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On the way: State pitches mobile crisis plan to city

Norman Transcript - 7/14/2021

Jul. 14—A statewide expansion to mobile crisis units and an emergency call center will roll out within a year, leaving the Norman City Council to rethink its plan to create a city-managed team.

The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) presented the agency's plans to the council during a Tuesday night study session. Mobile crisis units respond to people in mental health or behavioral crises and connect them with services. The legislature increased funding to expand crisis units, new crisis centers and a statewide call center for a national mental health hotline — 988.

Two units contracted through the state via the Central Oklahoma Community Mental Health Center have served Cleveland County adults and children for several years, The Transcript reported. The council began exploring a mobile crisis unit in July 2020, looking at a model comparable to Eugene, Oregon's Crisis Helping Out On The Streets.

To date, the council has set aside $1.1 million to fund a unit, but thanks to the recent additional state funding, the council is considering a partnership. The existing framework addresses issues the council has raised in previous meetings like setting up a dedicated hotline and staffing teams with mental health professionals rather than police or firefighters.

Using contracted mental health providers across the state, the goal for ODMHSAS is to divert people in crisis from police interaction and mental health crisis centers whenever possible.

"The entire purpose of what we're going to show is to meet people where they're at, to meet the patient exactly where he or she is and provide the services that allow them to become stable as soon as possible," said Jessica Wisdom, chief clinical integration officer for the state agency.

From medication to substance abuse treatment and emergency medical services, the program will connect those in need to the resources necessary, Wisdom said.

Ward 3 Kelly Lynn asked if the department's program had an average length of time necessary to complete the response to crisis calls.

Sheameka Williams, interim director of the community mental health center, said in her experience overseeing mobile crisis units, responses for mental health "episodes" tend to last between 30 minutes and an hour, but she was unfamiliar with the exact data trends.

The need to dispatch crisis units for lengthy response is mitigated by the hotline, said Nisha Wilson, chief clinical strategy officer for the state.

"From the national model, we do know that 80% of or more of calls can be addressed at the call center level and will never need a mobile crisis response," Wilson said. "Without a call center, the need for mobile crisis units is very overwhelming very quickly, because that team does not have an ability to prioritize calls and address calls. They're going out on everything."

Lynn also wanted to know if staff are injured or killed in responding to calls. No one could answer with statistics, but Wisdom said the work is dangerous when people are a threat to themselves or others.

"Within all our organizations, we call law enforcement," she said.

Williams said the training professionals receive based on best practices prepares them for difficult calls.

"We're not going to have mobile teams restraining folks, physically restricting them," Wisdom said. "I can think of multiple situations where law enforcement engaged and handled it in ways that was just miraculous here in Norman."

A new state law that goes into effect Nov. 1, 2021 will mean crisis units will be even less likely to involve law enforcement. It allows providers to transport a person to a crisis center or other resource without using police officers if the facility is outside a 30-mile radius.

"There will be times when law enforcement is absolutely the only safest way possible to transport this person to the next level of care," Wisdom said. "Our goal is to divert a large percentage of it away from law enforcement."

Mayor Breea Clark wanted to know how the council could be sure that this program would not be cut during dry budget years, leaving the city "picking up the tab." Wisdom said the expansion of Medicaid services, a push to sign up more people on Medicaid and increased state funding are the solutions to sustain the program.

Ward 7 Stephen Holman expressed some concern that state and federally-managed programs might not be localized enough to address specific needs unique to the area.

Clark asked ODMHSAS to help the city find those gaps.

"We've got money allocated for this year," Clark said. "I would ask that you meet with us as this solidifies to a plan where we can identify and address the gaps that are specific to our community. I don't want to duplicate services. All resources are limited, and I want to make sure that we're being very judicious with our taxpayer dollars and actually solving problems. I hope you can commit to working with us, since we are the one city that is prepared to find solutions."

"We want nothing more than for mental health across the state to be top notch," Wisdom said. "This is a great opportunity to do that, not only in Norman, but across the state."

The expanded program should be in place by July 2022, Wisdom said.

Mindy Wood covers City Hall news and notable court cases for The Transcript. Reach her at mwood@normantranscript.com or 405-416-4420.

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