Behavioral Health Landscape: Acronyms, Definitions & Community Questions
This content delves into the landscape of behavioral health, focusing on acronyms, definitions, and community questions. It discusses programs like the Mental Hygiene Transport/Arrest Process, Forensic Intervention Team, and Crisis Intervention Team in the context of law enforcement partnerships and community responses to mental health crises. The narrative raises critical questions about the role of law enforcement, best practices, cultural competency, and system transformations in addressing mental health needs effectively.
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RRH BEHAVIORAL HEALTH RRH BEHAVIORAL HEALTH CALL FOR TRANSFORMATON CALL FOR TRANSFORMATON 1 1
BEHAVIORAL HEALTH LANDSCAPE BEHAVIORAL HEALTH LANDSCAPE ACRONYMS, DEFINITIONS & COMMUNITY QUESTIONS ACRONYMS, DEFINITIONS & COMMUNITY QUESTIONS Acronym Meaning Definition MHT/A Mental Hygiene Transport/Arrest Process governed by NYS Office of Mental Health and Mental Hygiene Legal Services. Outlines the process in which an individual is determined to be at risk or harming themselves or others and is authorized to be transported to a hospital for further assessment to determine if a psychiatric admissions (voluntarily or involuntarily is necessary) Transport initiated by individuals designated by County Office of Mental Health based on scope of work and licensure Transports includes law enforcement and emergency management services ~7,000 Monroe County MHT 2020 YTD (~16% Children & Youth; 45% Rochester Police Department) Community Questions Who is best positioned to respond when individuals in the community are experiencing a crisis due to mental health and/or substance use disorders? What is or should be role of law enforcement? Are there National or Local Best practices? Are response teams providing culturally competent care; what role does implicit bias play in interactions? What is the role of 911 in this process? 2 2
BEHAVIORAL HEALTH LANDSCAPE BEHAVIORAL HEALTH LANDSCAPE ACRONYMS, DEFINITIONS & COMMUNITY QUESTIONS ACRONYMS, DEFINITIONS & COMMUNITY QUESTIONS Acronym Meaning Definition FIT Forensic Intervention Team Forensic Intervention Team (FIT) is an innovative program that partners Monroe County Office of Mental Health clinicians with our County's eleven law enforcement agencies to assist individuals with mental health needs and who have frequent contact with law enforcement. The goal of the program is to increase the individual's connectedness to outpatient services and decrease the utilization of emergency and crisis response services Current Staffing: 5 FTE dedicated to RPD and suburban City Council/County Investment - ~$360K- ensure team is available 24/7 Referrals initiate from law enforcement and only upon law enforcement request Community Questions FIT often presents with law enforcement; presents in police vehicles and may appear to be law enforcement- like, how does this team establish and built trust with community? The addition of a resource does not address a structural issue; what will the role of FIT be in the larger system transformation? How does FIT link into behavioral health care? How does law enforcement determine when to utilize FIT; why is it up to individual decision? 3 3
BEHAVIORAL HEALTH LANDSCAPE BEHAVIORAL HEALTH LANDSCAPE ACRONYMS, DEFINITIONS & COMMUNITY QUESTIONS ACRONYMS, DEFINITIONS & COMMUNITY QUESTIONS Acronym Meaning Definition CIT Crisis Intervention Team The NYS CIT program is targeted at law enforcement organizations with two primary goals: Transform crisis response systems to minimize the times that law enforcement officers are the first responders to individuals in emotional distress. Ensure that when police are the first responders, they have the knowledge, skills and support to de-escalate situations and divert individuals from the criminal and juvenile justice systems, when possible. Law enforcement staff volunteer to be CIT trained. RRH provides on-site training opportunities in psychiatric programming. Community Questions Should CIT training voluntary for law enforcement? Does CIT training and program include an understanding of racial disparities and unconscious bias? 4 4
