Through a partnership with the Oklahoma Department of Mental Health and Substance Abuse Services, HunterCare deploys telehealth technology for all Certified Community Behavioral Health Clinics in Oklahoma.
Under a funding mandate from Oklahoma Senate Bill 7, the Department of Mental Health and Substance Abuse has distributed more than 30,000 iPads statewide through MyCare Technologies, HunterCare’s behavioral health division, as a mental health resource.
A key component of this new initiative: Law enforcement officers often face challenges in transporting individuals in a mental health crisis to the nearest facility for assessment. So the legislative funding facilitated the delivery of MyCare iPads to the Oklahoma Police Department and to Certified Community Behavioral Health Clinics. The results were encouraging.
THE PROBLEM
Police officers serving Oklahoma communities routinely encountered individuals who may have had mental health issues and would have to choose one of two courses of action: take them into custody and incarcerate them, or take them to the local emergency room to have the individual assessed by a spiritual counselor. health professional.
“Because most ERs do not have in-house behavioral health professionals, our office is typically contacted by hospital staff, and we have our on-call licensed therapist go to the emergency room to perform a full evaluation,” explains Larry Smith, CEO of Major Mental Health .
“This process resulted in police officers having to wait with the person experiencing it mental health crisis in the ER before our arrival and remain there with them until a decision is made as to where the person would be admitted for treatment – or released and returned to where they were first picked up,” he added to it.
Waiting for the individual’s final statement can take several hours and then transporting the person to where they need to go can take several more hours, leaving police officers frustrated and unable to fulfill their role in protecting the community to fulfill.
In addition to wasting time from law enforcement, those needing treatment were often left waiting for hours in high-intensity emergency rooms, which would often worsen their trauma, Smith noted.
“In 2015, this process included more than 1,100 situations in which a person was taken to an emergency room for evaluation and then transported to an inpatient treatment hospital, sometimes several hours from where they were picked up and from the communities where they and their families lived. ” he said.
“We believed that the number of individuals admitted or incarcerated in inpatient hospitals could be reduced if police officers had a suitable alternative to the local emergency room or jail for those experiencing behavioral health problems,” he added.
PROPOSAL
The first part of the solution to the problem was to design a facility where police officers could bring an individualized experience mental health crisis and ensure they get the care they need without officer supervision.
Not only would this be what is best for the individual, but it would also allow law enforcement to get back to serving their communities as quickly as possible. However, if the facility assessed the person and they did not meet the requirements to be held against their will, the trip to the facility was a wasted trip. The facility was only part of the solution.
“We knew the best-case scenario would be for our trained behavioral health professionals to be able to conduct an on-site mental health assessment at the time the police officer first came into contact with the individual experiencing a mental health crisis ,” Smith explained. “What we needed was a therapist in every police car who could evaluate any person suspected of being a danger to themselves or others.
“Of course, having a therapist in every police and sheriff’s car in our community is cost-prohibitive,” he continued. “This would be a total of approximately 900 vehicles requiring a therapist 24/7.”
The teams knew that the solution also had to be efficient and cost-effective.
“We knew the solution needed to work in a way that police officers would find it easy to use and reliable 24/7, and have immediate access to a therapist who was awake and helpful in determining what was needed to get appropriate services for the person what they were dealing with,” Smith said. “Our hypothesis was that if we could accomplish all of this, we could prevent people from being sent to emergency rooms for non-physical emergencies, and as a result, everyone would win.
“So we asked the question, ‘What if the therapist could be contacted in real time by a police officer via video technology, and the assessment of the person in need could be conducted via videoconferencing?’” he continued. “It should be quick and easy for the officer and the individual to use, and the video should not be choppy and the voice should be clear.”
The size of the screen should be larger than that of a mobile phone to get a good idea of what is happening, and the connectivity should always be 100%.
“After looking at what needed to be done, it was clear that this was not something that would be solved without a lot of creativity and testing in a live environment,” Smith noted. “We had to ask a sheriff’s department to work with us on how the technology would work best and what they would like to use it for.
“We started with a simple process and an easy way for a police officer to contact our facility, where a 24/7 therapist would answer the video request and complete a mental health evaluation,” he added.
MEETING THE CHALLENGE
The Craig County Sheriff’s Department agreed to allow Grand Mental Health to place a custom iPad in their vehicles to use when they encountered a person who needed to be evaluated for mental healthcare. All the officers had to do was touch a single button on the iPad and it would be answered by a Grand therapist who worked at one of Grand’s 24/7 Behavioral Health Urgent Recovery Centers.
“We quickly learned that not only did the officers enjoy using the iPad, but the people being served enjoyed using it as well,” says Smith. “The amount of time the officer spent trying to get the appropriate help to the person in need was reduced, and the number of people sent to an inpatient unit or jail was further reduced.
“We quickly introduced the iPads to all police officers in the seven northeastern Oklahoma counties we served, and our relationship with law enforcement improved dramatically,” he continued. “Moreso, the access to services the individuals needed was immediate and helpful.”
Grand later realized that police officers face intense crisis situations and are themselves traumatized on a daily basis. To address this, Grand has added a second button to the iPad so that a police officer who has just experienced a traumatic episode can tap this button and talk to a therapist for de-escalation. Not a single file that the police have to worry about.
RESULTS
Since the inception of the iPad program, inpatient hospitalizations due to mental health crises have decreased by 93.1% between 2015 and 2021, resulting in cost savings of more than $62 million for federal and state governments.
“We have now expanded our services to 12 rural counties in northern, central and northeastern Oklahoma and every law enforcement vehicle in these 12 counties is equipped with our Grand iPad,” Smith reported. “But that’s just the beginning: every Grand customer receives an iPad for continuous access to services. We now have Grand iPads in the homes of more than 10,000 customers, so we can receive services wherever and whenever they want.
“As a result, we increased the total number of adult customers we serve by 362% between 2015 and 2023,” he continued. “We also recently expanded into Tulsa County and are working with local law enforcement to expand our reach and access. We expect to double our current footprint with the addition of Tulsa County.”
ADVICE FOR OTHERS
Ultimately, mental health is a dynamic sector filled with many complex challenges. It requires combining the very best staff with breakthrough thinking, emerging technology and results-based services to solve the problems of the day, Smith advised.
“If no solution exists, we will work relentlessly to create one,” he said. “My advice to other healthcare providers is to think outside the box and never settle for the status quo.
“The The mental health crisis in our country has reached pandemic status,” he continued. “It is our responsibility to break the stigma of mental health care through targeted education of our community partners and to increase access to results-oriented, data-based mental health care. by using the latest technology and service developments.”
Smith encourages his fellow providers, along with federal, state and local officials, to view mental health care not as the problem or responsibility of an individual, but as the problem and responsibility of a community.
“It will take all of us to make a difference,” he concluded. “I welcome the opportunity to work with any agency that could benefit from our first-hand experiences and successes.”
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