1. Stark County’s Mobile Response Youth Program
Michele Boone, LPCC-S, CDCA, Director of Clinical Services at StarkMHAR
Jeffrey Allen, LISW-S, LICDC-CS, CEO at Alternative Paths
Clifford Hall, Sergeant at Stark County Sheriff’s Office
September 15, 2018

2. What does StarkMHAR do?
Vision Hope, wellness and recovery for everyone Mission StarkMHAR supports wellness and recovery through innovation in funding, collaboration, education and advocacy What we do Advance public mental health and addiction prevention, treatment and recovery in Stark County

3. Program Beliefs
Mobile Response Youth Program (MRYP) serves birth to age 18
Mobile response requests can be made by any individual or any system at any time
No request for service refused
Come from place of yes
Language is important

4. Beliefs continued
Intervention aim is to avert hospitalization and out of home placement of youth in crisis
Family and natural supports inclusion
On-site response requests are met within 30 minutes (current average 24 minutes), with exceptions for outlying parts of county

5. Program Structure Team serves all of Stark County
.5 FTE Manager, 1 Supervising Clinician, 3 Clinicians, 2 Case Managers (CPST), and 1 Family Peer Supporter
Funded and oversight though Stark County Mental Health and Addiction Recovery
SAMHSA System of Care grant, OhioMHAS Strong Families grant, Medicaid, Insurance, Local levy

6. Program Components 3 Response Pathways Rapid Accelerated Supportive
Follow up contacts
Mobile Response request
Emergency Department request

7. Mobile Response Youth Program (MYRP) Response Protocol Call Crisis Hotline: 330-452-6000
Supportive Response Pathway
Accelerated Response Pathway
Rapid Response Pathway
Response Time
Within 12 Hours
Within 24 Hours
Within 30 Minutes
Response Indicators
Low degree of distress
Not at risk to self or others
Low risk due to mental health symptoms (e.g. delusions, psychosis etc.)
Social isolation
Would benefit from telephone engagement and support
Acceptance of treatment options
Would benefit from referral to behavioral health care services and social service agencies
Moderate degree of distress
Caller requests delayed activation
Parent or school personnel requests assistance during a specified timeframe
Rapidly increasing mental health symptoms
Moderate risk due to mental health symptoms (e.g. delusions, psychosis etc.)
Moderate emotional distress
Requires priority behavioral health triage
High degree of distress
Reports of high-risk behaviors
Individual presents as a danger to self or others
Acute suicidal ideation
High risk due to mental health symptoms (e.g. delusions, psychosis etc.)
Substantial risk of physical harm to self
Marked inability to provide basic physical needs due to mental illness
Significant emotional distress
Refusing voluntary treatment options and may benefit from inpatient hospitalization
Requires Rapid Co-Response
Response Team
MRYP Counselor
Family Peer Recovery Supporter
Law Enforcement if indicated
Response Elements
Collaborative Phone Consultation
Non-Face-to-Face Response
Engagement Call
Behavioral Health Triage
Service Navigation
Care Coordination and Linkage
Telephone Support
Coordinated Co-Response (as indicated)
Face-to-Face Response (home or community settings)
Crisis Mental Health Assessment (as indicated)
Family Peer Recovery Support Services
Coordinated Rapid Co-Response
Pre-Hospital Screening
Application for Emergency Admission for individuals 18 years or older
Collaborative Disposition Plan

8. Mobile Response Youth Program (MYRP) Response Protocol Call Crisis Hotline: 330-452-6000
Supportive Response
Pathway
Accelerated Response Pathway
Rapid Response Pathway
Response
Duration
Up to one week
Up to 30 days; may be extended as needed
Recovery Response
Scheduled Follow-Up Calls by Family Peer Recovery Supporter at the discretion of the MYRP Counselor.
Referral to the MYRP Counselor as Indicated for Reassessment of Needs
Scheduled Face-to-Face Encounters by MRYP Counselor and/or Family Peer Recovery Supporter in Home and Community Settings
Frequency of Encounters Collaboratively Developed Between Individuals Served and MRYP Counselor
Scheduled Follow-Up Calls by MRYP Counselor and Family Peer Recovery Supporter
Collaborative Face-to-Face Discharge Encounter with MRYP Counselor and Family Peer Recovery Supporter

9. Components continued
Behavioral health consultation, crisis management, assessment, care plan, linkage, and postvention
Embedded clinical practices
C-SSRS, Brown Stanley Safety Plan, CAMS

10. Components continued
Suicide and community tragedy postvention response
Suicide cluster and contagion

11. Community Partnerships – Law Enforcement
Diversion opportunity
How to engage law enforcement and get their buy in for use of mobile response
Wait time can be a downside
Consideration of time on scene for law enforcement

12. Community Partnerships – Law Enforcement
Ability to engage with people in crisis
CIT or MHFA trained law enforcement officers
Person may talk more freely with crisis staff
Overall, benefits of mobile outreach outweigh potential downside

13. Implementation Additional Community Partnerships Data
Systems – Education, Developmental Disabilities, Dept of Job & Family, Justice, Medical – Emergency Departments
Community organizations
Data
Tracking elements

14. Disposition – January to July 2018

15. Implementation continued
Roll out of the mobile service
Under promise and overdeliver
Staffing patterns and training
Use of data
Ongoing training and consultation

16. Calls by Hour – Jan. to July 2018

17. Response by Day – Jan. to July 2018

18. More on implementation
Ongoing marketing outreach activities
Outreaches vs calls for service per area
Cultures represented in calls for service
Billing
Third party payor
Non-Medicaid funds
Grants

19. Contact us Michele Boone, LPCC-S, CDCA,
Director of Clinical Services at StarkMHAR
Phone:
Jeffrey Allen, LISW-S, LICDC-CS,
Executive Director at Alternative Paths
Phone:
Clifford Hall
Sergeant at Stark County Sheriff’s Office
Phone: