Mental Health Crisis Triage

Increasing California’s capacity to respond to mental health crises by increasing the number of crisis triage personnel, supporting crisis stabilization efforts, and assisting mobile crisis support teams

Triage

The Investment in Mental Health Wellness Act authorized a competitive grant program to pay for county-run or sponsored entities to develop mental health crisis support programs.

The legislation calls for intensive case management to reduce unnecessary hospitalizations, decrease incarcerations, and improve the experiences of those needing help while serving them in the least restrictive manner possible.

Experience has shown that increasing outpatient and crisis services can reduce costs associated with emergency room and inpatient care and better meet the needs of people experiencing mental health crises.

“The collaboration and partnership that we now have between the Sheriff’s Department and Behavioral Health made it possible to keep track of our consumers and continue to build a rapport and bond each time they were in crisis.”
Brenda Hanley

Case Manager III, Calaveras County

Goal/Opportunity

Triage personnel may be the first mental health professionals in contact with someone requiring crisis intervention. At other times, mobile crisis response teams will be the first point of contact for someone in distress, with triage personnel coming second. This grant program is to help crisis responders connect those having a mental health episode with wellness, resiliency, and recovery-oriented programs that offer the least restrictive settings appropriate for their needs.

Crisis response workers confront a range of needs and refer people needing help to a wide variety of programs, including Medi-Cal reimbursable targeted case management. Some individuals may require hospitalization, while others may need only brief therapeutic interventions in which triage staff are available to listen and provide support. One of the goals of triage services is to provide support when and where it is needed so that individuals will not require hospitalization but can be stabilized and linked to less urgent levels of care.

Triage personnel may provide services anywhere in the community and ideally will be located at various access points best suited to providing immediate crisis interventions, such as schools, community clinics, emergency departments, homeless shelters, and jails.

Background

Established by Senate Bill 82 in 2013, the Investment in Mental Health Wellness Act was signed into law by Governor Jerry Brown in June 2013. It provides grant funds to improve access to and capacity for mental health crisis services. The grant program provides funds to California counties to increase crisis intervention, stabilization, treatment, rehabilitative services, and mobile crisis support teams.

Supported services reduce costs associated with expensive inpatient and emergency room care, reduce incarceration, and better meet the needs of people experiencing mental health crises in the least restrictive manner possible.

Project Milestones

Recommendations

Currently, not all counties have an array of crisis response services specifically intended to divert people experiencing mental health distress from unnecessary hospitalizations to less restrictive, more recovery-focused levels of care. That lack leaves people in crisis with little choice but to go to emergency rooms for assistance and risk unnecessary hospitalization.

Additionally, law enforcement personnel must stay in emergency departments with those needing mental health care until a less intensive and less restrictive setting is found.

SB 82 cited evidence from hospitals reporting that 70 percent of people taken to emergency rooms for psychiatric evacuation could be stabilized and transferred to a less intensive level of crisis care.

Increasing access to effective outpatient and crisis services helps reduce costs associated with inpatient and emergency room hospital care and to meet the needs of people in a mental health crisis in the least restrictive manner possible.

Expected Outcomes

Improving the client experience, achieving recovery and wellness, and reducing costs

Crisis response and triage professionals will engage with people experiencing mental health crises with services that have been proven effective at benefitting life outcomes for those needing help.

Adding triage personnel at various points of access, such as at designated community-based service points, homeless shelters, and clinics

Crisis response and triage workers will exist throughout communities to increase access to timely services and improve client experiences.

Reducing unnecessary hospitalizations and inpatient days

Increased availability of crisis stabilization and residential programs will help reduce unnecessary hospitalizations and divert people in crisis to less restrictive treatment settings.

Reducing recidivism and mitigating unnecessary expenditures of law enforcement

Reducing recidivism results in:

  • fewer additional crisis interventions
  • reduced hospitalizations
  • reduced interactions with law enforcement

Mitigating unnecessary law enforcement involvement results in:

  • less time with officers spent in hospital emergency rooms attending to people in crisis
  • fewer arrests and jail time

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