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First Responder Collaborations with our Comprehensive Psychiatric Emergency Programs

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Page 1: Harris Center for Mental Health and IDD

First Responder Collaborations with our Comprehensive Psychiatric Emergency

Programs

Page 2: Harris Center for Mental Health and IDD

Psychiatric Emergency

Services PES at the

(Neuropsychiatric Center-

NPC)

Mobile Crisis

Outreach Team

(MCOT)MHMRA Helpline

Crisis Intervention

Response Team (CIRT)Critical Time Intervention

(CTI)

Crisis Stabilizatio

n Unit(CSU)

Crisis Residentia

l Unit(CRU)

Chronic Consumer Stabilizati

on Initiative

(CCSI)PEER

Supports

CPEP Program Timeline

CIRT Expansion to

include Harris County

Sheriff’s Office

Homeless Outreach

Team (HOT)

20151986 1999 2002 2003 200

82009

Projects for Assistance

in Transition

from Homelessness (PATH)

20041990

Harris County

Psychiatric Intervention (HCPI)

BranardCo-

Occuring Disorders (COD)

2011

Post Hospitalization (PHCRU)

&911

HelpLine Project

2013

Interim Care Clinic (ICC)

Page 3: Harris Center for Mental Health and IDD

Psychiatric Emergency Services (PES)

Page 4: Harris Center for Mental Health and IDD

Psychiatric Emergency Services (PES)

Open 24 hours, 365 days per year for psychiatric crises and emergencies:

• Consumers can be held up to 23 hours for observation • Voluntary and involuntary admissions • Walk ins accepted for all ages and must be in mental health crisis • Assessment, medication and stabilization services • Provides referrals and linkages with continued mental health

treatment, both inpatient and outpatient

Page 5: Harris Center for Mental Health and IDD

Psychiatric Emergency Services (PES)

FY09 FY10 FY11 FY12 FY13 FY140

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

4,311 4,828 5,510 5,695 6,3438,705

6,7429,075 8,768 8,124 6,528

3,755

PES Visits by Admission Status

FY Total INV Admits FY Total VOL Admits

Page 6: Harris Center for Mental Health and IDD

Psychiatric Emergency Services (PES)

2007 2008 2009 2010 2011 2012 2013 20140

1,000

2,000

3,000

4,000

5,000

6,000

7,000

3,030 3,616 4,0544,908 5,032 5,179 5,783 6,034342

256325

457 476 539560 608

Law Enforcement

ADULT KIDS

Page 7: Harris Center for Mental Health and IDD

Law Enforcement Collaborations

• Crisis Intervention Response Team (CIRT)

• Chronic Consumer Stabilization Initiative (CCSI)

• Homeless Outreach Team (HOT)

• 911 Crisis Call Diversion Program

Page 8: Harris Center for Mental Health and IDD

Crisis Intervention Response Team (CIRT)

Page 9: Harris Center for Mental Health and IDD

Crisis Intervention Response Team (CIRT)

• Program partners a CIT officer or deputy with a licensed mental health clinician from the Harris Center

• 10 Teams with Houston Police Department (HPD• 10 Teams with Harris County Sheriff’s Office (HCSO)• Only program in Texas• One of three programs nationally

Page 10: Harris Center for Mental Health and IDD

CIRT Overview

• Hours of Operation: 24/7 except major holidays• Respond to calls involving the most serious

mentally ill individuals• Conduct proactive and follow-up investigations

on chronic mentally ill individuals

Page 11: Harris Center for Mental Health and IDD

CIRT Overview, cont.

• Respond to SWAT and Hostage Negotiation Team calls as a resource for the scene commander• Prisoner assessments at the city jails• Transport involuntary individuals in crisis from

local MHMRA clinics to emergency psychiatric facilities

Page 12: Harris Center for Mental Health and IDD

Chronic Consumer Stabilization Initiative (CCSI)

Page 13: Harris Center for Mental Health and IDD

Chronic Consumer Stabilization Initiative (CCSI)

• CCSI is a collaborative effort between the Houston Police Department and the Harris Center

• CCSI was designed to identify, engage and provide services to individuals who have been diagnosed with serious and persistent mental illness and who have had frequent encounters with the Houston Police Department

Page 14: Harris Center for Mental Health and IDD

Chronic Consumer Stabilization Initiative

Overview• Hours of Operation: M-F 8am-5pm (on call 24/7)• Case Managers maintain case load size of 15

• Reduce the number of interactions for clients with serious mental illness with the Houston Police Department

• Identify unmet needs and barriers in the community• Link and coordinate clients with needed mental health treatment and

psychosocial services• Reduce the number of crisis admissions to local hospitals and

emergency rooms

Page 15: Harris Center for Mental Health and IDD

CCSI Successes

Since its inception the program has

• Decreased the number of interactions between CCSI clients and the Houston Police Department by approximately 53%

• Decreased admissions to Psychiatric Emergency Service (PES) by 24%

• Decreased admissions to Harris County Psychiatric Center (HCPC) by 25%

Page 16: Harris Center for Mental Health and IDD

AWARDS AND RECOGNITION2010- IACP Community Policing Award

2015- Michael Shanahan Award for Excellence and Public/Private Cooperation

Finalist 2010- Herman Goldstein Award for Excellence in Problem-Oriented Policing

2011-2016 Simmons Foundation Grant

2013 -2014 Frees Foundation Grant

Page 17: Harris Center for Mental Health and IDD

Homeless Outreach Team(HOT)

Page 18: Harris Center for Mental Health and IDD

The goal of HOT is to reduce the number of homeless persons by helping them overcome the obstacles that have resulted in them living on the streets. The team is relationship oriented and has established an excellent working relationship with the homeless population, government agencies and the provider community.

