Stark County’s Mobile Response Youth Program Michele Boone, LPCC-S, CDCA, Director of Clinical Services at StarkMHAR Jeffrey Allen, LISW-S, LICDC-CS, CEO at Alternative Paths Clifford Hall, Sergeant at Stark County Sheriff’s Office September 15, 2018

What does StarkMHAR do? Vision Hope, wellness and recovery for everyone Mission StarkMHAR supports wellness and recovery through innovation in funding, collaboration, education and advocacy What we do Advance public mental health and addiction prevention, treatment and recovery in Stark County

Program Beliefs Mobile Response Youth Program (MRYP) serves birth to age 18 Mobile response requests can be made by any individual or any system at any time No request for service refused Come from place of yes Language is important

Beliefs continued Intervention aim is to avert hospitalization and out of home placement of youth in crisis Family and natural supports inclusion On-site response requests are met within 30 minutes (current average 24 minutes), with exceptions for outlying parts of county

Program Structure Team serves all of Stark County .5 FTE Manager, 1 Supervising Clinician, 3 Clinicians, 2 Case Managers (CPST), and 1 Family Peer Supporter Funded and oversight though Stark County Mental Health and Addiction Recovery SAMHSA System of Care grant, OhioMHAS Strong Families grant, Medicaid, Insurance, Local levy

Program Components 3 Response Pathways Rapid Accelerated Supportive Follow up contacts Mobile Response request Emergency Department request

Mobile Response Youth Program (MYRP) Response Protocol Call Crisis Hotline: 330-452-6000   Supportive Response Pathway Accelerated Response Pathway Rapid Response Pathway Response Time Within 12 Hours Within 24 Hours Within 30 Minutes Response Indicators Low degree of distress Not at risk to self or others Low risk due to mental health symptoms (e.g. delusions, psychosis etc.) Social isolation Would benefit from telephone engagement and support Acceptance of treatment options Would benefit from referral to behavioral health care services and social service agencies Moderate degree of distress Caller requests delayed activation Parent or school personnel requests assistance during a specified timeframe Rapidly increasing mental health symptoms Moderate risk due to mental health symptoms (e.g. delusions, psychosis etc.) Moderate emotional distress Requires priority behavioral health triage High degree of distress Reports of high-risk behaviors Individual presents as a danger to self or others Acute suicidal ideation High risk due to mental health symptoms (e.g. delusions, psychosis etc.) Substantial risk of physical harm to self Marked inability to provide basic physical needs due to mental illness Significant emotional distress Refusing voluntary treatment options and may benefit from inpatient hospitalization Requires Rapid Co-Response Response Team MRYP Counselor Family Peer Recovery Supporter Law Enforcement if indicated Response Elements Collaborative Phone Consultation Non-Face-to-Face Response Engagement Call Behavioral Health Triage Service Navigation Care Coordination and Linkage Telephone Support Coordinated Co-Response (as indicated) Face-to-Face Response (home or community settings) Crisis Mental Health Assessment (as indicated) Family Peer Recovery Support Services Coordinated Rapid Co-Response Pre-Hospital Screening Application for Emergency Admission for individuals 18 years or older Collaborative Disposition Plan

Mobile Response Youth Program (MYRP) Response Protocol Call Crisis Hotline: 330-452-6000 Supportive Response Pathway Accelerated Response Pathway Rapid Response Pathway Response Duration Up to one week Up to 30 days; may be extended as needed Recovery Response Scheduled Follow-Up Calls by Family Peer Recovery Supporter at the discretion of the MYRP Counselor. Referral to the MYRP Counselor as Indicated for Reassessment of Needs Scheduled Face-to-Face Encounters by MRYP Counselor and/or Family Peer Recovery Supporter in Home and Community Settings Frequency of Encounters Collaboratively Developed Between Individuals Served and MRYP Counselor Scheduled Follow-Up Calls by MRYP Counselor and Family Peer Recovery Supporter Collaborative Face-to-Face Discharge Encounter with MRYP Counselor and Family Peer Recovery Supporter  

Components continued Behavioral health consultation, crisis management, assessment, care plan, linkage, and postvention Embedded clinical practices C-SSRS, Brown Stanley Safety Plan, CAMS

Components continued Suicide and community tragedy postvention response Suicide cluster and contagion

Community Partnerships – Law Enforcement Diversion opportunity How to engage law enforcement and get their buy in for use of mobile response Wait time can be a downside Consideration of time on scene for law enforcement

Community Partnerships – Law Enforcement Ability to engage with people in crisis CIT or MHFA trained law enforcement officers Person may talk more freely with crisis staff Overall, benefits of mobile outreach outweigh potential downside

Implementation Additional Community Partnerships Data Systems – Education, Developmental Disabilities, Dept of Job & Family, Justice, Medical – Emergency Departments Community organizations Data Tracking elements

Disposition – January to July 2018

Implementation continued Roll out of the mobile service Under promise and overdeliver Staffing patterns and training Use of data Ongoing training and consultation

Calls by Hour – Jan. to July 2018

Response by Day – Jan. to July 2018

More on implementation Ongoing marketing outreach activities Outreaches vs calls for service per area Cultures represented in calls for service Billing Third party payor Non-Medicaid funds Grants

Contact us Michele Boone, LPCC-S, CDCA, Director of Clinical Services at StarkMHAR Email: michele.boone@starkmhar.org Phone: 330-455-6644 Jeffrey Allen, LISW-S, LICDC-CS, Executive Director at Alternative Paths Email: jallen@alternativepaths.org Phone: 330-725-9195 Clifford Hall Sergeant at Stark County Sheriff’s Office Email: 44@starksheriff.org Phone: 330-430-3800