FAST Teams Traverse City Record Eagle

TRAVERSE CITY — Children with mental disorders likely won’t find the help they need in an emergency room, though that’s where they’ll end up should it escalate into a crisis.

Northern Lakes Community Mental Health is rolling out a new program this to curb those unnecessary visits to the emergency room —and the trauma and wait times that come with them. The agency received a near half-million-dollar grant to form mobile treatment teams that would offer immediate help to children in a behavioral or mental health crisis.

Stacey Kaminski, operations manager of crisis services at the agency, said the term “crisis” varies from person to person and is as vague and all-encompassing as its definition suggests: Any event leading to an unstable and dangerous situation for an individual or group.

The “crisis” scenarios Kaminski sees can range from a child acting out physically or verbally to having suicidal thoughts. Families’ responses vary from calls to a crisis center, law enforcement or a behavioral health specialist, but all have the same result: A trip to the emergency room.

“People in crisis are being advised to go to the emergency department, mostly because there aren’t any other good options,” said Terri LaCroix-Kelty, director of behavioral health at Munson Medical Center, one of several local agencies involved in the grant.

She said emergency departments nationwide are becoming “defacto crisis centers” as a result of diminishing behavioral and mental health resources.

Munson is no exception. LaCroix-Kelty estimated of of the thousands filtering through the hospital’s emergency department, up to 10 percent are people in a behavioral or mental health crisis. That group, which she’s watched nearly double in the last 2 years, usually includes those struggling with stress or a history of significant trauma.

“That goes on until a big crisis occurs and the family can’t handle it,” LaCroix-Kelty said. “They go to the ER because they don’t know what else to do.”

But emergency rooms aren’t equipped to handle those types of crises, and trips there can pile on more trauma to an already volatile situation, Kaminski said.

“It’s not an appropriate place for them, because the issue is behavioral, not medical,” Kaminski said. “Typically, once they get to the emergency room, their behavior has changed, so the response team isn’t seeing what the family sees.”

NLCMHA hopes to address that problem with FAST — Family Assessment and Safety Teams. The agency received nearly $500,000 from the Michigan Health Endowment Fund to roll out three mobile treatment teams over the next 2 years for Grand Traverse, Leelanau, Wexford, Missaukee, Crawford and Roscommon counties.

The teams — made up of a master’s level clinician and a bachelor’s level case manager — will respond immediately to assess and stabilize the crisis, followed by up to 90 days of monitoring and support, Kaminski said.

“We’re hoping that we can continue to follow them to make sure families have what they need to help their child,” she said.

That could mean connecting the family with a therapist or agencies like Child and Family Services, or developing a safety plan and returning to the home regularly to make sure its implemented, Kaminski said.

“We’re trying to avoid the trauma and lengthy hospital stay that come with a trip to the ER by dealing with the crisis at home,” she said.

LaCroix-Kelty said children in crisis now might be in the emergency department for days at a time waiting for the appropriate treatment, all the while taking up hospital beds that already run scarce.

“It’s unmanageable,” she said. “There are times when the emergency department is full and the waiting room is full. People in behavioral health crises are taking resources that people in medical crises need.”

NLCMHA will spend the next six months developing the mobile treatment teams and has already started interviewing physicians to staff them, Kaminski said. Grand Traverse and Leelanau counties will be the first to receive FAST, followed by the other four counties in the second year. The goal is to provide the crisis services regularly through Medicaid and other insurance providers by the end of the 2-year grant, and adding more teams remains a possibility.

“We’ll always be evaluating those numbers and keeping track to see if we need more staff,” Kaminski said.