Crisis event dispositions following a crisis response team intervention.

Abstract

Objective: We examined dispositions of crisis response team (CRT) events over 2 years in a large Midwestern city. Method: Between January 1, 2018 and December 31, 2019, the CRT self-dispatched to mental/behavioral health-related 9-1-1 calls. Data utilized for analysis included demographic information of persons in crisis, crisis type, and crisis event dispositions. Crisis types were mental health, self-harm, and substance use related. Event dispositions included immediate detention, arrest, transport, and issue resolved. Multinomial regression models were used to predict crisis event dispositions as a function of the three crisis types, controlling for covariates. The sample included 1,426 events to distinct individuals. Results: Most CRT events involved persons who were White (47.7%; n = 680), male (56.1%; n = 800), and an average of 39.3 years of age (SD = 16.6). Most crises were mental health (65.4%; n = 932), followed by self-harm (31.7%; n = 452), and substance use (25.9%; n = 370). Events were generally resolved at the scene (55.0%, n = 784); over a quarter resulted in immediate detention (26.9%, n = 384), followed by voluntary transport (14.0%, n = 200), and arrest (4.1%, n = 58). Crisis type was a significant predictor of event dispositions: Self-harm crises were associated with immediate detention and voluntary transport, and substance use crises with arrest. Homelessness was also a significant predictor of arrest. Conclusions and Implications for Practice: The findings provide a better understanding of the short-term impact of CRTs. Data highlight how crisis type indicators predict event dispositions, demonstrating potential for more efficient emergency responder utilization by dispatching units according to crisis type.

Introduction to the special section on recovery-oriented services in crisis settings.

“…This is an introduction to the special section "Recovery-Oriented Care in Acute Care and Crisis Service Settings." Please see the without stable housing, while Bailey et al (2021) found persons experiencing homelessness were more likely to be arrested than those who are not. Clearly, even recovery-oriented services such as these struggle to support the recovery of persons experiencing homelessness.…”

“…In this special section, Bailey et al (2021) report on one of many promising alternative approaches to criminal justice response to mental health crises—crisis response teams (CRTs). While prior trials have shown CRTs to be promising in reducing arrest of persons referred for mental health crisis, their study further elucidates factors associated with disposition at the scene.…”

“…Their study provides a longitudinal perspective on peer respites within the United States, particularly regarding their staffing, administration, and policies. Importantly, both their study as well as the paper by Bailey et al (2021) point toward gatekeeping of therapeutic services for persons lacking stable housing. Pelot and Ostrow (2021) noted that peer respites increasingly exclude persons without stable housing, while Bailey et al (2021) found persons experiencing homelessness were more likely to be arrested than those who are not.…”

“…Importantly, both their study as well as the paper by Bailey et al (2021) point toward gatekeeping of therapeutic services for persons lacking stable housing. Pelot and Ostrow (2021) noted that peer respites increasingly exclude persons without stable housing, while Bailey et al (2021) found persons experiencing homelessness were more likely to be arrested than those who are not. Clearly, even recovery-oriented services such as these struggle to support the recovery of persons experiencing homelessness.…”