60-hour training for all crisis intervention volunteers, our staff also does QPR, CIT, and ASIST trainings for law enforcement, school officials, and any other community member or group who requests it. Staff serve on the boards of Contact USA and the American Foundation for Suicidology. Our Mobile Crisis Outreach Program coordinator, Timothy Kelly, is also a PhD candidate at the University of Iowa and teaches in the Department of Rehabilitation and Counselor Education. Kelly and the mobile crisis team use evidence-based practices in the follow-up program and he has produced and disseminated a white paper describing our model. They also incorporate the Critical Time Intervention model into the program and are planning to access additional training on this model.

Sustainability

We currently receive funding through the Victims of Crime Act, Iowa East Central Mental Health Region, the Community Foundation of Johnson County, Johnson County Social Services, and other foundation resources. We have partnerships throughout the community, most notably with three hospitals, three municipal police departments and two county sheriff’s offices. Our Mobile Crisis Outreach Program has become a very trusted resource in our community and we have developed partnerships with other organizations that need assistance transitioning their clients to longer-term resources. We have become the first call for many organizations in need of assistance with clients who need more intense counseling services or additional services beyond that organization’s scope of care. Our service has proven to be incredibly valuable in our community since its inception in 2015 and we have secured funding for the program through 2018. We are working with an anonymous donor to sustain the program beyond 2018.

Replicability

With proper staffing, the program could be replicated easily by other organizations. The model is not difficult, but it is time intensive. If our program has the resources to implement CTI, we believe we can demonstrate it’s effectiveness in mobile crisis services. Our model can then be used by other programs seeking to develop an evidence-based, robust follow-up program in crisis intervention.

Results/Outcomes

During the first half of fiscal year 2017, the Mobile Crisis Outreach Program responded to 228 calls. This is a huge increase from the number of calls received in FY16, in which we received just 188 calls for the entire year. This is in large part due to the addition of two full-time staff and the fact that law enforcement officers are being CIT trained in our community. Hospital diversion is a critical component of mobile crisis. Through our extensive follow-up program, which saw a total of 211 contacts in the first quarter, our hospital diversion rate reached 84%, well above the national average. Additionally, of those who received follow-up services, 85% reported attending their mental health appointments, which is, again, well above average. This shows that the program has been successful at providing vital linkages and interim care coordination for individuals in crisis in this community.