BEHAVIORAL HEALTH LANDSCAPE BEHAVIORAL HEALTH LANDSCAPE CRISIS SERVICES CRISIS SERVICES Acronym BHACC CPEP ED Open Access Community Response Team Program Name Behavioral Health Access & Crisis Center Comprehensive Psychiatric Emergency Program Emergency Department Open Access Monroe County Community Response Team Program Operator & Location RRH Monroe County: URMC Eastern Region: RRH - CSHC 5 Acute Care Hospitals Delphi Rise 835 W Main Street Rochester NY 14611 Monroe County Department of Health Community-Based 69 Genesee Street Rochester, NY Monday-Friday; 8am-11pm 24/7 24/7 24/7-Telephonic Description: NYS Office of Mental Health (OMH) licensed program that is specific to NYS and includes: Clinical evaluation services assessed and determine appropriate level of care and intervention and linkages to behavioral health services. Includes mobile crisis a mobile multidisciplinary team that includes Master s prepared licensed clinicians, access to psychiatrists, peers (individuals with lived experience) that can go into the community in response to individual crisis in the community. Rochester Regional Health provides emergency services to the Greater Rochester, Finger Lakes and Genesee County regions. Emergency services are provided by teams of board-certified emergency medicine physicians supported by specially trained nursing staff and technicians. Evaluates and makes a referral for the appropriate level of care: Detoxification Inpatient Outpatient * Coordinates transportation to the treatment facility (even if it s out of Monroe County). * Provides peer support. * Provides substance use education and information as well as Narcan training and distribution. Community Response Team includes team of Peers (individuals with lived experience in recovery), available to present in community to support individuals in need. Serving adults in crisis as a result of mental health or substance use disorder. Individuals can present to the facility to be assessed and determine appropriate level of care and intervention and linkages to behavioral health services. Mobile Component two person team that presents in the community to respond to individual crisis. Jail Diversion Program program embedded in BHACC in which law enforcement can transport an individual with behavioral health needs directly to BHACC for assessment and linkage as opposed to initiating criminal charges Monroe County Department of Health has communicated intent to hire: Addiction Director Data Analyst Eligibility: Must be 12 years of age or older Definitions: RRH= Rochester Regional Health URMC= University of Rochester Medical Center 5 5
COUNTY EXECUTIVE DIRECTIVE COUNTY EXECUTIVE DIRECTIVE CALL TO ACTION CALL TO ACTION System Transformation Transform broken crisis services access points and ongoing linkage to care Coordination Require better coordination across existing behavioral health services Resource Investment City & County ~$360 Investment FIT 24/7 Response To not just increase resources to mental health services or to offer new programs, but to really think about how to systematically re-design the system, focusing on racial and structure equity. Commission on Racial & Structural Equity (RASE) (https://www.rocrase.com) Mental Health & Addiction Committee tasked with making recommendations regarding this work 6 6
RRH BEHEAVIORAL HEALTH RRH BEHEAVIORAL HEALTH LAW ENFORCEMENT EXISTING PARTNERSHIP LAW ENFORCEMENT EXISTING PARTNERSHIP Eastern Region: CPEP Law Enforcement Collaborative Clifton Springs Hospital & Clinic CPEP mobile team initiated a collaborative response program with Ontario County in which law enforcement can request a member of CPEP team to present with them in response to calls with a behavioral health component. Within this role, CPEP team members can initiate evaluation of current crisis, make determinations regarding whether a mental hygiene transport is necessary, de-escalate situations and provide linkages and ongoing support to community members in need. An OMH endorsed telehealth component has also been added (late 2019) as an option for the CPEP clinician to intervene remotely to a scene where law enforcement is physically present at the scene of a mental health crisis. Monroe County: Jail Diversion Program: As part of the BHACC Jail Diversion program, law enforcement can bring individuals with non-violent offenses directly to BHACC for evaluation, support and linkages to care. This program ensures a plan of care is developed that is individual specific and BHACC staff continue to work with patients to track engagement in care as needed. This includes individuals with substance use disorders or picked up on the community due to substance use or intent to buy/sell. CIT Training: As part of the CIT training for law enforcement, police officers enrolled in the training shadow on psychiatric inpatient units and within the BHACC, allowing them to better understand mental health symptoms and recovery. Preventing & Managing Crisis Situations: All ED and Inpatient staff members working in psychiatry are trained in this model. RRH BH maintains number of trainers and regular trainings in this modality within the department. 7 7
