LEBANON — West Central Behavioral Health is seeking the City Council’s support as it pursues a $500,000 federal grant to launch a mobile crisis team to respond in person to mental health crises as they arise in Lebanon.
Demand for mental health services has been on the rise in recent months, at least in part as a result of the pandemic, according to the description of the project known as the “Mobile Health Crisis Response initiative” included in the Lebanon City Council’s agenda packet for its Wednesday meeting. The City Council is being asked to schedule a public hearing on the community development block grant later this month.
“We see quite a few calls that have some sort of mental health connection to them,” said Lebanon Police Chief Richard Mello, who worked with the Lebanon-based West Central and the City Manager’s Office to put together the proposal.
Another goal of the initiative is to shift the response to mental health crisis calls away from police and onto more appropriate service providers. Mello compared it to the relationship the department has with WISE, which allows the department to refer victims of domestic violence to that nonprofit for services.
“We hope to have a situation where we can refer individuals to West Central when they are in crisis and there is no criminal element to our involvement,” he said.
Now, when people call the Lebanon police seeking assistance with a mental health crisis, officers respond to the call, assess the situation and try to intervene, Mello said. From there, they really have only one option, he said, which is to take the person in crisis to a hospital emergency room. Though some people in crisis may still need that level of support, Mello said he’s hopeful that being able to connect people who are struggling with clinicians at West Central will meet some people’s needs without a trip to the hospital.
“Something like this is the answer,” Mello said.
When people wind up in hospital emergency rooms due to a mental health crisis, they sometimes get stuck there for long periods as they wait for an appropriate bed to open up somewhere else. While they wait, their illness often goes untreated.
Though the number of people waiting in hospital emergency departments for inpatient mental health treatment dipped at the beginning of the pandemic, it has climbed again so that last week it once again hit the all-time high of 71 people waiting in emergency departments across New Hampshire for inpatient mental health treatment, said Ken Norton, executive director of the state’s chapter of the National Alliance on Mental Illness.
“We’ve certainly seen a big surge in people coming into emergency rooms and needing inpatient care,” Norton said.
He said that mobile crisis units have been shown to divert people both from the hospital and from incarceration. Norton said he knows from personal experience that families and people with mental illness need an alternative to calling police when they are in crisis.
“Law enforcement isn’t necessarily equipped or trained in how to deal with somebody in a mental health crisis,” said Norton, who sits on New Hampshire Gov. Chris Sununu’s Commission on Law Enforcement Accountability, Community and Transparency, which was established in June following the killing of George Floyd by police in Minnesota.
West Central CEO Roger Osmun said Lebanon City Manager Shaun Mulholland, himself a former police officer, approached West Central looking to figure out a better way to respond to some of the calls going to the city’s police department. At the same time, West Central was already hoping to expand its mobile crisis services.
West Central currently has just one full-time clinician available to respond to mental health crises in the Upper Valley on weekdays from 8 a.m. to 5 p.m. Phone assessment and support is available after hours, but the organization refers most urgent calls to Dartmouth-Hitchcock Medical Center for an in-person assessment and/or emergency admission.
Should the grant funding go through, Osmun said West Central would increase the number of mobile crisis staff to 4.2 full-time equivalent positions so that someone would be available to respond to mental health crises in Lebanon 24/7. Because that would leave just one person available at a time, Osmun said the organization would see whether it also needs a form of on-call support that could potentially be provided via iPads or other devices that police could carry with them in their cruisers.
The “goal is to be as proactive as possible,” Osmun said.
After helping people through the initial crisis, West Central clinicians involved would follow up with people within 24 hours to ensure they are getting the care and services they need. The follow-up would be aimed at reducing the likelihood that people would again reach a crisis point requiring emergency services.
Though he said he hasn’t had a chance to review the details, Lebanon Mayor Tim McNamara voiced enthusiasm about the new initiative. He said he likes the idea better than embedding a mental health clinician in the police department, which could mean that person isn’t available when the services are needed.
“With this grant you get them when you need them,” he said. “I think it’s a wonderful concept.”
The grant would give the city and West Central 18 months to try out this model of delivering the service. After that, if it works, McNamara said the city or perhaps region could look for money elsewhere to continue it.
“I think we always have mental health needs,” he said.
While the project is initially focused on addressing crises in Lebanon, West Central aims to eventually expand it to the other communities in the New Hampshire part of the Upper Valley that the Lebanon-based community mental health center serves, according to the council’s agenda packet.
If the council agrees to hold a public hearing, it most likely would take place Sept. 16.
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.