A new program designed to provide an appropriate response to a behavioral health crisis and limit the role of first responders saved Missoula taxpayers an estimated $252,000 over a six-month period by diverting clients from jail and reducing visits to the emergency room.
Missoula’s nascent Mobile Support Team also saw case facilitators work to navigate clients who are in crisis toward a better outcome, according to data released on Wednesday.
“The primary goal of the program is to provide the right care in the right setting to people experiencing behavioral health emergencies,” said Gretchen Neal, a mental health coordinator at Partnership Health Center. “We’re also aiming to reduce the time and resources that Missoula’s first responders spend addressing situations where behavioral health is the main concern.”
The program also looks to decrease the number of arrests and emergency room visits, something that was common before the program was launched on a pilot basis last October. In those categories, Neal said the response of the Mobile Support Team diverted 169 emergency room visits and 13 trips to the jail.
The data, released this week, covers the program’s first six months and offers recommendations moving forward. During the pilot period, the teams were available for 890 hours and responded to 537 calls.
“Of those 537 calls, they saw 293 clients. That tells you there are a lot of repeat faces,” said Neal. “The number of calls to the mobile support team increased over time, and they continue to increase.”
The majority of the calls, or 44%, were to a public location while 30% involved calls to a private household. Neal said most of the calls resulted with the individual remaining in the community while a smaller number – 109 calls – saw a transport to medical care. One client was transported to jail.
Broken down by demographics, the data suggests that the calls involved an equal number of males and females, though the age of the clients varied. Roughly 18 patients ranged in age from 10 to 19 while 34 patients were between the age of 20 and 29.
However, those between the ages of 40 and 59 represented the highest call volume at 80. The median age was roughly 45 and Caucasians represented 57% of all calls – the most of any category.
“It’s important to point out that 6% of the unique clients were Native American,” said Neal. “It’s a higher percentage proportionally than the Native American population of Missoula as a whole.”
While 32% of the calls involved clients who were housed, 40% involved unhoused individuals. While Neal dislikes the term, 29 individuals were listed as “frequent utilizers” of the team’s response and 16 were considered “super utilizers.”
The later represents those individuals who had at least three calls and sometimes more.
“Those 16 super utilizers accounted for 103 of the 537 calls and 20% of the Mobile Support Team’s response time,” said Neal. “They also accounted for 139 hours of follow up for 227 total hours spent by the team and a case facilitator. Those familiar faces are a big portion of the Mobile Support Team’s time and effort.”
As designed, the program represents a pairing between the Partnership Health Center and the Missoula Fire Department. It provides local consultation, screening and intervention to people in crisis, mainly those with behavioral health and substance abuse issues.
The response team includes a licensed behavioral health clinician, an EMT and a case facilitator who provides resource navigation for clients. Among the many goals, it looks to lessen the role of law enforcement in calls involving behavioral health issues and get the clients the help they need.
“Data like this is super important and a very powerful tool we use these days, but there’s also things outside of data that are also very valuable,” said City Council member Gwen Jones. “The Mobile Support Team is an excellent example of that. Having this kind of response to someone having a crisis, you can’t always quantify that, but it’s the right thing to do.”
As the program evolves, the data also points to future needs. Missoula Mayor John Engen’s executive budget this year provided additional funding to grow the program, and it was approved by the City Council.
John Petroff of the Missoula Fire Department said the approved additions are needed as the call volume continues to grow. Over the last six months, the team has been fully staffed seven days a week and operates from 10 a.m. to 8 p.m.
The team now sees an average of 130 calls per month, he said.
“It has definitely increased,” said Petroff. “Our hours on scene per month averages 93 hours. It’s a lot of time on scene engaged with clients. That doesn’t include the report writing and response back to the station and everything they’re doing in between. The team is busy, which is why we asked for an expansion in services and staffing this upcoming year.”
Additions to the program will include at least one additional clinician at Partnership and two new EMTs, which Petroff expects to hire within a month. They’ve also increased the lead clinician to full time and the outreach specialist from half time to full time.
“That will help as we increase the amount of time we’re in service,” said Petroff. “We’re working through that right now and looking at where we’re needed more often. Hopefully by the end of the fiscal year, we’ll be working from that 8 a.m. to 10 p.m. or Midnight time range, if we can make it happen.”