CrisisNow.com David W. Covington, LPC, MBA Young people who have a - PowerPoint PPT Presentation

CrisisNow.com David W. Covington, LPC, MBA

Young people who have a first psychosis and their families should be supported to achieve an ordinary life and quickly move beyond a diagnosis to recovery New Castle Declaration, UK (2001)

2005

Police Mobile Individuals, Primary Care & Crisis Call Lines Outreach Friends, Family Social Services Walk-In Core Community Crisis Flow HOSPITAL ED SERVICES DECLINED ACUTE SERVICES REFERRED ELSEWHERE Social Isolation Homelessness Unemployment Suicide Increased Mental Trauma PSYCH HOSPITAL

“The increasing dependence on...hospital EDs to provide behavioural evaluation and treatment is not appropriate, not safe, and not an efficient use of dwindling community emergency resources. More importantly, it impacts the patient, the patient’s family, other patients and their families, and of course the hospital staff.” Sh Sheree (Kru (Krucken enberg rg) L ) Lowe, VP VP of of B Behavio ioral l Hea ealt lth for r the Calif lifor ornia ia Hospit ital al Associa ciatio ion, repres esentin ing 4 400 hos ospit itals ls an and healt lth systems ems

Every t tim ime a Seattle Times 2013. psychia iatri ric c boar ardin ding o occ ccurs rs, Lack of space forced those the h hospit ital l involuntarily detained in EDs experie riences a a cos ost/lo /loss o of to wait on average 3 days. $2,26 264

Crisis Now

Individual, Primary Friends, Care & Family Social Crisis Line % whose assessed need Walk-In Services Police & Mobile matched their linked crisis service Most all community crisis referrals flow through the hospital ED. STE TEP Compute your crisis system flow. Community Crisis Flow 200 persons in crisis per 100,000 persons in your Hospital ED community on a monthly basis. Greater What do they Divide by 100k 4m 8,000 look like and multiply by Phoenix clinically? 200 Community Total Pop. Monthly Crisis Flow STE TEP STE TEP STE TEP LOCUS Levels of Care Stratified Crisis Need Clinically Matched Care Dimensions Risk of Harm Functioning Co-Morbidity The typical Environment LOCUS Treatment History distribution for community Engagement crisis flow. Do you have the crisis continuum What do they capacity to look like meet the need? clinically?

Individual, Primary Friends, Care & Family Social Crisis Line % whose assessed need Walk-In Services Police & Mobile matched their linked crisis service Most all community crisis referrals flow through the hospital ED. Compute your crisis system flow. Hospital ED

Individual, Primary Friends, Care & Family Social Crisis Line % whose assessed need Walk-In Services Police & Mobile matched their linked crisis service Most all community crisis referrals flow through the hospital ED. STE TEP Compute your crisis system flow. Community Crisis Flow 200 persons in crisis per 100,000 persons in your Hospital ED community on a monthly basis. What do they Divide by 100k look like and multiply by clinically? 200 Community Total Pop. Monthly Crisis Flow

Individual, Primary Friends, Care & Family Social Crisis Line % whose assessed need Walk-In Services Police & Mobile matched their linked crisis service Most all community crisis referrals flow through the hospital ED. STE TEP Compute your crisis system flow. Community Crisis Flow 200 persons in crisis per 100,000 persons in your Hospital ED community on a monthly basis. Greater What do they Divide by 100k 4m look like and multiply by Phoenix clinically? 200 Community Total Pop. Monthly Crisis Flow

Individual, Primary Friends, Care & Family Social Crisis Line % whose assessed need Walk-In Services Police & Mobile matched their linked crisis service Most all community crisis referrals flow through the hospital ED. STE TEP Compute your crisis system flow. Community Crisis Flow 200 persons in crisis per 100,000 persons in your Hospital ED community on a monthly basis. Greater What do they Divide by 100k 4m 8,000 look like and multiply by Phoenix clinically? 200 Community Total Pop. Monthly Crisis Flow

