Macchione is the director of San Diego County’s Health and Human Services Agency. Bergmann is the director of the agency’s Behavioral Health Services Division. Both live in San Diego.
In recent years, the County of San Diego, with support from its Board of Supervisors and Chair Nathan Fletcher, has made significant investments to reimagine how mental health and substance use care is delivered to improve the lives of residents and families.
Driving that work is the county’s Behavioral Health Services, which
provides mental health and substance use disorder services to over
111,000 San Diego County residents of all ages.
One of the most promising models to launch and expand during this time has been the county’s Mobile Crisis Response Team Program.
Dispatched when appropriate to assist anyone, anywhere experiencing psychiatric distress, the Mobile Crisis Response Teams deliver no-cost, in-person support via a non-law enforcement team comprised of a mental health clinician, a case manager and a trained peer support specialist.
Piloted in early 2021 throughout the north coastal region of the county, Mobile Crisis Response Team services are now available countywide with 16 separate mobile teams ensuring availability 24/7.
The Mobile Crisis Response Team approach is a prime example of transforming and shifting from a system of care driven by crisis to one rooted in prevention, ongoing and long-term care, and integration with primary health care.
Crisis interventionists with the program are generally able to spend more time with clients than other first responders, which can be crucial to stabilizing an individual.
Beyond the initial crisis response, the Mobile Crisis Response Teams also follow up with everyone they serve for 30 days after the initial contact to help ensure clients are connected to care that supports their behavioral health and also assesses if an individual could use help getting other services to support their basic needs.
From their launch through late July, the Mobile Crisis Response Teams have responded to more than 2,245 referrals.
Of those, 40 percent have resulted in the individual in crisis being able to remain in the community without the need for more acute care or law enforcement involvement.
More than 515 individuals have been connected to behavioral health resources and services for the first time.
Perhaps surprising to some, most of those helped have also been housed individuals experiencing a crisis, a moment that truly may be the worst day of their life. Only about 18 percent of clients served to date have been people experiencing homelessness.
The majority of clients have been between 26 and 39 years of age, with just over half presenting with schizophrenia or symptoms of psychosis.
These early results indicate a benefit and need for more programs like the Mobile Crisis Response Team, and steps to refine the program continue.
Recent advancements include increased coordination involving 911 calls to all 11 regional law enforcement agencies. This complements the county’s longstanding Access and Crisis Line crisis call center.
Typically, when someone is experiencing a crisis of any kind, it can be second nature to call 911. Yet we know not every call to 911 requires a law enforcement response.
Providing this new crisis response option has been a win-win for clients and emergency personnel, not only freeing up law enforcement, but emergency medical providers who might have otherwise been dispatched to nonviolent, nonmedical emergencies.
With the recent nationwide launch of 988, residents with a San Diego County area code now have a quick-dial option to get connected to the Access and Crisis Line, and if the situation calls for it, subsequently directed to a Mobile Crisis Response Team.
Successful as it may be, the Mobile Crisis Response Team program is just one piece of the body of work that remains to be done to more fully address the region’s behavioral health needs.
Data from the U.S. Substance Abuse and Mental Health Services Administration and 2020 California Health Interview Survey indicate substance misuse and mental health challenges continue to rise, with 1 in 7 San Diegans ages 12 years and older reporting drug use or serious psychological distress in 2020, highlighting the need for broader, more normalized behavioral health care.
County Behavioral Health Services, with its many and expanding list of partners, will continue to push efforts, like the Mobile Crisis Response Team program, forward to help get the most appropriate care to individuals when they most need it.
Our ultimate collective goal is ensuring more sources of stability and support for those most in need.