EMERGENCY MOBILE PSYCHIATRIC SERVICES

1. EMERGENCY MOBILE PSYCHIATRIC SERVICES An Option for Serving Children With Mental Health Needs Name of Presenter

2. What is EMPS? • A Team of trained mental health professionals who can respond immediately on-site, or by phone, when a child is experiencing a mental health need or is in crisis • Who can receive EMPS? • Anyone can call on behalf of a child/youth with a mental health need • Any child or youth 17 or younger in Connecticut who is in crisis (can serve 18 year olds if enrolled in school) • Service is provided regardless of insurance status or ability to pay • Excludes youth currently in Residential Treatment Centers, Sub-Acute Units, or Inpatient Hospital Settings

3. Goals of EMPS • Be Highly Mobile: Go to where the youth is • Be Responsive: Arrive within 45 minutes or less • Convenient Hours: Mobile hours are 8am-10pm M-F; 1pm-10pm weekends/holidays. Available by phone all other hours • High Volume: Reach all in need • Widespread community awareness • Consistent, high quality service • Responsive to Schools, Emergency Departments, Police, Foster Families, and others • Coordinate with Emergency Departments • Reduce inappropriate use of inpatient care • Reduce inappropriate arrests

4. EMPS Components • Six (6) Service Areas Cover Whole State • Single Statewide Call Center • Dial 211 from anywhere in CT, improves access to EMPS • Allows for improved marketing • Consistent response and improved accountability • System Features • Mobile hours are 8am to 10pm M-F; 1pm to 10pm Sat/Sun/Holidays) • Telephonic response during non-mobile hours • Capacity to handle multiple calls • Performance Improvement Center • Performance standards; data reporting; feedback and service improvement activities at all EMPS sites • Standardized expert training for all clinicians • Regular feedback from families and other referrers (schools, EDs)

5. EMPS works in collaboration with the Emergency Department (ED) Rates of ED visits for BH increased significantly over the past 10-15 years - contributes to gridlock • Unnecessary ED visits interfere with ED practice • EDs are not the best environment to provide mental health care, especially for youth and families • Many youth have to stay in the ED for hours or even days before a satisfactory disposition • Hospital staff may have limited knowledge of community options • Children more likely to be unnecessarily hospitalized if they visit an ED • EMPS can help assess the need for further evaluation in an ED

6. EMPS works in collaboration with the Police • Police response to youth with mental health needs may interfere with other police business • Youth with mental health needs are at increased risk for arrest when police are called • Many youth would benefit from treatment rather than arrest and juvenile justice system involvement • EMPS can provide assessment and intervention as an alternative to police involvement and arrest

7. What You Can Expect from EMPS • “An educated consumer is our best customer.” • Available 24 hours per day, 365 Days per Year • DIAL-211 At Prompt – Press 1 for Crisis, press 1 again for EMPS • Connect to a Crisis Specialist • Provide Basic Information • Triage – Three Options 1. Information and Referral 2. 911 3. All Other Calls to Local EMPS Provider

8. What You Can Expect from EMPS • 211 will transfer call to EMPS provider • Seamless transition from 211 to EMPS provider • EMPS may collect some additional clinical information • EMPS staff is dispatched to the home, school, foster home, ED or wherever help is needed • Most responses occur in 45 minutes or less

9. What You Can Expect from EMPS • EMPS can be divided into two phases: • Phase 1 - Assessment: intended to support initial crisis stabilization and gather clinical information to inform next steps. The assessment includes the development of a safety plan. • Phase 2 - Ongoing Crisis Stabilization and Transition: Ongoing clinical care for up to 45 days. Individualized follow up based on needs of the child.

10. What You Can Expect from EMPS • Ongoing Crisis Stabilization and Transition • Provide ongoing acuity/ risk assessment • Provide coordination of care and collaboration with involved providers • Develop a comprehensive care plan • Address trauma exposure/ traumatic stress • Refer for psychiatric evaluation, as needed • Facilitate transition to ongoing supports and services

11. To Call or Not To Call? • Call 211 for EMPS • Harm likely to occur if there is not immediate assistance • Behaviorally “acting out” or out of control • In distress and uncommunicative • Depressed and you are worried • Threatens or at risk for suicide • Threatens or at risk for violence • Victimized/Traumatized • Can’t reach service provider • Have already called the police • In Crisis as defined by the family or caller • Considering an ED evaluation • Call Police or ED • When child needs immediate medical attention (overdosed, currently intoxicated, seriously injured, etc.) • When child needs immediatepolice intervention (weapons, serious assault)

12. Contact Information • Contract Manager – [Insert Clinic Name] • [Insert clinician name, credentials, contact info] • [Insert supervisor name, credentials, contact info] • DCF Program Managers • Tim Marshall, LCSW – 860-550-6531tim.marshall@ct.gov