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Community Crisis Response

Last year, a dedicated group of people from across Contra Costa joined forces to look closely at how we respond to and help those experiencing a mental health crisis in our county. Individuals representing diverse experiences - from people who work across the behavioral health system, those with lived experience, and their family members - to police, and members of community organizations, began meeting regularly to share their stories, ask tough questions, and collectively come up with new ways to better serve some of the most vulnerable members of our community.

The group came together to reimagine a future with a clear goal: to create a system where anyone in Contra Costa County can access timely and appropriate behavioral health crisis services anywhere, at any time.

Approximately one in five adults in Contra Costa County are struggling with behavioral health issues. The complex and decentralized system of intervention and mental health treatment programs in our county often means those experiencing a behavioral health crisis cannot access the care they need when they need it. All too often, calling 911 can feel like the only option a family or caregiver has when behavior escalates beyond what they can manage. Unfortunately, there are limited options available in managing acute behavioral crisis responses.

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 behavioral health services for all.

This work clearly identified and prioritized four areas that are critical to reducing the stigma associated with mental health issues and ensuring that anyone in Contra Costa County experiencing a mental health crisis gets the help they need. The four key areas identified as highest priority are:

  • Having a single number in the county for people to call when experiencing a behavioral health crisis
  • Availability of mobile crisis response 24 hours a day, seven days a week
  • Availability of a non-police crisis team
  • Availability of alternate destinations to jail for those experiencing a behavioral health crisis

The first in a series of three week-long “Rapid Improvement Events” begins on March 29, 2021 and will focus on having a single number for people to call to access services and a non-police mobile crisis response team available within forty-five minutes.

These events offer everyone involved the opportunity to step away from their day-to-day work and identify real-world solutions to improve the behavioral health system and better serve those experiencing mental health crises. They will be performing observations and time studies to improve the process of when a community member identifies a need for behavioral health crisis response until the crisis is stabilized and supportive services are provided.

The public is invited to hear the public report with key findings and recommendations on Contra Costa Television (CCTV).

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

  • Timeline

  • 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