National Dialogues on Behavioral Health 2020 Conference
Implementing Crisis Response at State and Local Levels: New Paradigms, Partnerships and Innovative Approaches
The recent COVID-19 pandemic has underlined the critical role of crisis services in the United States. The need for adaptation and flexibility to be more responsive has become apparent, even for evolving crisis systems.
As hospital emergency rooms and jails have become de facto extensions of the behavioral health system, states and local jurisdictions are redesigning crisis response systems so that they are more appropriate, timely and effective. A major emphasis is on developing a crisis service continuum that allows for more meaningful triage so that levels of care can be matched to levels of need, reducing the inappropriate burden on law enforcement, community hospitals and jails. For example, how did these crisis systems revamp themselves during the COVID-19 crisis? What innovations and lessons were learned that can be built upon?
There is recognition that the crisis care response needs to include the larger public health system as well as the behavioral health system, especially in a recovery-oriented environment where pre-crisis and post-crisis options are critical. That is, from an individual-specific perspective, the resolution of a “crisis” depends as much on the larger system that provides links to housing, employment, and social supports as on the actions of first responders and the more immediate crisis response components.
Innovative models of partnerships, cross-system collaboration and coordination are emerging that are using community coalitions that include law enforcement, hospitals, judges, community service organizations, and the public and behavioral health systems to address these emerging needs. The county based Stepping Up program is an example of such an initiative. At the same time, peers are providing a value-added essential role in different capacities at different levels of crisis care. In Arizona, for example, 50% of the crisis response workforce consists of peers.
An ongoing challenge is crisis response in rural areas, not just in terms of the services that are available, but also in the recruitment of psychiatrists, counselors and other professionals. New technologies incorporating the use of artificial intelligence and telehealth are some of the innovative solutions being applied in these areas as well as urban areas. And finally, the infrastructure of funding, workforce development, quality improvement and management by outcomes are the pillars on which the crisis response system rests.
The bottom line is that new paradigms and innovations must be implemented or incorporated into existing crisis response systems so that cross-system collaboration and support for individuals experiencing a crisis become the norm. This will be the focus of the 2020 Conference.
Psychiatrists, Social Workers, Nurses, Psychologists, Counselors, Addiction Counselors, Case Managers, Administrators, Health Policy Makers, Behavioral Healthcare Providers, State/County Behavioral Healthcare Administrators, Peer Recovery Workforce, Judiciary Justice System Administrators, Law Enforcement/Justice System Stakeholders, Emergency/Disaster Response Professionals, Educators and School Based Counselors, Human Services and Child Welfare Administrators and Providers, and Academicians.