Mental health crises need quick, skilled, and caring help. For many years, communities faced long waits for help. Police often responded instead of health workers. There were not enough treatment options. This led to many hospital stays, repeated crises, and crowded emergency rooms.
Two examples from cities in California show how special crisis teams can change how mental health emergencies are handled. San Francisco’s MentalHealthSF program and the Los Angeles County Sheriff’s Department (LASD) Mental Evaluation Team (MET) both aim to lower hospital stays by offering early help in the community.
MentalHealthSF is a law made to fix San Francisco’s mental health and substance use care system. The city set aside $607 million for behavioral health in one year’s budget. About $55.5 million goes to MentalHealthSF, which includes new treatment spots and special crisis teams.
A main part of MentalHealthSF is the Street Crisis Response Teams. They answer less urgent 911 calls for people having mental health problems. These calls used to need police. Since the teams started, they handle about one-third of these calls. This lowers police contact with people with mental illness. It also helps keep people in the community instead of hospital or jail.
Still, there are many problems:
The Office of Coordinated Care is still being planned. It should handle and connect care plans but has no full staff or leader yet.
In short, San Francisco is trying to change crisis response from police to health workers. But making this work takes time and faces many problems even with money involved.
The LASD runs the Mental Evaluation Team (MET) since 1991. Now, there are 33 teams that work all day and night. They help calm crises, negotiate, and support people’s mental health.
Important facts about MET:
The Risk Assessment and Management Program (RAMP) follows up with people who have serious mental illness to keep them out of jail and into treatment. In 2022, RAMP reviewed 9,000 contacts and started 500 new cases.
LASD also has the Veterans Mental Evaluation Team (VMET). It is made up of veterans or their family members. VMET works with the U.S. Veterans Administration to help veterans with mental health needs.
MET uses unmarked cars and trained staff to reduce stigma and improve help. They focus on kindness and calming down crises rather than arrests.
Though both San Francisco and Los Angeles teams show good results, they share challenges:
Crisis teams face a tough job. To lower hospital stays, they need quick field work, community help, and ongoing outpatient support. Without these working well together, patients may end up in crisis again and again.
For medical administrators and healthcare IT managers in the U.S., crisis response teams bring important lessons:
Artificial intelligence (AI) and automation are becoming useful for crisis response and behavioral health services.
Patient Triage and Call Routing: Many crisis calls come through dispatch centers. AI phone systems can quickly judge how bad a call is. They can send mental health emergencies to special teams instead of police. This lowers wrong police responses and makes help faster.
For example, AI systems can use speech recognition and language processing to figure out caller needs. Then, they notify trained crisis teams.
Care Coordination and Follow-Up: AI can look at patient records to find people at high risk of crisis. It can send reminders for appointments and medicine, and note missed visits. This helps lower hospital returns.
Resource Allocation: AI uses data to decide where to put limited resources like street teams or hospital beds based on demand.
Training and Simulation: AI simulators help train staff by showing real-life crisis scenes. This improves skills faster and more evenly.
Reducing Administrative Burden: Automation helps with paperwork, managing cases, and reports. This lets staff spend more time on patient care.
Using AI and automation, mental health programs can respond faster, deliver better care, and manage complex work more easily.
Staff in these programs say training, kindness, and community care are very important. Captain Geoffrey Deedrick of LASD said MET changed the department toward a more caring and trauma-aware way of public safety.
Annie Le from San Francisco’s Dore Urgent Care Clinic notes ongoing space and wait issues but agrees specialized teams help keep people in the community rather than hospitals or police custody.
Mental Evaluation Team deputies get more than 750 hours of training on mental health, calming crises, and understanding veterans. This helps them better interact with the public and avoid arrests for people in crisis.
Crisis response teams like San Francisco’s Street Crisis Response Teams and Los Angeles County’s MET give good alternatives to traditional emergency responses. They provide trained help in the community and reduce hospital stays and police encounters.
But problems with capacity, care coordination, and staffing mean more work is needed. Using AI and automation in crisis response and follow-up care can make programs work better and faster. Medical administrators and IT managers are in a good position to help by connecting technology, sharing data, and training clinical teams to work with local crisis groups.
As mental health needs grow in the country, working with crisis teams and using technology can lead to faster care, fewer hospital stays, and better mental health for communities.
MentalHealthSF is a legislative initiative passed by San Francisco to reform its mental health and substance use treatment system, aiming to provide more resources, staff, and coordinated care to prevent individuals from cycling through inadequate services.
The Dore Urgent Care Clinic offers 24-hour respite for individuals in crisis, providing meals, therapeutic support, medication management, and assistance with substance use withdrawal.
San Francisco is spending $607 million this fiscal year on its behavioral health system, which serves approximately 20,000 individuals, including $55.5 million specifically for the MentalHealthSF initiative.
Key challenges include long wait lists for services, a fragmented care system, hiring delays, and the ongoing impact of the COVID-19 pandemic on treatment accessibility.
MentalHealthSF has led to the addition of Street Crisis Response Teams and 87 new treatment beds, although plans for a centralized care coordination office and entry-point service remain in development.
Street Crisis Response Teams respond to low-priority 911 calls concerning individuals in crisis, reducing police interactions and helping connect people to community services without hospitalizations.
The Office of Coordinated Care, designed to create care plans and manage cases across the system, is still in its planning phase, with limited staffing and no director yet hired, as of late November.
The demand for mental health services increased significantly during the pandemic, exacerbating existing problems such as a shortage of available therapists and heightened crisis levels among the population.
Critics express concerns that the city’s new programs may not effectively integrate with existing services, risking the creation of separate programs that operate independently rather than forming a cohesive system.
Legislators are considering updating the MentalHealthSF legislation by adding deadlines and data requirements to ensure better oversight and accountability for service expansion and coordination.
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