Individual, Primary Friends, Care & Family Social Crisis Line % whose assessed need Walk-In Services Police & Mobile matched their linked crisis service Most all community crisis referrals flow through the hospital ED. STE TEP Compute your crisis system flow. Community Crisis Flow 200 persons in crisis per 100,000 persons in your Hospital ED community on a monthly basis. Greater What do they Divide by 100k 4m 8,000 look like and multiply by Phoenix clinically? 200 Community Total Pop. Monthly Crisis Flow STE TEP LOCUS Levels of Care Dimensions Risk of Harm Functioning Co-Morbidity Environment Treatment History Engagement What do they look like clinically?

AnyBigCity, USA Pop. 4m Dimensions Risk of Harm Functioning Co-Morbidity Environment Treatment History Engagement

Individual, Primary Friends, Care & Family Social Crisis Line % whose assessed need Walk-In Services Police & Mobile matched their linked crisis service Most all community crisis referrals flow through the hospital ED. STE TEP Compute your crisis system flow. Community Crisis Flow 200 persons in crisis per 100,000 persons in your Hospital ED community on a monthly basis. Greater What do they Divide by 100k 4m 8,000 look like and multiply by Phoenix clinically? 200 Community Total Pop. Monthly Crisis Flow STE TEP STE TEP STE TEP LOCUS Levels of Care Stratified Crisis Need Dimensions Risk of Harm Functioning Co-Morbidity The typical Environment LOCUS Treatment History distribution for community Engagement crisis flow. What do they look like clinically?

We utilized more than a decade of statewide crisis A Fully data to produce the analysis in this report. Informed Model Our team compared the outcomes of a traditional inpatient beds model alone versus a Crisis Now continuum model in a metropolitan population of 4 million.

Individual, Primary Friends, Care & Family Social Crisis Line % whose assessed need Walk-In Services Police & Mobile matched their linked crisis service Most all community crisis referrals flow through the hospital ED. STE TEP Compute your crisis system flow. Community Crisis Flow 200 persons in crisis per 100,000 persons in your Hospital ED community on a monthly basis. Greater What do they Divide by 100k 4m 8,000 look like and multiply by Phoenix clinically? 200 Community Total Pop. Monthly Crisis Flow STE TEP STE TEP STE TEP LOCUS Levels of Care Stratified Crisis Need Clinically Matched Care Dimensions Risk of Harm Functioning Co-Morbidity The typical Environment LOCUS Treatment History distribution for community Engagement crisis flow. Do you have the crisis continuum What do they capacity to look like meet the need? clinically?

Model #3 Crisis Now In the Third Model, fully deploy the principle practices of the Crisis Now System and add Crisis Navigator and a 24/7 Outpatient Clinic

What is the Crisis Now model? Call Center Hub Mobile Crisis “Air Traffic Control” Crisis Call Center Hub Crisis Connects and Ensures Facilities Timely Access and Data

Law Enforcement By- 5 to 7 Minute Turn- passes the Emergency Around Police Drop Off. Room and Proceeds No Call. No Referral. Directly to Crisis No Rejection. Simple.

States Self- 38% Assessment 29% 14% 12% 0% Level 1 Level 2 Level 3 Level 4 Level 5

The Crisis Now Dif Differ erence ence In 2016, according to Aetna/Mercy Maricopa, metropolitan area Phoenix law enforcement engaged 22,000 individuals that they transferred directly to crisis facilities and mobile crisis without visiting a hospital emergency department. What difference did it make? Reduced potential Improved Crisis Clinical Fit to Need (CCFN) by 6x state inpatient spend by $260m Calculated from Arizona data, 2017 Saved equivalent of 37 FTE police officers Saved hospital EDs $37m in avoided costs/losses Reduced total psychiatric boarding by 45 years Calculated from “Impact of psychiatric patient Firefighter savings not yet realized / quantified. boarding in EDs” (2012) (Nicks and Manthey)