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Colorado Springs groups work to lessen mental-health related 911 calls, better help those in need

Gazette (Colorado Springs, CO)
Jul 27, 2015

July 27--In one year, Colorado Springs police received 325 calls about just one woman -- most made by neighbors and passersby who were concerned by her erratic and mentally unstable behavior.

Something had to change.

People like her inspired the creation of the city's Community Response Team, which addresses 911 calls that involve suicide threats or mental health concerns and might require a more nuanced response.

CRT is the newest addition to the fire department's Community and Public Health Division, which also created Community Assistance, Referrals and Education Services (CARES) in 2012 to better provide access to resources and healthcare education for 911 "super-utilizers."

This team -- often referred to as CRT or the Mobile Mental Health Unit -- is part of a city-wide shift in how first responders treat mental health calls. It was created in December 2014 to fix a previously inefficient system and to help an under-addressed population of mental health patients.

During a shift last week, the team -- composed of a nurse with the fire department, a police officer and a clinical social worker -- went on calls that illustrated the variety of work its members do, including:

- Checking on a combat veteran suspected of being suicidal and talking him off of an apartment complex roof.

- Helping a woman with bipolar disorder who was causing a disturbance that prompted several 911 calls in one morning. Police officers were on scene, but they left when CRT arrived.

- Following up with a patient to ensure she was doing well.

In its first seven months, CRT responded to 893 incidents for 563 patients, according to Lt. Jane Anderson with the police department. Of those calls, nearly 60 percent had been responded to by police officers who were able to leave once the more appropriately trained CRT arrived.

"The officers are relieved when they hear that CRT is clear and available to come," Anderson said. "They know that (CRT team members) have those skills to deal with the mentally ill and talk to them and calm them down."

Officer Pat Turecachek said the biggest benefit of working with CRT in the field is their specialized expertise, which allows her to more efficiently do her job.

"It has freed us up to handle other calls," Turecachek said. "Even some of the callers (CRT is) familiar with and they know the course of action to take with them. It's certainly a benefit for us."

A better way

This team supplements CARES, the Colorado Springs Fire Department's effort to better provide access to resources and healthcare education for emergency services super-utilizers -- people who call 911 more than 10 times per year.

These super-utilizers may use fire or police department resources in a way that is an unnecessary or as an unhelpful solution to their medical needs.

The two teams, both part of the fire department's Community and Public Health Division, complement each other to create a better way to address 911 calls, officials running the programs said. They also help to better treat people who require specialized attention.

Since it began in 2012, CARES has decreased the average number of calls made by each super-utilizer by 69 percent, according to Jeff Martin, Colorado Springs Fire Department administrator of community and public health.

CRT responds to emergency calls and is equipped to administer on-scene care, while CARES comes along after person has been identified as a super-utilizer. Like people assisted by CRT, many of the super-utilizers CARES works with struggle with mental health problems -- 76 percent of identified super-utilizers have mental health concerns, according to Martin.

"They didn't really know what to do with them," said Mindie Verplank, a nurse and firefighter who works on CRT. "Oftentimes, (the police department) would just take them to the hospital because they didn't feel they were safe to just leave in their situation," which would lead to them being medically cleared, released and sometimes charged with a crime.

This policy was unhelpful to those who "can truly be helped," Verplank said.

Overuse or misuse of the system can be detrimental to a patient, Martin said. He related these patients to debris stuck in a whirlpool.

"Things get caught in the eddies, and we saw these patients caught in there and we wanted to get them back out and move them down the rest of the health care continuum," Martin said.

In early July, Martin said CARES was working with around 600 patients that had been identified as super-utilizers -- but the number fluctuates since the goal is to help each patient off of that list.

Staying in contact

When a super-utilizer is identified and addressed by the CARES team, the process is more leisurely, occurring as an in-home visit or scheduled meeting, and that person remains in the program for an average of 90 days, according to Martin.

Those 90 days are filled by helping a patient find a primary care provider, sorting out transportation options and alleviating the overwhelming nature of the health care system.

"We walk with them through that process," Martin said. "It's not like a one-time visit and we're done."

Similarly, after being introduced to a patient, CRT stays in touch. When the team checked in on the woman they had been dispatched to the previous week, the visit consisted of chatting with her -- asking about her needs and habits -- and making sure she had been improving. It felt personal, especially as the team silently determined who would best take the lead on the visit.

As the nurse and clinical social worker on the team began to chat with the patient, the police officer stepped back -- he wasn't needed, and it would be a mistake to overwhelm the patient, he later said.

On the next call, though, his expertise would be vital.

After checking in on the woman, CRT was dispatched to the combat veteran's apartment, and this time, Sean Collins, the police officer on the team, stepped forward. Collins was able to reason with the man whose home they had been dispatched to, drawing on his own military experience and knowledge of how medical services work for veterans.

With the morning's calls, CRT's goal was met: "Our biggest thing is, we try to talk to them and do what's right," Collins said.

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Contact Ellie Mulder: 636-0115

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(c)2015 The Gazette (Colorado Springs, Colo.)

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