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Missoula mobile crisis unit nets startup funding; attention now shifts to outcomes

When the city submitted its grant application to the state for a mobile crisis unit, the application sought to fund one unit for four months before bringing a second unit online to close out the 10-month trial program.

But on Monday night, and after consulting other partners, the Missoula City Council invested another $114,000 into the program. The additional funding from the FY21 budget will fund two crisis units from the start and pay for a program manager.

“We can build that foundation now with capacity, with a program manager, with the grant funding, pushing this along for the 10-month program while gathering that data,” said assistant fire chief Brad Davis. “We’ll be continually looking for other funding options and funding sources to continue this program. As we roll this out, we want to get everything right and get the foundation laid.”

The additional investment of $114,000 will be added to the $380,000 grant received from the Montana Department of Health and Human Services. Within that grant, the city had already committed $75,000.

The city’s contribution to the trial program now stands at roughly $200,000.

“I have all the confidence this pilot program is going to provide the data and the results and everything we say it’s going to do will be proven by the end of 10 months,” Davis said. “It’s a needed service for Missoula. I’m trying to set up now for months 11 and beyond. To do that, we need the capacity at the fire department.”

As designed, the mobile crisis teams will address 911 calls and other service requests that include a mental or behavioral health issue. The two teams will each include an EMT and a mental health professional and will work in tandem with other local services.

The program will also be under scrutiny as it finds its footing. Advocates of the new approach said data collection over the first 10 months will be key to future funding, as will positive outcomes.

“I’m interested that the folks to whom we’re responding to get the help they need,” said Mayor John Engen. “I would hope we can demonstrate this intervention at the right level and the right time is producing better outcomes for folks in crisis, and those crises become one-time events in people’s lives.”

Davis said the state is also expecting a comprehensive data report each month. Other entities, including Partnership Health Care, area hospitals and local government will also monitor the program.

The key data points will be wide ranging and include the number of behavioral health calls, the way those calls come in, the time of day and who’s calling, be it a family member or 911 dispatch.

Other elements will monitor how many responses successfully diverted someone from going to jail or the emergency room, and how long emergency responders, including police and fire, spent on scene.

“Because we’re not having to spend as much time on behavioral health calls, this unit can come in and take over for us to get us back in the station so we can respond to those other calls,” Davis said. “We’re going to be looking at it from several different angles. Data collection is going to be a huge part of this 10 month program.”

The program is part of a new push by local officials to develop a response to mental and behavior health issues. A new low-income and affordable housing project planned off Mullan Road and West Broadway will include a crisis stabilization center and other wrap-around services.

But that’s not expected to open until 2022.

“Our initial role will be to identify some of those holes in the system,” said Dr. James Quirk with Partnership Health Center. “There’s a good chance we’ll still be transporting people to the emergency room, in part because there won’t be other resources available.”

Even with a mobile crisis unit on the road, the city still lacks some of the costly infrastructure that has made the mobile crisis units successful in other cities that have adopted them.

Sarah Potts, director of behavioral health at PHC, said the trial run in Missoula may demonstrate a similar need.

“After talking to other sites around the U.S. that do have these mobile crisis units, they all have these stabilization zones or areas,” said Potts. “I do look forward to seeing how that community option can be supportive of the people we may be contacting in this mobile crisis unit.”

While the program is filling what many experts see as a community need, it’s also committing city and county government to a long-term funding requirement in future budgets.

“This start up has got grant award from state and various resources,” said council member Stacey Anderson. “We as a community are gong to need to look and figure out how to fund this beyond this original grant award cycle. The intention is to build this out as a permanent community asset, not just a 10 month pilot program.”