Nov. 29—King County will soon launch an expanded, streamlined mobile crisis team program, designed to provide emergency mental health care throughout the county in two hours or less.
Two-person teams will travel across the county to de-escalate mental health crises and connect people to other social services. Each team includes a combination of mental health professionals, mental health care providers and certified peer counselors.
The expansion, which takes effect Monday, is part of the county’s broader investment in its behavioral health system, funded by a $1.25 billion levy approved by voters last year. County leaders are working toward a mental health system with “someone to call” (the 988 suicide and crisis helpline), “someone to respond” (mobile crisis teams) and “somewhere to go” (King County’s five planned crisis care centers).
The expansion adds 10 teams for a total of 27, which the county hopes will allow for a quicker response and the capacity to serve more people.
King County officials also hope the new system will simplify what has been a disjointed patchwork of different hotlines and response teams.
Previously, first responders and the general public called different organizations, which then dispatched their own teams or referred back to each other. Medicaid-enrolled clients could call their community behavioral health agency, which coordinated its own crisis responses.
“It was very decentralized and siloed, and depending on who you were and how you were getting services, you would call a different way, and there was more variability in response,” said Susan McLaughlin, the director of King County’s Behavioral Health and Recovery Division.
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What callers can expect
The new process will start when callers call 988, the three-digit number for the national suicide and crisis helpline. In King County, those calls are routed to Crisis Connections, a nonprofit that staffs a 24-hour crisis line.
If a caller is in an emotional or behavioral crisis that can’t be resolved over the phone, Crisis Connections staff will consult with a clinician to refer the caller to a mobile crisis team. The clinician will look for criteria including suicidal or homicidal ideation, self-harm, history of hospitalization, signs of psychosis or lack of basic functioning.
Then, staff will transfer the caller to in-house dispatchers, who will look at the caller’s location and dispatch the closest available team. Mobile crisis teams are a voluntary service — the caller or a person with the caller must agree to meet with the team.
“There won’t be a moment where the caller is alone throughout this process,” said Wynonna Susilo, Crisis Connections’ clinical manager of dispatch hub services. “Someone’s always going to be on the phone with them, and all of our staff are trained in emotional de-escalation and emotional support.”
Crisis Connections will not dispatch mobile crisis teams to calls that could present safety risks, including a person with homicidal ideation with a plan and the means to carry it out, active domestic violence situations or calls where a weapon can’t be secured. Those calls will be referred to law enforcement.
Police, fire and EMS can also call a separate number to connect directly to Crisis Connections dispatchers if they think a call is a good fit for a mobile crisis team. A separate county program, operated by the YMCA of Greater Seattle, sends mobile crisis teams to youth and their families.
Dispatching teams is a new responsibility for Crisis Connections and has required significant training and preparation, Susilo said. The company has had to scale up its staffing for the 25-person dispatch department and train staff on RainbowCare, a new software that will help teams coordinate and store information.
“We know how traumatizing it can be to be detained involuntarily or to be brought to the emergency room,” Susilo said. “We’re really trying to promote everything else but the most restrictive option for intervention.”
Working together to cover the county
Once Crisis Connections dispatches a team, one of two organizations will respond.
Downtown Emergency Service Center, a homelessness and housing nonprofit, has provided mobile crisis services for adults in all of King County since 2009. A higher proportion of Seattle calls involve homelessness compared to the rest of the county, executive director Daniel Malone said, so DESC proposed to county leaders that the organization narrow its focus to Seattle.
Starting Monday, DESC’s teams will be primarily responding to calls in Seattle and on Vashon Island. With Crisis Connections stepping in, DESC will no longer be dispatching teams directly, which Malone called a “very welcome change.”
Sound Behavioral Health, a nonprofit mental health and addiction treatment provider based in Tukwila, will cover the rest of the county. The agency already provides 24/7 emergency crisis services — including phone consultation, medication management and assistance with hospitalization — for its own clients and some other agencies.
Sound has had to hire more staff and has dedicated a full-time recruiter to hiring more than 80 staff members for the teams. The organization has been training staff on the dispatch system and technology before Monday’s launch.
It also ordered nine customized vans for $144,000 each, built to serve as mobile offices equipped with Starlink satellite internet, first aid kits, snacks, coolers and computer monitors. The vans will provide a quiet, weatherproof place for crisis responders to meet with callers, then write clinical notes and move to the next call, CEO Katrina Egner said.
“That’s new for us, and it’s very exciting for us,” Egner said.
The nonprofits expect there will be bumps in the road as they figure out new technology and coordinate between organizations, but they hope the expansion will help people who need urgent mental health care to get it more quickly and consistently.
“Most people don’t even know mobile crisis (care) exists, and part of that is because there’s never been enough,” McLaughlin said.
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