The Impact of Mobile Crisis Services on the Use of Community-Based Mental Health Services

Abstract

Objective: To examine the impact of community-based mobile crisis services on postcrisis community-based mental health service use and user characteristics related to likelihood of postcrisis service use. Method: Differences in use of postcrisis mental health services and timing between a community-based intervention cohort and a matched hospital-based cohort were assessed using a Cox proportional hazards model. Results: A mobile crisis intervention consumer was 17% more likely to receive community-based mental health services within 90 days after the crisis event. Controlling for prior service use, mobile crisis intervention consumers with no prior mental health service use were 48% more likely to receive community-based mental health services within 90 days after the crisis event than a consumer from the hospital-based intervention cohort. Consumers more likely to use postcrisis services were African American, homeless, experiencing acute problems, previous mental health service users, and severely mentally disabled. Conclusions: Implications for social work practice are discussed.In reviewing the need for and role of psychiatric emergency services, Mollenhauer and Kaminsky (1996) stress the importance of these services being intimately connected to the rest of the community mental health 731

A Controlled Before-and-after Evaluation of a Mobile Crisis Partnership between Mental Health and Police Services in Nova Scotia

“…7,8 Even without police officers, mobile crisis services can enhance the subsequent use of mental health services in people who are disadvantaged or disenfranchised, in particular people with serious and persistent mental illness and the homeless. [9][10][11][12][13] The only controlled evaluation of a service involving police and mental health clinicians was a small retrospective US study, not a controlled before-and-after design. This showed that the crisis team led to fewer subsequent admissions, as well as greater police and consumer satisfaction over 3 months.…”

Helping Persons with Mental Illness: Partnerships between Police and Mobile Crisis Units

“…Scott (2000) and Cowell, Broner, and Dupont (2004) found cost savings in criminal justice expenditures; however, this was also accompanied by an increase in treatment costs (Cowell et al, 2004). In addition, Dyches et al (2002) found MCUs to be more effective than hospital-based mobile crisis services in connecting services and PMI.…”

“…The existing research seems to agree that MCUs serve a different population than hospital emergency rooms. The MCU PMI are more likely to have past arrests and/or histories of violence, possess more major disorders, and be homeless (Dyches et al, 2002;Gilling, Dumaine, Stammer, Hillard, & Grubb, 1990;Lamb et al, 1999). These PMI often refuse emergency room treatment or are unaware of a need for treatment and possess fewer capabilities to meet their own physical needs.…”

“…Communities discovered that psychiatric emergency services worked better if they were connected with community mental health providers. The underlying assumption was that community-based mobile crisis services improved linkages to the broader mental health network and facilitated the more frequent and timely use of community-based mental health services (Dyches et al, 2002). By the early 1990s, 37 states had implemented some type of mobile crisis services (Geller, Fisher, & McDerment, 1995).…”

“…MCUs are one form of formal links between law enforcement and psychiatric services that allow officers to make decisions involving PMI that direct them to the treatment and/or resources they need. MCUs have been heralded as an effective way for law enforcement to partner with community mental health entities to provide more appropriate and effective interventions to PMI (Dyches, Brezel, Johnsen, Guo, & Min, 2002;Guo, Biegel, Johnsen, & Dyches, 2001;Kiseley et al, 2010 …”