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Community Crisis Response

About one in five adults in Contra Costa County are struggling with behavioral health issues. A complex and decentralized system of intervention and treatment programs often means people experiencing a behavioral health crisis cannot access the care they need when they need it.

Calling 911 can feel like the only option for families and caregivers when behavior escalates beyond what they can manage. The reality is that, there are limited options currently available when faced with responding to mental health crises in our county.

In Fall 2020, we brought together a multi-disciplinary, county-wide team with diverse experiences and created an initial framework to develop a system where anyone in Contra Costa County can access timely and appropriate behavioral health crisis services anywhere, at anytime.

Over the last several months, the team of community stakeholders has worked together to understand exactly what happens when someone experiences a mental health crisis – and most importantly, to identify the barriers that prevent us from providing compassionate care and easy access to effective behavioral health services for all.

The first in a series of three week-long "Rapid Improvement Events" began on March 29, 2021 and focused on three goals:

  • having a single number for people to call to access services,
  • creating a streamlined triage assessment tool, and
  • a non-police mobile crisis response team available within forty-five minutes.

Some of the ideas tested during the week included: soliciting community member responses on who they would call during a mental health crisis; applying mental health crisis scenarios with a city police department to determine whether a nonpolice mobile crisis team would be deployed over the police; and using a mental health first mobile crisis response when appropriate.

The week concluded with the following recommendations from the team:

  • Develop a 24/7 Centralized Crisis Call Center Hub (virtual)
  • Create 4 regional county Crisis Teams to be deployed by the Hub
  • Empower law enforcement dispatch with a standardized, clear county wide protocol to utilize the mental health crisis response team
  • Offer a clear alternative to 911 for mental health and substance use crises
  • Establish a review process that includes, law enforcement, behavioral health, emergency medical services, families for how we are doing, identify and explore possible improvements
  • Establish training program for mental health, law enforcement, emergency medical services – all call takers and crisis responders

The public is invited to hear the public report on Contra Costa Television (CCTV) and on YouTube.

We are looking forward to the second Rapid Improvement Event which will take place from April 26thβ€”30th, 2021 to refine these recommendations and create alternatives to incarceration and admission to psychiatric emergency services.

Collaborative Process Underway
Existing Resources

  • Collaborative Process Underway

    In close collaboration with Contra Costa cities through the Contra Costa Public Managers Association, community-based organizations and interested residents, CCHS has launched an intensive evaluation of current programs and existing needs to identify areas for improvement.

    • A multidisciplinary, representative and diverse team of community stakeholders, service providers and staff are developing a vision for the future of crisis response.
    • A multi-day workshop to assess the current state and identify possible short- and long-term actions took place from Nov. 9-20, 2020.
    • Participants, consisting of front line staff including those working in crisis response, police and dispatch, as well as clinicians and persons with lived experiences, spent about 50 hours over the course of two weeks in November observing, analyzing and interviewing subject matter experts about the current state.
    • The participants are using that learning to develop a vision for the future and identify areas for improvement.
    • The public was invited to attend a report-out on the findings of this process on Nov. 20, 2020. Video | Watch in YouTube

  • Statistics

    • Behavioral health issues are widespread
      • About one in five adults are currently experiencing behavioral health issues
      • About 13% of all EMS calls address mental health issues
      • There are between 10,000 and 11,000 involuntary psychiatric holds (5150s) in our county each year

  • Existing Resources

    • CCHS provides a variety of behavioral health services. A limited number provide crisis response, however none provide emergent response like 911.
      • Crisis Intervention Training (CIT)
      • Homeless Services (H3 & HCH)
      • Alcohol & Other Drug Services
      • Medical and Psychiatric Emergency Services
      • Behavioral Health Crisis Teams
    • Existing crisis response resources serve a small number of residents
      • Mental Health Evaluation Team (MHET) serves 293 people annually at a cost of $2 million
        • Designed to reduce law enforcement repeat calls for service and violent encounters, reduce visits to Psychiatric Emergency Services, increase community and police safety, and increase appropriate use of mental health services.
      • Mobile Crisis Team (MCRT) takes about 1,600 calls per year at a cost of $2 million, serves adults only
        • MCRT is designed to have mental health providers respond in the field to de-escalate crisis, provide stabilization, and prevent psychiatric hospitalization. If the situation cannot be de-escalated in the field, the MCRT will assess for 5150 criteria and, if criteria are met, the Mental Health Clinical Specialist can initiate a 72-hour 5150 involuntary hold.
        • In addition to responding in the community to the immediate situation that led to calling the MCRT, the team provides a 30-day period of follow up during which they focus on linking individuals to a variety of services to help them stabilize and prevent ongoing crisis experiences.
      • Mobile Response Team (MRT) receives about 1,000 calls from youth each year, budget is $2.2 million
    • MRT provides risk/safety assessments, crisis intervention, follow up services, collaboration with existing treatment team members and linkage for youth in their natural settings. The CCC MRT aims to provide same day services and/or services as close to 24 hours of immediate crisis.
    • We have researched models from other communities
      • Regardless of what model we choose, the key to success is alignment with our cities and community partners across the county.

  • Documents