Abstract: Utility of Service Records to Describe Services Provided and Outcomes after a Non-Police Mental Crisis Intervention (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Schedule:

Friday, January 12, 2024

Independence BR B, ML 4 (Marriott Marquis Washington DC)

* noted as presenting author

Tomoko Udo, Professor, State University of New York at Albany

Preston Roberts, MA, Doctoral Student, State University of New York at Albany

Jordan Dyett, LSW, Student, State University of New York at Albany, Albany

Denard Cummings, Student, State University of New York at Albany

Timothy Campbell, LCSW, Doctoral Student, State University of New York at Albany

Carmen Morano, PhD, Professor, State University of New York at Albany

Background: Alternative mental health crisis response programs designed to reduce law enforcement presence are increasingly being implemented across the United States. The Albany County Crisis Officials Responding and Diverting (ACCORD) program is an alternative currently being implemented in Albany County, NY. This paper describes the results of a comprehensive descriptive analysis of ACCORD service records during the first-year of the ACCORD program, including the number of types of services provided, the nature of crises, and characteristics of the clients, as well as the rates of repeat service utilization and hospitalization will be presented.

Methods: Details on each service interaction and client information were extracted from the ACCORD fieldnotes. These included sociodemographic characteristics of the clients, primary reasons for requesting the ACCORD team, methods of services (e.g., on scene, phone), known mental health and other conditions, and outcomes of the service. Means and standard deviation (for continuous variables), and frequency and percentage (for categorical variables) were calculated for each of key measures.

Results: In the period June 2021-June 2022, ACCORD provided 325 crisis response intervention services and 212 follow-up services to 191 unique individuals. Of those 86.9% were reported no prior history of utilizing other mental health services by the county. The most frequent reasons for ACCORD dispatch included: suicidal behaviors (25.1% with 89.6% involving suicidal ideation), domestic incidence (17.3%), and someone exhibiting behavioral distress such as having a panic attack, a PTSD episode, or a severe depressive episode (26.4%). Twenty-seven percent of the patients required multiple crisis response interventions. Transportation of the patient to the hospital was needed for 32.0% of cases, with 84.6% resulting in involuntary admission. Among those with hospitalization records, 19.8% of clients being hospitalized more than once. Many crisis cases were resolved on the scene (65.6%) by providing a safety plan, service and treatment recommendations, service linkages, and treatment plan to address the immediate needs of the patients. Hospitalization was the outcome for 38.2% of cases. The team also provided patients additional resource and service referrals, as well as called hospitals and other providers for care coordination albeit with a limited capacity (~12% of follow-up services).

Implications: To our knowledge, this is the first comprehensive evaluation study of non-police mental crisis response models in the United States. Our findings support the ACCORD’s potential to address gaps in mental health services in a historically underserved community. We also identified a missed opportunity where the ACCORD may be able to better support particularly high-risk individuals with evidence-based social work case management models such as critical time intervention.