Mobile crisis outreach program lowers overuse, misuse of ED, psychiatric hospital services

LAS VEGAS — A poster presented at the National Council for Behavioral Health annual conference indicated efficacy of a mobile crisis outreach program to prevent the overuse and misuse of ED and psychiatric hospital services.

“Our goal is to prevent the over and misuse of ED and psychiatric hospital admissions. We offer up to 90 days of crisis relapse prevention services, including crisis counseling, case management and medication evaluation to ensure the individual is treated for the duration of the crisis episode,” Laura Slocum, LPC, practice manager of the Mobile Crisis Outreach Team, Austin Travis County Integral Care, Texas, and colleagues wrote. “This may include 30-day inpatient hospitalization.”

In July 2013, the Mobile Crisis Outreach Team and Austin Travis County Emergency Medical Services community health paramedics began a pilot program to divert low medical acuity psychiatric patients from unnecessary ambulance transport and ED admission.

Mobile crisis outreach teams include mental health professionals and licensed clinicians who conduct crisis assessments to determine the least restrictive care environment that adequately resolves the crisis.

Researchers found that the team diverted 88.88% of assessed individuals during the initial pilot phase.

The current diversion rate is 77.1% and the Austin Travis County Emergency Medical Services community health paramedics dispatched the team 1,118 times.

Less than 2% of individuals assessed by the team are admitted to a psychiatric hospital within 30 days of receiving mobile crisis outreach services.

Most of the time an individual is diverted from the ED they remain in the community and receive subsequent crisis relapse prevention services from the mobile crisis outreach team or a preexisting treatment team, according to researchers.

“The [Mobile Crisis Outreach Team] and [Austin Travis County Emergency Medical Services] collaboration has yielded a hugely successful outcome in diverting individuals experiencing a psychiatric crisis from the overuse and misuse of ED admissions and psychiatric hospitalizations,” the researchers wrote. “[Mobile Crisis Outreach Team] intervention and subsequent diversion are a more cost-effective crisis intervention service and more clinically appropriate and solvent. It also has a major systemic impact as it creates more availability for ambulance units and more capacity at EDs for medical emergencies.” – by Amanda Oldt

Reference:

Slocum L, et al. MCOT & EMS: Diverting psychiatric patients to least restrictive environment of care. Presented at: The National Council for Behavioral Health Conference; March 7-9, 2016; Las Vegas.

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