Online Program

A community-wide approach to behavioral health crisis management

Wednesday, November 6, 2013

Jan Kasofsky, PhD, Department of Health and Hospitals, Capital Area Human Services District, Baton Rouge, LA
The Mental Health Emergency Room Extension (MHERE) serves patients in acute psychiatric distress and ensures public safety by providing rapid assessment, observation, stabilization and treatment initiation. These patients are either a danger to themselves, others or gravely disabled. The MHERE is a crisis continuum component that assists law enforcement, hospital emergency departments, jails, and public and private sector budgets. The goals of the MHERE are rapid stabilization and disposition to an appropriate level of care and establishing connections for ongoing care to avoid readmissions and cycles of crises. Within two years of operating 10 beds, it served more than 3,400 patients and saved the state over $20.6M, by avoiding hospitalizations for 68% of the patients admitted. Its operational linkage to community-based public behavioral health clinics and the use of a mobile treatment component increased show rates for post-discharge clinic appointments from 32% to 79.6% in a six month period. The mobile team provided face to-face and telephonic outreach to increase appointment show rates. Demand for units of this type is growing due to deinstitutionalization, increasing substance abuse, and our warriors returning from active combat and their family members. A specialized crisis center addresses serious personal and public safety consequences of behavioral health crises and decreases the strain on local emergency departments which otherwise board these patients until they are stabilized, transferred at a higher rate to costly, acute psychiatric hospital beds, or discharged, often to an environment that cannot provide them ongoing support needed to prevent a cycle of crises.

Learning Areas:

Administration, management, leadership
Chronic disease management and prevention
Program planning
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe a community based process to identify gaps in needed services for people in a behavioral health crisis Describe successful specialized interventions for people experiencing behavioral health crisis Identify best practices in connecting people with community-based behavioral health providers to prevent recidivism and a cycle of crises

Keyword(s): Access and Services, Mental Health System

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: For over 16 years has served as Executive Director of a human services district serving over 14,000 individuals annually. Responsible for regional integration, leadership and management of a $32M, public program, providing community-based behavioral health and developmental disabilities programs. Provides regional leadership for disaster response and a cross-sector prevention/response continuum for behavioral health crises. Initiated an integrated behavioral health and primary care program supported by community providers that became a SAMHSA funded site in 2011.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.