For more than two hours and 40 minutes, Santa Barbara County Behavioral Health Mobile crisis teams spoke to patients at their doorsteps, trying to convince them to seek urgently needed medical and mental health care.
Police and paramedics had visited the patient the previous day but were unable to persuade him to seek help.
The following day, after the patient’s brother called emergency services, Olivera and his partner, along with paramedics, persuaded the patient to leave the home and seek treatment.
A few hours later, the patient suffered a heart attack. The ambulance was able to transport him to the hospital, where he received the treatment he needed.
The mobile crisis response team has been around for nearly a decade but has recently expanded, with staff now working in pairs to respond to mental health calls.
Increase in services and calls after expansion
Before the expansion of services, the team was primarily called out to determine whether a patient needed to be involuntarily detained for a 72-hour psychiatric admission (5150 hold).
Currently, teams of two assist with de-escalation, crisis assessment, and handoff to support services. The team is available 24/7 in Santa Barbara, Lompoc, and Santa Maria.
The state recently reimbursed Medicare beneficiaries for a mobile crisis service that anyone can call at any time, in an effort to reduce the use of police and emergency rooms for mental health-related emergencies.
Olivera said things have been going well since they expanded their services and they have noticed an increase in calls through their 24/7 access lines.
“We brainstorm ways to better support patients, and in complex cases, we have another person to work with,” Olivera said. “I think having two of us gives people in the community a sense of security.”
Olivera said he and his partner will personally answer calls and liaise with police. They will deal with situations in the community, prisons and hospitals.
“We were able to convince the patient to resume treatment and take the prescribed medication,” Olivera said.
John Winkler, branch director of specialized programs at Behavioral Wellness, said his team can usually respond to calls within 30 minutes.
“We can arrive on scene when a crisis is occurring, see what’s going on, effectively assess and provide the assistance that person needs,” Winkler said.
Mental health services advocate Lynne Gibbs said increasing staffing on crisis teams would ensure a timely response to people who need help.
Gibbs said law enforcement and mental health clinicians complement each other’s work.
“As partners, they’re able to de-escalate potentially dangerous situations,” Gibbs said. “They’ve told us that sometimes a person in crisis will bond more closely with a clinician and sometimes they’ll bond more closely with a police officer. They really work as an experienced team.”
Funding needed to expand joint response teams
Gibbs also serves as public policy chair for the Santa Barbara County chapter. National Alliance on Mental IllnessOne thing she would like to see in crisis services is a 24/7 joint response team.
Mobile crisis services are available 24/7, while joint response teams, which pair mental health crisis responders with members of law enforcement, have different hours of availability depending on location in the county.
Suzanne Grimsey, Behavioral Wellness’ director of strategy and community engagement, said ideally they would expand services, but that would require more funding.
The countywide teams are funded by the county, the city of Santa Barbara and the city of Santa Maria. Behavioral Wellness supports clinicians on these teams using funding from the Mental Health Services Act (MHSA). Proposition 1California voters approved this in the state’s presidential primary earlier this year, but that could change.
The proposal requires counties to spend 30% of the revenue they receive from the MHSA on housing rather than services, and Grimsey said that and other funding changes have resulted in less funding for joint response teams.
The impact of joint response teams
While the future of the Joint Response Team is uncertain, staff recognize the benefits the program brings to the community.
Susan Newman has worked with Santa Maria Police officers for a year as a member of a joint response team. She has seen firsthand how the team provides more discreet care while simultaneously easing the burden on law enforcement.
“Having mental health professionals out there with the police is a little bit gentler than if you’re calling for help and five police cars show up to your house and all of a sudden your whole neighborhood is looking out the window,” Newman said.
Newman said working with police can be beneficial in dangerous situations or when a patient is refusing to go to hospital.
“A lot of times, when you put them on hold and tell them you’re going to the hospital, they say, ‘No, I’m not going,’ so the police help convince them,” Newman said, “whereas when you’ve only got two emergency responders, it’s very hard to get someone to go to the hospital if they don’t want to go.”
Prior to joining the Joint Response Team, Newman worked with a mobile crisis response team for five years. She said she enjoys joining the Joint Response Team because she likes working in the field, rather than in a prison or hospital.
Newman works in the mental health field in North County and has seen an increase in homeless people with mental illnesses and how the cycle of substance abuse affects people and their families.
“Working in the drug, alcohol and mental health field for the last 25 years, I start seeing the children of people I worked with 25 years ago coming in with mental health issues, so I see the generational aspect of it,” Newman said.
She has also seen some improvements, such as research on substance use and mental health and collaboration between the two systems.
“The flip side is that the people we worked with 20 years ago are now off drugs, dealing with their mental health issues, and becoming productive members of society,” Newman says. “The difference is that there are more resources available now than there were back then.”
Newman said the most rewarding part of her job is helping people get the care they need and watching them recover.
“It’s great to see people coming back and starting to move on with their lives,” Newman said. “It’s big to see people rising from nothing and to be a small part of that is a big thing.”
Santa Barbara County residents can call the 24/7 access line at 888-868-1649 to contact the Mobile Crisis Response Team or Joint Response Team. If someone is in imminent danger of harming themselves or others, call 9-1-1.
