The Alaska Mental Health Trust Authority, Department of Health and Social Services (DHSS) and other partners have been evaluating the existing crisis system of care, and working to identify models which can demonstrate improved outcomes for those in mental health crisis. Not unique to Alaska, we rely heavily upon public safety officials/first responders and hospital emergency rooms as a primary if not the only disposition for people in mental health crisis.  The lack of the proper levels of care in the community contributes to psychiatric boarding of patients in hospitals and other institutions, and diverts critical public safety resources away from crime prevention and other law enforcement activities.

In partnership with DHSS and other community partners,  the Trust has been working to conceptualize the implementation of the Crisis Now model in three Alaska communities: Anchorage, the Mat-Su, and Fairbanks.  Recognizing that Alaska’s current system to manage individuals in crisis is not adequately meeting the need, the Crisis Now model seeks to best apply existing resources, to expand the psychiatric crisis continuum to improve outcomes for those in crisis, and to ease stress on first responders, public safety officers, and hospital emergency rooms.

The Crisis Now model has three components and is designed to optimize resources to prevent suicide, and the overuse of emergency rooms and correctional settings to provide the best supports for individuals in crisis. The components of the Crisis Now model include:

  • A regional or statewide crisis call center that coordinates in real time with the other components
  • Centrally deployed, 24/7 co-response mobile crisis outreach teams (clinician and peer) to respond in-person to individuals in crisis
  • Short-term, “sub-acute” 23-hour observation and short term residential crisis stabilization center for individuals to be supported and observed, not hospitalized or institutionalized.

As a part of examining  the Crisis Now model, the Trust has led a stakeholder outreach effort in Anchorage, Fairbanks, and the Mat-Su, along with contractor RI International (RI), to ascertain how such a model could be implemented.  The Trust also led a recent site visit to Maricopa County, AZ, during which Trust leadership, representatives from DHSS, and other key agencies representing  Alaska’s behavioral health system toured that community’s infrastructure supporting the Crisis Now model of serving individuals in psychiatric crisis. 

These efforts have culminated in a report that examines the assets and systems needs to support the Crisis Now components in the three identified communities and also considers what elements of the model could be implemented statewide.  The report identifies existing gaps in services, and examines demand, optimization, feasibility and conceptual costs of implementing this model, as well as the policy and regulatory steps that should be considered.

The Trust intends to use the report to advocate and support the implementation of the recommendations.

Link: Crisis Now Consultation Report, RI International, December 2019

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