Community Assessment & Transport Team (CATT)
Many counties and cities struggle with developing a crisis response system that is efficient and effective – getting clients to the right services at the right time, without unnecessary use of first responder and client time, and in a respectful and non-stigmatizing manner. In Alameda, there have been a variety of efforts made to improve crisis response. But the impact has been limited – Alameda has the highest rate of 5150 holds in California, people who do not qualify for 5150 holds are not successfully linked to planned services and continue to over-use emergency services, and first responders spend many hours addressing behavioral health related 911 calls that would be better served in a different manner.
Alameda County proposes to test two primary strategies to improve the crisis response system:
- A collaboration among core Alameda County Health Care Services Agency programs - Behavioral Health Care Services, Emergency Medical Services, and Alameda Care Connect (Whole Person Care) – as well as other partners – 911 dispatch, the County Sheriff’s Office, city police departments, city health and human services, and other relevant services - to ensure the crisis response system is more agile and flexible. Participating partners will:
- Provide the staff time, training, and support to ensure that in the moment client services are responsive. For example, keeping records up to date so the mobile crisis teams have current information about the client and available services
- Participate in an ongoing Continuous Quality Improvement process to ensure that system improvements are made in a timely manner, resulting in better outcomes.
- Outcome: More responsive crisis services and timely systems improvements.
- Combining a unique crisis transport staffing model with current technology supports to enable them to connect clients to a wider array of services in the moment:
- A mental health provider and an Emergency Medical Technician in a van to provide mental and physical assessment and transport to a wide range of services.
- Technological support, such as ReddiNet to provide current availability of beds and Community Health Records to provide up-to-date information about the client’s physical and mental health history. This assists with connecting a client to the most appropriate service in the moment, especially if they are not on a 5150 hold.
- Outcomes: Increase accuracy of assessments; transport to non-emergency services, resulting in more planned services for the clients; reduce the time law enforcement and ambulances spend on addressing psychiatric emergencies.
This project is beyond adding a discrete service to a challenged system, it is a test of concept for how to improve the system through a collaborative approach and change in staffing models paired with technological support. If successful, it will contribute to increased efficiency for the emergency system, more appropriate services for the client, and a model that other counties can adopt or adapt to significantly improve their crisis response system.
