Alaska Mental Health Professionals Discuss State’s New Crisis Response Services – State of Reform

Mental health professionals are working to introduce multiple new crisis response services in Alaska, and several experts discussed ongoing initiatives in 2022 Alaska Health Reform Conference.

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Eric Boyer, senior program officer at the Alaska Mental Health Trust Authority (AMHTA), is leading the implementation of the new statewide Crisis now program. Crisis Now will include components that will work together to prevent suicide, reduce inappropriate use of emergency departments and correctional facilities, and provide support for residents in crisis. Its components include:

  • Regional or state crisis call center
  • Centrally located mobile crisis teams that respond personally to people in crisis 24/7
  • Short-term and 23-hour stabilization services that offer safe and supportive behavioral health accommodation for those who cannot be stabilized by call center clinicians or a mobile crisis team

Boyer said the system will help reduce the state’s reliance on law enforcement and EMS services to respond to people experiencing crises.

“[EMS] did a great job [but] that’s not what they’re trying to do or why they’re in the business of keeping people in the community safe,” Boyer said. “So we wanted something that addressed this behavioral health crisis with a larger response. We want to meet everyone’s needs. Mobile crisis teams will respond to anyone unless it is dangerous or law enforcement is truly needed. But otherwise they suit everyone.

Previous state emergency practices have resulted in residents staying longer in emergency rooms or facing obstacles in reintegrating into their communities after crises. Five years ago, AMHTA worked with the Alaska Hospital and Health Association to study the use of emergency rooms by people who had an acute episode and what their length of stay was, Boyer said. They also looked at waiting times for people who needed competency checks.

“And these studies told us that the problem is real,” Boyer said. “The data showed that the length of stay for people in emergency rooms across the state was long, and we had a backlog of people waiting for competency to stand trial.”

The Crisis Now model aims to address these issues with 23-hour stabilization centers and short-term stabilization centers that can provide care for 2 to 7 days.

“Once stabilization occurs, what we’ve seen from other states is that most of the people who go into one of them resolve those issues,” Boyer said. “They can go back into the community.”

Michelle Baker is vice president of behavioral health at the South Central Foundation, which provides health and wellness services for Alaska Natives and American Indians living in Anchorage and the Matanuska-Susitna neighborhood. She said the foundation is working with Providence Alaska Medical Center to install a crisis stabilization center for adults.

“We are really excited to offer this service on campus as a tribal health system,” Baker said. “We are also looking at an intermediate care facility to offer crisis housing services for adults and youth, crisis stabilization and crisis housing services. Housing services could be for Anchorage, our Alaska Native clients in the Mat-Su Valley, and a referral source for tribal organizations that do not have the staff or facilities to support these programs in their regions.”

Leah Van Kirk, state suicide prevention coordinator for the Alaska Department of Behavioral Health, helped the state implement 988 suicide prevention linewhich went live on July 16.

“The National Suicide Prevention Lifeline consists of over 200 call centers across the U.S.,” Van Kirk said. “And every state has a call center. Alaska was very well positioned because we had one call center that covered our entire state 24/7. Not every state had this when it came to implementation.

The department uses data from the call center’s previous suicide hotline, 877-266-HELP, to understand how Alaskans use the center. The center typically gets 20,000 to 25,000 calls a year, Van Kirk said.

“Most of our usage data shows the root causes are people [use it] are loneliness due to anxiety, depression and relationship struggles,” Van Kirk said. “And it’s important that Alaskans have a resource like [this] to get in touch so we can talk to someone and connect them to a service that might be available before they get to that crisis state.’

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