BEN DORGER, Standard-Examiner file photo

It started when a young woman desperately sought help in a mental health crisis and her call went to voicemail. She then took her life.

State Rep. Steve Eliason, R-Sandy, told the story Tuesday as a national group of experts discussed the growing challenges of communities effectively responding to life-or-death behavioral health situations without throwing people in jail or handing them off to overwhelmed hospital emergency rooms.

A study released Tuesday by the Pew Charitable Trusts found that most states and communities are struggling to meet the demand and are ill-prepared to seamlessly implement the nationally mandated 988 emergency system for behavioral health emergencies.

But Eliason and other speakers reported during a Zoom presentation that Utah is farther ahead than most, with extensive planning already in motion for 988 and significant progress made on existing behavioral response programs. And Tina Mathieu, director of the Weber Area Dispatch 911 and Emergency Services District, said in an interview that Weber County leads the state in the category.

Several years ago, Mathieu said, Ogden City led the local formation of mobile crisis outreach teams, or MCOT, that are dispatched to behavioral health calls at the same time as police and firefighters. MCOT units have social workers and peer advocates to give on-the-spot help. If police and firefighters determine there are no physical issues involved, many calls then are handed off to MCOT.

Image supplied, Pew Charitable Trusts

“Weber County has by far the best system,” Mathieu said. “The average MCOT response is 15 to 19 minutes, which is amazing.”

She said after Ogden City’s success, the MCOT model was adopted by all agencies in Weber and Morgan counties.

Eliason said with MCOT, “we are able to divert from emergency rooms and jails, which is absolutely critical in terms of justice reform.” He said a person in a behavioral crisis “needs someone to call, and a better option than 911.” Getting someone in crisis into a continuum of care is vital, he said.

The Pew study said Utah and Indiana are the only states that have moved to acquire Medicaid funding for some of that care. For example, Eliason said, Medicaid funds may support receiving centers, including a program in Farmington. There, in a Davis County Jail space converted for a behavioral health purpose, police can drop off nonviolent suspects for mental or addiction help rather than arrest.

The study found that few emergency calls centers in the nation have staff with behavioral health crisis training; they have limited or, in some places, no options to dispatch specialized responses; and patchwork systems are frustrating efforts to gather reliable data about how such calls are handled.

Image supplied, Pew Charitable Trusts

“The common themes are that few have sufficient staffs and training,” said Dr. Debra Pinals of Michigan, past president of the American Academy of Psychiatry and the Law. And it’s not as easy as hiring a clinician to work as a dispatcher, she said — the disciplines must collaborate.

Mathieu said Weber dispatchers receive basic training in behavioral crisis response. But more would help. She said the agency recently was disappointed when a crisis intervention training program team members had signed up for was canceled.

Funding is always a challenge and will be important to expand MCOT and gear up for 988. “It’s not all money, though,” Mathieu said. There’s a shortage of behavioral health professionals.

Mathieu and others favor relaxing the requirement that MCOT social workers have a master’s degree. “Are we really doing someone any favor by not having anything available?” she asked. A worker with a lesser degree in behavioral health would be able to help someone in crisis “rather than continuing them on to arrest.”

Eliason said the evolution of emergency behavioral health systems in Utah over the past four years has had excellent results, but the next test will be how well 988 is rolled out. The completed service will go live next July. Current calls to 988 go to the national suicide hotline. “Patterned after 911, it could assist with suicide intervention and save countless lives,” he said.

Photo supplied, Weber Area 911 Dispatch

With anxiety and depression worsened during the COVID-19 pandemic, “the time for focus couldn’t be better” for improving 911 and 988. He got heavily involved in the issue when several years ago a friend’s daughter “called for help, it went to voicemail and she ended her life.”

He said he discovered there were nearly two dozen crisis lines around Utah, “some going to voicemail or a phone tree, some 24-7 when someone took the cellphone on the weekend.” Since then, he has been a spearhead for several bills leading to 988 and better associated services.

While it is up to local governments to provide the services, “the state needs to act as an air traffic control center, where there is no wrong door to help in a crisis and we ultimately get people the care they need and deserve,” Eliason said.

Need help?

Call the National Suicide Prevention Lifeline at 800-273-8255.

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