Jim Kenyon: Appropriate response for mental health crises

Valley News Columnist
Published: 9/17/2022 10:54:07 PM
Modified: 9/17/2022 10:53:39 PM

As a small-town New Hampshire cop in his early 20s, Zack Brock responded to a 911 call about a man who was threatening suicide by jumping into rush-hour traffic on Interstate 93.

Brock, the only officer on the scene, was able to talk the man out of harm’s way. After frisking the man and finding no weapons, Brock did just as he was trained — as minimal as that was.

Brock placed the man in handcuffs, plopped him into the back of the cruiser, and drove him to a nearby hospital’s emergency department.

Twenty years and a few career changes later, Brock is back responding to crisis calls about people who are contemplating ending their lives.

Only now he’s not equipped with handcuffs and a handgun. He carries a three-ring binder and a notepad.

Last summer, Brock, 43, joined the mobile crisis response team at West Central Behavioral Health that was in its infancy.

Brock, a mental health clinician with a master’s degree, and the other six members of the team are called out at all times of day and night. Traveling in pairs, they’re dispatched to homes, schools, parking lots and even the Sullivan County jail.

“Wherever the crisis is, we go,” Brock said.

Until last year, New Hampshire’s only mobile crisis response teams were in Concord, Manchester and Nashua.

In June 2021, the New Hampshire Executive Council approved $52.4 million in contracts with the state’s 10 mental health centers. West Central, a nonprofit that covers Sullivan County and the southern tier of Grafton County, saw its state allotment jump from $1.4 million to $3 million.

“This is a huge change,” Bill Metcalfe, West Central’s director of mobile crisis services, told me. “It’s a culture shift.”

It brings the state “in line with best practices throughout the country,” Ken Norton, executive director of the New Hampshire chapter of the National Alliance on Mental Illness, said in an interview last year with Valley News staff writer Nora Doyle-Burr.

For years, mental health advocates have promoted mobile crisis teams as a way to keep people out of hospital emergency departments that may not be well-equipped to treat mental illnesses. They argued that not only was it better for patients, but it could reduce costly emergency department visits.

Early returns are promising.

Of the 113 calls that West Central’s crisis team responded to during the first six months of this year, only nine involved emergency department visits.

An additional selling point: Of the crisis team’s 113 “outreaches,” 99 occurred without police involvement.

Claremont Police Chief Brent Wilmot told me West Central’s mobile crisis team is a welcome addition at a time when many Upper Valley police departments, including his own, are stretched thin by staff shortages.

When police get calls about people experiencing mental health crises, there’s only so much that officers can do other than drive them to a hospital for evaluation.

“We have been accustomed to doing it a certain way,” Wilmot said. “We’re seeing the same people over and over again, and it’s not working.”

But with the mobile crisis team up and running, police aren’t going it alone. “We’re having some success with them coming in to help,” Wilmot said. “They’re diverting people from the hospital.”

The challenge now is making people experiencing mental health crises — or anyone reaching out on their behalf — aware that their first call doesn’t have to be to police. A call center, where mental health workers operate a 24/7 statewide rapid response line, opened in January.

After talking with the caller and assessing their needs, mental health workers decide whether to send in a crisis response team.

To not draw attention, Brock and his teammates drive unmarked West Central vehicles. Brock dresses casually — khaki pants, collared shirt and sneakers — to make “clients” feel more at ease.

Sometimes he starts out “just shooting the bull. The more trust people have in you, the more they’ll open up.”

He usually takes notes, but “sometimes, I don’t take my pen out,” he said. “A person can be intimidated. They feel like they’re being critiqued.”

A visit can last from 30 minutes to three hours, during which time Brock and other team members must sum up the situation. Is the person at risk to harm himself or others? Do they need to be hospitalized?

“When you go out on a crisis call, usually you don’t know the person or what’s been going on in their lives,” Brock said. “You’re just trying to figure out the pieces of a puzzle.”

A person’s mental health crisis could stem from relationship troubles or money woes. Job or health stresses might make someone feel overwhelmed.

The three-ring binder that Brock carries with him is filled with contact information for social service agencies. A big part of the job is “connecting people to resources,” he said.

West Central follows up by phone to see if there’s more it can do. Brock also tells clients not to hesitate to call again. “A crisis isn’t always one and done,” he said.

Brock is working on a Ph.D., with plans to become a child psychologist. Until he finishes his studies, the mobile crisis response team is an ideal job.

“You’re trying to help someone whose life at that moment is in shambles,” he said. “The chance to help them get their bearings is a great feeling.”

The 24/7 New Hampshire Rapid Response crisis line can be reached by calling or texting 833-710-6477. To chat online go to www.nh988.com.

Jim Kenyon can be reached at jkenyon@vnews.com.

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