Mental Health Trust Authority evaluates a “Crisis Now” model for Alaska

On August 6, the Alaska Mental Health Trust Authority held a stakeholder meeting along with the Department of Health and Social Services (DHSS), the Alaska State Hospital and Nursing Home Association (ASHNHA), Providence, and Southcentral Foundation to review findings and recommendations from two studies on Alaska’s acute behavioral health system. 

A key topic of conversation during the stakeholder meeting, and a subject we heard referenced multiple times during the 2019 Alaska State of Reform Conference on October 2, was the incorporation of a “Crisis Now” model of care in Alaska.  

 

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The Crisis Now stabilization model incorporates several components to divert individuals experiencing a mental health crisis away from jails and the emergency department. The model utilizes a crisis call center to serve as a hub to coordinate all crisis encounters, 24/7 mobile teams to meet people in crisis, as well as short-term crisis stabilization facilities for individuals in need of additional support and observation. 

One of the studies discussed during the August 6 meeting evaluated policies and processes that might address Alaska’s backlog of competency to stand trial evaluations and restoration in the forensic psychiatric system. 

One recommendation to reduce the backlog is to reduce the inflow of individuals experiencing a mental health crisis into the criminal justice system, and to reduce the rate of those that repeatedly return. 

“Alaska lacks services to divert people experiencing mental illness and psychiatric crisis from the criminal justice system and has an insufficient supply of treatment and behavioral management programs as well as programs that address basic needs,” reads the report. 

“Individuals end up cycling through the system and correctional settings become the de facto placement for people with mental illness. This is not only poor care for the individual that often leads to more trauma and a worsening of symptoms, it is also expensive and overburdens safety net providers such as hospital emergency departments, police, fire and EMS services, and the mental health treatment resources within Department of Corrections.”

To address this, the report recommends implementing a Crisis Now crisis stabilization model in Alaska in the next 6 months to 2 years.  

States that have already adopted the Crisis Now model are seeing savings in money and resources. According to a presentation delivered during the meeting, in 2016, Phoenix law enforcement transferred 22,000 individuals directly to crisis facilities and mobile crisis, without visiting the emergency department. This saved hospital EDs $37 million in avoided costs, reduced potential state inpatient spend by $260 million, and saved the time equivalent of 37 FTE police officers. 

The report states that the Alaska Mental Health Trust Authority and the DHSS Division of Behavioral Health are already in communication with Recovery International (RI), a leader in the Crisis Now model. 

“Next steps include contracting with RI to provide technical assistance to identify recommendations for Anchorage and Mat-Su’s behavioral health crisis system. Long term needs include funding to implement the recommendations,” adds the report.