Homeless Outreach Team(HOT)

Page 19: Harris Center for Mental Health and IDD

• Partners case managers with HPD Officers on the streets of Houston, working with homeless individuals.

• The Harris Center case managers work with homeless individuals who also experience a mental illness to assist with housing, access to social services and to engage individuals in mental health treatment

• Once opened to the Harris Center, the client is assigned a Rehab Worker or Case manager attached to one of the clinics for ongoing support

Homeless Outreach Team(HOT)

Page 20: Harris Center for Mental Health and IDD

Hours of Operation: M-F 7am-6pmThe Team Members:• Build personal relationships with those living on the streets and

to find out why those living on the streets are not taking advantage of the available help

• Network and build relationships with the providers in order to find out what help is available

• Match the person with the provider and then assist them though the process to the best of our ability

Homeless Outreach Team Overview

Page 21: Harris Center for Mental Health and IDD

911 Crisis Call Diversion Project

Page 22: Harris Center for Mental Health and IDD

911 Crisis Call Diversion Project Mission Statement

• Pairing the skills of mental health phone counselors with the 911 system to divert consumers not at imminent risk away from any police interaction and toward more appropriate levels of care, in addition to de-escalating consumers before police involvement on scene, is consistent with the strategic directions of both The Harris Center for MH and IDD and The Houston Police Department.

Page 23: Harris Center for Mental Health and IDD

23

Vision Statement

• The collaboration with 911/HPD will reform the way consumers are connected to mental health resources and diverting them away from the police/criminal justice system and de-escalating callers in crisis to aid in public safety before police arriving, simultaneously reducing the recidivism rate of police interaction.

Page 24: Harris Center for Mental Health and IDD

24

Key Players

• The 911 Crisis Call Diversion Program is a collaboration of The Harris Center for Mental Health and IDD Services - HelpLine, Houston Police Department – Mental Health Division, and the Houston Emergency Communications Center.

• The HEC Center processes approx. 9,000 calls for service daily.

Page 25: Harris Center for Mental Health and IDD

25

Brief History• Building on the successes of prior HPD/MHMRA

collaborations (such as the Crisis Intervention Response Team, Chronic Consumer Stabilization Initiative, and Homeless Outreach Team) and the steady increase of mental health related calls for service through 911, the idea was formulated to look at diverting non-imminent risk calls that concern mental health issues away from HPD and to Harris Center Phone Counselors.

Page 26: Harris Center for Mental Health and IDD

Psychiatric Emergency

Services PES at the

(Neuropsychiatric Center-

NPC)

Mobile Crisis

Outreach Team

(MCOT)MHMRA Helpline

Crisis Intervention

Response Team (CIRT)Critical Time Intervention

(CTI)

Crisis Stabilizatio

n Unit(CSU)

Crisis Residentia

l Unit(CRU)

Chronic Consumer Stabilization Initiative

(CCSI)PEER

Supports

CPEP Program TimelineCIRT

Expansion to include Harris

County Sheriff’s Office

Homeless Outreach

Team (HOT)

20151986 1999 2002 2003 200

82009

Projects for Assistance

in Transition

from Homelessness (PATH)

20041990

Harris County

Psychiatric Intervention (HCPI)

BranardCo-

Occuring Disorders (COD)

2011

Post Hospitalization (PHCRU)

&911 HelpLine

Project

2013

Interim Care Clinic (ICC)

Page 27: Harris Center for Mental Health and IDD

27

911 Call Statistics• HPD Mental Health Related Calls for Service:• 2010 25,105• 2011 25,489• 2012 27,655• 2013 29,272• 2014 32,544

• Typically, less than 1% of this call volume result in criminal charges.• Between 9,000 and 12,000 calls coded as mental health related in 2014 were cleared

as “information only” which means that an officer took no action on the scene.

Page 28: Harris Center for Mental Health and IDD

28

Program Phases• Phase 1 – 0 – 6 months – Project Clinical Team Lead will work

directly with HEC, HPD, and The Harris Center to solidify processes at all levels and prepare for the team to go live in Phase 2. During this phase the Clinical Team Lead will also be available to provide on-site crisis call de-escalation for crisis calls in progress while an officer is in route.

• Phase 2 – 6 months – 24 months – Phone Counselors will take calls at HEC as routed to them by the Call Takers. Clinical Team Lead will do quality assurance on all calls, Data Analyst will track data, adjustments will be made as needed.

Page 29: Harris Center for Mental Health and IDD

29

Funding• 2 years of funding has been awarded for this project from private

philanthropy.• Year 2 of funding is contingent on submitting a sustainability plan

to these funders for how the project will be funded past the end of the pilot.

• 3 years of partial funding has been awarded through a Department of Justice grant.

• We are working with city, county and state government to form a sustainability plan for permanent funding.

Page 30: Harris Center for Mental Health and IDD

30

For more information please contact:

Barbara DawsonDeputy Director, CPEP

The Harris Center9401 SW FreewayHouston, TX 77074

[email protected]

rg

Jennifer BattleHelpLine DirectorThe Harris Center9401 SW FreewayHouston, TX 77074

[email protected]