Mobile crisis initiative can’t find staffing

By NORA DOYLE-BURR

Valley News Staff Writer

LEBANON — A long-anticipated program to offer in-person support to people experiencing mental health and substance use crises in New Hampshire is within reach, but difficulties finding workers is causing delays in its full rollout.

Through state contracts that went into effect at the beginning of July, New Hampshire’s 10 community mental health centers now have funding to operate mobile crisis teams to respond in-person to people in crisis, but they don’t yet have the staff to make those visits, said Bill Metcalfe, director of the Lebanon-based West Central Behavioral Health’s mobile crisis services.

West Central, which serves people in Sullivan County and southern Grafton County, currently has about half of the 12 workers it needs to staff three shifts of teams of two, including a master’s degree-level clinician and a bachelor’s degree-level outreach worker, at both its Lebanon and Claremont sites, Metcalfe said.

To get fully staffed, “we’ll take anybody,” Metcalfe said, noting that he’s happy to have some employees who are willing to work just one shift a week and that he will take qualified applicants with degrees in a wide range of re-

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Mental health advocates have been lobbying for statewide mobile crisis services for years as a way of addressing people’s needs within the community, rather than requiring that they come to a hospital emergency department that may not be well equipped to treat mental illness. The teams, which have until now only been in operation in Concord, Nashua and Manchester, are written into the state’s 10year mental health plan, which was released in January 2019.

“We look forward to it beginning because this brings us in line with best practices throughout the country,” Ken Norton, executive director of the New Hampshire chapter of the National Alliance on Mental Illness, said of mobile crisis services.

Though Norton acknowledged the delays in launching the service, he said, “I try to be really optimistic.”

After years of advocacy, Norton said he’s glad to see the state’s mental health centers begin to move forward with the mobile teams, which he said he expects will contribute to “improved care and better outcomes for people.”

In June, the New Hampshire Executive Council approved spending $52.4 million in contracts through June 2022 with the state’s 10 mental health centers, which is nearly twice what the contracts had previously totaled. The contract for West Central increased from $1.4 million to $3 million.

The additional funds are intended to support mobile crisis services, as well as six supported housing beds in each region and one full-time work incentives counselor in each region to help people with mental illness meet employment goals.

Community mental health centers’ programs, including mobile crisis services, are necessary to ensure that roughly 43,000 adults, children and families in New Hampshire get the care they need, DHHS Commissioner Lori Shibinette wrote in an explanation of the contracts for the Executive Council.

Without them “these individuals may experience an increase in symptoms causing them to seek more costly services at hospital emergency departments due to risk of harm to themselves or others and may have increased contact with law enforcement, correctional programs, or primary care physicians, none of which have the necessary services or supports available to provide necessary assistance,” Shibinette wrote. “Lack of these services may also increase the likelihood of inpatient hospitalizations and death by suicide.”

Once West Central’s mobile crisis teams are staffed, they will have the ability to continue to do the emergency response work the organization has been doing with 4.5 employees, which includes answering the phone, addressing the needs of walk-in clients and assessing the mental health needs of patients at Valley Regional Hospital in Claremont who are experiencing symptoms such as suicidal ideation, Metcalfe said.

In addition, the mobile crisis teams are to respond in person to meet with people experiencing a psychiatric emergency. The two-person teams are to be on site in Lebanon and Claremont 24 hours a day, seven days a week. They will be equipped with computers with laptop computers and cellphones, so they can “pick up a bag and go,” Metcalfe said.

Lebanon Police Chief Phil Roberts said he is looking forward to having mental health providers available to respond to people in crisis. Almost every day, Roberts’ department responds to calls involving someone at risk of suicide or of harming others, he said. Roberts also said he’s hopeful that West Central’s mobile response team will be able to partner with the department in encounters with people who are homeless or those who are struggling with addiction.

“We respond to all these calls as the police,” Roberts said. “Other than that we can take you to the (Dartmouth-Hitchcock Medical Center) emergency room.”

Working with West Central’s mobile crisis response teams gives officers another way of connecting people with services they may need, Roberts said.

“We’re happy to have someone to partner with to better serve these people,” he said.

Even as West Central is staffing up its mobile crisis teams, it has begun doing some in-person outreach. For example, a West Central team went to debrief workers at Morningside Flight Park in Charlestown last month, following a fatal plane crash there, Metcalfe said.

The session was “well attended” and “definitely needed,” he said.

West Central’s crisis response phone line can be reached at 1-800-564-2578.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.