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Saving lives are crisis responders' passion

Tribune - 8/4/2021

Aug. 4—Every moment across the region, tireless mental health professionals answer calls for help from people of all ages who are experiencing a mental health crisis.

Terros Health's team of frontline heroes meet these individuals wherever they are to provide assessment, intervention and connection to ongoing care resources.

For Mesa resident Molly Fisher-Foster, saving these lives is its own reward.

"The reward comes from within," she said. "There are days where I go home and know that I was able to make a positive difference in someone's life."

Fisher-Foster has been at the center of delivering mobile crisis services for Terros Health for more than 23 years, addressing mental health emergencies involving suicidal thoughts, self-harm, potential harm to others, trauma, loss, substance abuse, increased depression or anxiety, and more.

Once dispatched, Fisher-Foster works with a partner to stabilize individuals in crisis and provide mental health services to them no matter their location or situation.

"Every day is different," she said. "When you think you've seen everything you haven't because there's another day."

Fisher-Foster recalled how once an elderly woman with physical and mental health conditions walked out of a skilled nursing facility in Massachusetts and boarded a bus for Arizona.

The woman, who had feeding tubes, was unable to take her medications or had had no food or water for four days. After receiving the call, Fisher-Foster was able to meet her and get her the help she needed.

It's a taxing job, but one that reaps big rewards when there's an opportunity to change someone's life, she said.

She compares situations like these to solving a puzzle, putting all of the pieces together to help people become whole again.

Fisher-Foster especially does well with grief calls, she said.

"People who are suffering and in crisis or in grief will always remember what you said to them, how you treated them and how they felt when you left," she said.

Fisher-Foster emphasized the importance of being present and unafraid.

Listening to people and providing compassion and companionship is key. She has stayed with individuals as their loved ones passed, joined in prayer circles and attended funeral services.

"It's important when we can leave knowing we've provided some comfort and help to someone," she said.

It is the work of frontline heroes like Fisher-Foster that has contributed to the success of mobile crisis response in Arizona.

Thanks to their work — as well as continuous system improvements, extensive training and collaboration — Arizona and Maricopa County have become gold standards in mobile crisis response.

"We have the largest, most supported and well-funded crisis system in the country," said Justin Chase, president and CEO of Solari Inc.

Trained clinicians answer calls to stabilize and resolve challenges that individuals face, but in the event that they are not able to stabilize the situation over the phone mobile crisis teams are dispatched.

Maricopa County's community stabilization rate — the benchmark for keeping mobile crisis patients out of the hospital — now stands at 80 percent compared with a national guideline of 70 percent.

About 2000 mobile crisis teams are dispatched per month throughout the Valley with an average response time of fewer than 30 minutes, said Pat Norris, clinical manager of Terros Health.

An 80 percent stabilization rate essentially means that 1,600 people don't go to the hospital every month. This takes pressure off inpatient facilities by diverting people who don't need to be there.

One reason Maricopa County's mobile crisis system is so successful is their two-clinician team model, Chase said. Other models like the co-responder model where a police officer goes out with a clinician have a stabilization rate below 50%.

"There's a difference when you bring a gun and a uniform to a scene," Chase said. "There's a power dynamic there so the success rate is less."

Other crisis systems may be left with their last resort of dispatching law enforcement, which is not in the best interest of the individual or a safe environment, Chase said. Those in crisis may end up in emergency departments or facility-based care that have lower success rates.

This experience can also be demoralizing or dehumanizing for the individual as critical compassion is lacking.

"Our teams are independent," said David Obergfell, senior director of crisis services at Terros Health. "We partner with first response upon request and as part of the system of care but we are an independent unit that can respond anywhere without law enforcement to deliver psychiatric assessment, health intervention, connections to care and on-site stabilization support."

Obergfell said their two-person mobile response teams are not pressure-bound or time-bound, so they can stay as long as needed to understand the nature of the crisis, listen and de-escalate the situation.

They assess the individual's needs to see what services can be applied at the right time and partner with them to change how things are operating in their current environment for better long term outcomes.

"Trust is critical to establish a connection with the person you're working with," Obergfell said. "We build rapport and trust by introducing ourselves and listening. It's not rigid, it's not a checklist."

"They can drop their guard and feel safe sharing information."

Another important aspect of mobile

crisis success is following up with individuals. "A crisis episode isn't just the time we come out," Obergfell said. "There's a next day."

Terros Health follows up the next day with the people they helped to see how they are, remind them that they are not alone, and provide any additional care to prevent another crisis from happening, Obergfell said.

"We're not just here to save you, but we're going to partner with you," Obergfell said. "We don't save people, we join people in recovery."

Terros Health and Solari have taken steps to strengthen partnerships with law enforcement, schools, first responders and municipalities; develop a cutting-edge clinical model that guides response in the field; and create a state-of-the-art disaster response program in the event of shootings, fires, school incidents and other critical events, Obergfell said.

In a crisis? Call 1-800-631-1314 for help


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