By Cheryl McDonald
Cheryl McDonald is the Crisis Program Director for Adapt Integrated Health Care.
Mental health disorders—including depression, anxiety, post traumatic-stress—comprise the most common health conditions in the United States. It’s estimated that 21% of people every year have a mental health disorder—over twice as many people who have diabetes. Mental health and substance use disorders affect our friends, our families, and are linked to complex societal challenges, including homelessness, involvement with the criminal justice system and costs to health systems. At the invitation of the News Review, we would like to share information about how Adapt’s Mobile Crisis Team works in response to mental health crisis situations in the community.
The Mobile Crisis team was created through a partnership with the City of Roseburg in January 2019 and was originally funded by a federal Justice and Mental Health Collaboration Program grant. Funding from the Substance Abuse and Mental Health Services Administration has allowed the program to expand from 11 to 17 hours a day, and now serves even the most remote areas of Douglas County. When 911 dispatchers receive a report of someone experiencing a mental health crisis, they can request that a Mobile Crisis counselor respond to the call alongside law enforcement officers. The mental health counselor, accompanied by a case manager, works to de-escalate the situation and provide support and resources to the person experiencing the crisis.
Adapt’s Mobile Crisis team primarily responds to 911 dispatch calls when there is a concern or request involving mental health crisis is in the community, including risk assessments, welfare checks, fatal incident response, grief counseling and conflict resolution. The Mobile Crisis vehicle is equipped with basic need items that are offered to anyone receiving crisis services, including tents, sleeping bags, tarps, clothing, food and water. While these items are offered free of charge and with no strings attached, the Crisis Team respects the individual’s right to make their own decision about what they need in any given situation. In other words, the Mobile Crisis Team cannot force someone to accept services, resources or treatment—whether it be medical care, psychiatric care, shelter, or basic need items. The Mobile Crisis team makes every attempt to continue follow-up with individuals receiving crisis services to help them engage in receiving assistance to support their stabilization.
Although Adapt is not involved with routine hospital discharges, our Crisis Pre-Commitment Investigators may be called on to respond to individuals who are hospitalized due to a psychiatric emergency. Skilled staff meet with the individual to determine if the person is at risk of danger to themselves or others due to a mental health diagnosis. When a risk is identified, steps may be taken to initiate a civil commitment proceeding or voluntary admission to an acute inpatient psychiatric facility. In most cases, civil commitment or admission to acute inpatient facility is not warranted. Adapt staff will then work in close coordination with hospital staff and local social service partners to assess the patient’s needs and make connections to resources to ensure safe transitions for patients who are discharged, including the support of family and friends, foster homes, short-term motel stays and shelters. In Douglas County, the scarcity of temporary housing, capacity issues, and admission criteria can be barriers at discharge. Even if shelter is available, patients have the right to refuse help, choosing instead to go to a location of choice, including back to a familiar park or encampment.
Unfortunately, there are no easy answers to the problem of homelessness; it is a multi-faceted issue that impacts individuals across diverse populations and communities. Our community is in need of crisis stabilization resources and housing options that include short-term transitional housing, supportive housing and affordable low barrier permanent housing. Resolving homelessness is not an issue that any one entity can resolve due to the unique needs of the unhoused. In Douglas County, however, city and county representatives, coalitions and housing programs, healthcare and social service agencies are working together to find creative solutions to mitigate the traumatic impact of homelessness on individuals, families and communities. Adapt is committed to working with community partners to identify and address the primary care and behavioral health needs of our community, regardless of a person’s ability to pay. For individuals who are in need of primary care or treatment for mental health or substance use disorders, Adapt offers a full array of services to assist in meeting immediate and long term health needs. For information about Adapt’s programs and services, visit adaptoregon.org. If you or someone you know is in need of mental health or substance use treatment, call 541-440-3532 or 24/7 Crisis Line 1-800-866-9780.