Mental health program internationally recognized

Community Response Team looks to expand in the future

Posted 9/28/18

When depression struck a 25-year-old Castle Rock woman in June, she knew all too well what was happening. The woman, who asked that her name not be used for privacy reasons, had already experienced …

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Mental health program internationally recognized

Community Response Team looks to expand in the future


When depression struck a 25-year-old Castle Rock woman in June, she knew all too well what was happening.

The woman, who asked that her name not be used for privacy reasons, had already experienced the condition in high school and watched it subside, then flare up again after the birth of her first child — and subside again.

On a day in late June, she found herself trapped in what she described as a loop with no exit — she felt she couldn't do anything right, and that the problems of the world were her fault. She struggled to find the motivation to properly care for her two children.

She also began feeling as though she wanted to harm herself.

“It boiled over to the point where I didn't feel that I was safe caring for my kids by myself,” she said.

Finally, she called her father, who rushed to her side, called her husband — and also called the Castle Rock Community Response Team, a special police unit made up of a clinician and an officer.

The team, which was internationally recognized in September, arrived at her home in under two hours.

“Looking back on that day, I'm relieved that that happened when it did,” the woman said. “Without having that happen, I don't know if I would be here today. I don't know if I would be as stable as I am today.”

An international stage

The Community Response Team, or CRT as it is commonly called, piloted in Castle Rock in May 2017 as part of the Douglas County Mental Health Initiative, and expanded from one to two teams in December.

In late September, the program received the Community Health & Safety Program Excellence Award from the International City/Council Management Association.

Martha Perego, director of member services and ethics for ICMA, said the nation is experiencing a mental health crisis and Douglas County's application stood out as one where local government was taking an intentional and innovative approach to addressing mental health in its community.

“You can see the statistics that they put out in their application,” Perego said, “where they are having an immediate effective response, a positive response to what they've done.”

Douglas County Deputy County Manager Barbara Drake accepted the award at the Baltimore conference, a gathering of approximately 3,500 city and county managers from an estimated 3,000 communities in the U.S. and abroad.

“I think what it means for us is we have to be on our toes,” Drake said. “There's likely to be a lot of interest generated because it's a widely attended conference.”

Jason Lyons, special operations division commander with the Castle Rock Police Department, isn't surprised at the recognition. He describes the CRT as the “most profound piece” of the Mental Health Initiative, a group of roughly 30 stakeholders from various branches in the mental health field.

Lyons called managing and being part of the CRT “the most impactful thing I've done.” He's been in law enforcement for 24 years and hopes the CRT becomes a national model.

With the CRT's one-year anniversary, the county got its first comprehensive look at data analyzing the program's effectiveness. Overall, the number show the team helped divert the mentally ill from jail and the emergency department while alleviating pressures on patrol and fire/EMS crews.

The program's annual report showed CRT met with 499 unique individuals 1,001 times in its first year. The team released 599 active patrol officers back into service, 127 fire employees and 66 fire vehicles.

Douglas County estimates the CRT saved $1.7 million by releasing the fire and EMS crews and avoiding emergency department and jail visits.

Their CRT program is similar to co-responder programs found throughout Colorado and the country, but unique to Douglas County in certain ways, she and CRT members said.

For one, Douglas County EMS and medical crews respond to CRT calls when needed. In other communities, they respond to each co-responder call. Or, the law enforcement agency has an in-house clinician who handles follow-up case management but doesn't ride with an officer full-time.

Success in numbers

Fearing for the safety of the Castle Rock woman, Dr. Allison Shew and Officer Wes Body with the Castle Rock CRT determined she needed to be removed from her home immediately.

With her consent, she was connected to an acute treatment facility in Littleton that day where she stayed for 72 hours. Meeting the Castle Rock CRT kick-started her journey to a healthier place, she said.

Although considered a success story, it's not the typical success story the CRT celebrates.

Of 911 calls the team responded to between May 2017 and April 2018, 60 percent ended with clients being assessed, stabilized and allowed to stay at home, the annual report shows.

That's a stark difference from how mental health calls played out before Douglas County piloted the CRT, said Body and Deputy Brian Briggs with the Douglas County Sheriff's Office CRT.

Law enforcement officers tend to “err on the side of caution” when encountering the mentally ill, the officers said. Calls where someone was in a mental health crisis frequently resulted in the person being taken to the emergency room or jail.

That's costly and usually ineffective, they said. People are released from the hospital and rarely receive ongoing care for their mental health or sit in jail when they truly need mental health treatment.

In its first year, 16 percent of 911 calls the CRT answered resulted in a person being directly admitted to treatment from the field, like the woman in Castle Rock.

In a quarterly report for this year, 57 percent of 911 calls between May and August were treated in place.

They can't force anyone to accept treatment, CRT members said, explaining that's a decision left to their clients — although, they may on rare occasion arrest someone they suspect of a crime or transport people to the emergency room during a medical emergency. They also use rare M-1 holds, where a person who's an imminent threat to themselves or others may be taken to the hospital.

In its first year running, the CRT did not initiate any arrests, according to the annual report.

One of the most important elements to the CRT is the follow-up case management it provides, team members said. Case managers call clients the CRT refers to them and help them find resources and make sure they are getting help.

“They're the meat of the program,” Briggs said.

Looking ahead everyone hopes the CRT can expand to cover the entire county. Discussions are underway with one community not currently covered by the CRT.

The Mental Health Initiative is also in the early stages of implementing a software program designed to integrate the local mental health system. In the program, officials such as the CRT can enter information about a client's case so providers can analyze data and communicate with one another. Officials would need proper clearance to access certain sensitive or private data, Drake said.

“That's exciting to think about — what it might look like,” she said.

'I knew they were there to help'

The Castle Rock woman said she truthfully answered the CRT's questions about wanting to harm herself because she believed they could help.

During intake at the acute care facility, though, she grew afraid.

“I felt like I was neglecting my kids by being there,” she said, breaking into tears. “And that first night there was the scariest time in my life, because I was away from my kids for the first time.”

But the CRT didn't just connect her with immediate care like the acute treatment center that helped her emerge from crisis. They also helped her find places to seek help beyond her three-day stay. She still sees a Castle Rock counselor once a week.

She not only feels comfortable asking for help, she said, but speaks openly about how she feels. Before meeting the CRT, she said she internalized her emotions. Through counseling she's learned what her triggers are. She's learned to take time for herself.

She's back to doing what was always most important to her — spending time with her family. Together they enjoy going to the zoo, taking a hike and being outdoors.

While speaking with Colorado Community Media by phone, the woman's two children played in the background, frequently coming up to ask their mother questions, and in two instances, to say “I love you.”

Gently, she responded.

“I love you, too.”


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