Mobile response teams put clinicians at the scene

FINDLAY — Historically, law enforcement have been the ones to respond when someone calls about a loved one having a mental health crisis. Today, that is changing, with efforts expanding throughout Ohio to instead dispatch a team of mental health professionals. Kati Rinker, crisis supervisor at the Findlay Family Resource Center, oversees two mobile crisis response teams, one serving adults and the other youth. Often they go out when someone calls the 988 crisis line, but Rinker said area law enforcement officers sometimes also call her team directly when they're on the scene of what is clearly a mental health crisis and not a crime. "This is our lane," she said. "This is like our bread and butter, what we do. ... We do it all day long, and we're trained to do it. "I feel it puts less of a burden on law enforcement (and) the health care system," Rinker said. As one example, her team can assess who needs to go to the emergency department and who does not, preventing someone from being taken there unnecessarily and making sure ER beds are available for those who need them. The FRC has had its youth Mobile Response and Stabilization Services program since 2021, she said. This team responds to youth aged 20 and under who are experiencing overwhelming mental, emotional or behavioral distress or trauma that is impacting their ability to function within their family, school or community. "It is very much a 'you define the crisis,'" Rinker said. That is, sometimes the youth is experiencing suicidal or homicidal ideation, but other times it's a family conflict or something else that may seem relatively minor, but is causing distress for the youth. When a call comes in, a team of two responds, starting with a crisis assessment and safety screening. They work on creating a safety plan or a coping skills plan, unless it's clear that the youth needs to be admitted to a hospital. (Youth psychiatric hospital beds are not available in Hancock County, so the youth must be transported elsewhere.) The family is eligible for up to 42 days of follow-up care to stabilize the situation. During this time, the mobile response team helps them develop the tools they need. They are seeing more concerns with children, and the children are getting younger, Rinker said. "The schools call us almost daily," she said. Hancock County also created an adult mobile crisis program after the Hancock County Board of Alcohol, Drug Addiction and Mental Health Services saw a need. While the youth program defines "crisis" broadly, the adult program responds specifically to suicidal or homicidal ideation or severe, persistent mental illness. Rinker said the process is the same. The crisis response team screens the individuals and develops a safety plan when needed. Adults do not qualify for the 42 days of stabilization, but the team attempts to follow up three times afterward to see how they are doing. Whenever the Findlay Police Department or Hancock County Sheriff's Office gets a crisis intervention team (CIT) call, the adult mobile response team provides outreach to those individuals afterward as well. While the goal of the mobile response team is to avoid having to call the police, Rinker said sometimes they do need to have law enforcement accompany them, simply to ensure safety. Rinker said the mobile response team functions in a sense like a firehouse. "Our bags are hanging there, and we grab them and go," she said. Mobile crisis response for all ages is available from 8 a.m. to 8 p.m. The program is free to those it serves, funded through state Medicaid dollars. The Ohio Department of Behavioral Health has been recently pushing to expand mobile response programs for all ages statewide. A group of 23 northwest Ohio counties, led by Lucas County, recently received a $2.5 million state grant for a pilot program serving adults. Last year, Gov. Mike DeWine announced expansion of youth mobile response statewide. The Mental Health and Recovery Services Board of Seneca, Ottawa, Sandusky and Wyandot counties piloted a mobile crisis team around five years ago in Sandusky County. Like Hancock County's program, this one started before there was a state initiative and state funding. Executive Director Mircea Handru said law enforcement kept saying they were being called to scenes that were not criminal but involved mental health concerns. Sheriffs were telling him jails were not the appropriate places for these individuals, but often they were taken there for their own safety. They were looking for another approach. So, with the help of the sheriffs, the MHRS board created a nonprofit. From 8 a.m. to 11 p.m., vehicles with two individuals each go out into the community to address these crises. After conducting a screening, the team may transport the person to an inpatient psychiatric facility if needed, or can leave them with a safety plan, or with an appointment already scheduled for the following day. Handru said the mobile crisis allows clients to receive better care and avoid incarceration. "It gives more rapid access to care, which is great," he said. The team is not yet available 24/7, but all law enforcement agencies in the district have access to the software the mobile crisis team uses, and can leave notes if they encounter a mental health crisis in the middle of the night so Handru's team can follow up. Handru noted that success is hard to measure. Each county may report that a certain number of residents died by suicide or overdose in a given year. "But you never have the data to say, 'by the way, 72 were saved.' ...Sometimes you just don't know," he said. But he said his team believes they are making a difference, and those in this work are passionate about it. "We have a few champions that have been with us almost since day one," he said. Handru said other counties have visited to learn about the mobile crisis team with the hope of replicating it. He said this approach benefits first responders, people experiencing crises and the community as a whole. "If we really believe in quality of care for clients with mental health or addiction, then you have to have it," he said. "You just have to have it." Both Rinker and Handru encouraged people to call 988, the crisis line, to reach a mobile response team. It's also possible to text or chat at https://chat.988lifeline.org/ If it's a crime or someone needs immediate medical attention, always call 911, Handru said. "But if it's behavioral health, call 988," he said. Rinker said the work can be challenging, so those on her team need to prioritize self-care. But it's rewarding to stand with families on the other side of a crisis, she said. "Maybe they're alive today because we were a small piece of that story… There's nothing better than seeing lives flourish because we were a piece of it," she said. "A small piece, but a piece."