Three Things To Read This Week
1. In Virginia, The “Someone To Call, Someone To Respond And Somewhere To Go” Vision Takes Shape.
Whether it’s “the depths of depression so severe that there seems no way out” or “delusions [that] won’t leave a sufferer in peace,” Dave Ress reports for the Richmond Times Dispatch on the process that begins when someone in crisis calls for help.”
Someone To call: Dispatchers at the 9-8-8 crisis dispatch center work around the clock and handle over 8,000 calls every month in Virginia, giving people in crisis “a trained counselor who can help when you're experiencing mental health-related distress.” The Times Dispatch reports that while “thirty minutes is typical … calls can last for hours” and involve active listening, empathy, “listening for disconnection of thought and feeling that delusions bring …. and listening to get a sense of whether too much alcohol or too many drugs are an issue.” Dispatchers are extremely proficient at handling these calls, and “roughly 90% of the time, the conversation is enough to move people past the moment of crisis…” Dispatchers also can send people who need more help to a “same-day assessment at a local Community Services Board” to ensure that the person gets on the path to stabilization.
Someone To Respond: When a crisis can’t be resolved by the 988 counselors, one of Virginia’s mobile crisis response teams is deployed and “70% of the time, those teams can calm a crisis and steer someone to longer-term help…”. For WTVR, Richmond’s local ABC News affiliate, Tracy Sears rode-along with the mobile crisis response team to get a first-hand look at their work. The teams, composed of clinicians, certified peer recovery specialists and outreach workers respond to calls for service “24 hours a day, seven days a week helping people experiencing a mental health, substance use, or suicide crisis.” If the patient is in need of additional care, the team can then help them connect with “outpatient therapy, mental health skills building services, or it could be a higher level of care is needed,” so the team can transport the patient to a crisis stabilization center.
Somewhere To Go: In the same way that dispatchers resolve the vast majority of calls without sending a mobile crisis team, the mobile crisis team is able to “calm a crisis and steer someone to longer-term help without admitting them to a hospital” or taking them to jail, “70% of the time.” Now, though, when a person does need to go somewhere, jail or an emergency room aren’t the only—or even the default options. Crisis stabilization centers throughout the state provide 23 hours of inpatient care during which time the person can stabilize and get connected to ongoing services. Two-thirds of the time, a person who enters a stabilization center in crisis is able to avoid hospitalization, including by utilizing up to fourteen days of outpatient care through the crisis stabilization center.
2. Quick Response Teams On The Frontlines Of Overdose Epidemic.
For the Akron Beacon Journal, Alan Ashworth reports on a “quick response team” in Green, Ohio that takes its “outreach door to door to battle fentanyl, substance abuse, [and] overdoses.”
The team consists of “a community paramedic [based] in the Green Fire Department,” a “clinical coordinator,” and a Sergeant from the Summit County Sheriff's Office. They scan police reports looking for people who overdosed, and then attempt to contact them at their residence within 48 hours of the overdose (“the window when substance abusers are most likely to respond to the message the team brings: Help is available, and it can be accessed.”).
The goal is to “schedule the person for assessment and treatment” and “sometimes leave naloxone or fentanyl test strips.” It’s not that people who overdose are unaware of these options, but rather “a lot of people don't know where to start.” The quick response team helps them to chart a path forward.
Three important lessons that the quick response team learned, according to the Akron Beacon Journal:
Teams Make Multiple Attempts To Connect. One attempt to reach a person who has overdosed often isn’t enough. Thus, the team built persistence into its model “sometimes going out multiple times before making contact.”
Law Enforcement Uniforms Make It Harder To Connect. Seeing a law enforcement officer in uniform can decrease the odds that a person who has recently overdosed will answer the door. Some quick response teams address this issue with teams composed of civilians only, which also frees up law enforcement resources. The team in Green, Ohio, took a different approach. As the Sergeant put it, wearing “street clothes” so that people [don’t] look through the peephole and see me and [not] answer the door.”
Outreach After An Overdose Is One Part In A Broader Strategy To Combat Overdose Deaths. About “30% of those contacted do take some action to receive help for their addiction … We know that a lot of times we are just actually planting the seed.” Thus, Summit County, where the city of Green is located, also distributed “6,934 boxes of naloxone, making them available through the mail, and working with businesses to install the medicine in high overdose areas.”
Related: In its first month of operation, the Portland Fire and Rescue’s new overdose response team — an EMT and paramedic — responded to 90 overdoses downtown.” As Blair Best reports for the local Portland, Oregon NBC affiliate, “nearly half [of those overdoses] were treated on the street instead of the emergency room, freeing up resources. A spokesperson for the overdose response team told the news station that “once the [team] addresses somebody in the street, they establish that relationship, and they follow up 24 hours later … doing everything we can to meet the people in the street where they are and provide them a pathway out.”
3. “New Initiatives Credited For Drop In Burlington, Vermont Opioid Overdoses.”
Early last year, after Vermont endured its deadliest overdose year yet in 2022, Burlington’s Mayor Miro Weinberger shepherded through “a patchwork of initiatives” focused on reducing opioid overdoses such as the city’s overdose response team, a community emergency shelter, and a re-entry and recovery center. The result: As Katharine Huntley reports for WCAX3, last month Burlington had its “first sustained decrease in monthly overdoses since before the pandemic.”
This comprehensive approach focuses both on ensuring that the right expert handles each part of the complicated journey that accompanies opioid use disorders, and that each of these pieces are coordinated. For example:
A Dedicated Critical Response Team To Stop Overdoses. In its first six months of operation, the team—composed of two trained medical experts who respond out of the city’s Fire Department—engaged with over 1,200 patients who either overdosed or are at high risk of overdosing, distributed life-saving Narcan to a still broader universe of patients in-need, and referred many of these patients to continuing medical services. WCAX News reports that due to the success of the pilot programs, the Burlington’s City Council recently extended the overdose response team pilot until at least the end of this calendar year.
A Re-Entry And Recovery Center To Provide Treatment. People returning home from prison have a heightened overdose risk, which is why Burlington created a re-entry and recovery center to provide them with “direct medical care and case management support … [as well as] mental health care, and medication treatment,” Mayor Weinberger announced in March. Since it opened in 2022, the center has provided treatment and medical care to more than 200 people.
An Emergency Shelter For The Homeless Community. Opioid overdoses are also particularly high among homeless populations. Thus, in an effort to increase access to treatment for the homeless community, city leaders launched the Elmwood Shelter last year to provide an ongoing “connection to supportive services including medical care, mental health care, substance use disorder treatment, work training, and housing case management,” Mayor Weinberger announced. Moreover, for WCAX, Katharine Huntley reported that “people living there who are successful can move on to permanent housing.” A year after the shelter first opened its doors, about “35 people [are] living here at any one time” with “a waitlist of over 100.”
