Mobile Crisis Response – Rural Innovation
The Western Lane Fire & EMS Authority (WLFEA) secured a three-year intergovernmental agreement with annual direct funding of $280,000 approved.
Nearly 150 responses to mental health crisis were supported in the first five months of program launch. Residents of this rural community now have 24 hour/seven days a week face-to-face and telephone screening for mental health crisis.
Law enforcement first responders reported that their time on scene has been reduced significantly on calls of a social or mental health nature. They express enthusiastic support for the program feeling that access to mental health practitioners trained in de-escalation is beginning to reduce jail hold admissions and enabled more appropriate services and resources to people needing mental health intervention and follow up.
Context and challenges
Located in Florence, Oregon, WLFEA provides all-hazards emergency response and emergency medical services to approximately 19,000 people over 984 square miles.
Mobile Crisis Services are mental health services for people in crisis, provided by mental health practitioners who respond at the location in the community where the crisis arises and provide a therapeutic response.
The goal is to help an individual resolve a psychiatric crisis in the most integrated setting possible and to avoid unnecessary hospitalization or incarceration. Western Lane County experiences greater incidence of mental health issues and suicide rates per capita than county and state averages.
Although need is clearly high, development of rural Mobile Crisis Response (MCR) and equitable access to public health funded services was challenged by population being spread across large and remote geographic service area, long response times and public safety inter-jurisdictional issues. No playbook for rural MCR existed.
The regional health authority was willing to provide funding for planning and development only on the condition that rural stakeholders would collaboratively design a customized MCR and reach agreement on goals, roles and operational implementation that would strongly leverage existing community assets.
WLFEA’s goal was to develop a crisis response model program to improve access to mental health services, reduce demand on more costly interventions in the overall health and human safety system and address unique challenges of their rural service area.
The objectives for the facilitated process were to:
- Form a collaborative stakeholder group and foster group connections and trust.
- Develop a proposal for program design, administration, staffing and budgeting that built on existing community assets that would enjoy broad support and participation of stakeholders in its development and subsequent implementation.
- Establish a workplan for rapid launch of a pilot project to secure funding.
WLFEA engaged Kathy Smith from KJ Smith Associates to help it achieve its objectives. The project involved four stages:
- Process design and agenda development. Working closely with client project leaders and engaging stakeholders in contributing to process design.
- Facilitation of stakeholder sessions. Facilitated five sessions of two to three hours each and developed and ultimately submitted a proposal for funding. Preliminary agendas for each session were finalized in advance of each session. Client/stakeholders provided “content” materials. The facilitator provided “process” support aids.
- Documentation of a funding proposal for submission to the health authority that included service delivery process flows and workplan for pilot project program development that reflected outputs of the facilitated sessions.
- Facilitation of post funding award standing meetings of one to two hours each month to provide a forum for discussion of issues identification and resolution among community stakeholders involved in the early rollout of the MCR program.