Case Management
One of the key components of each of the teams was their approach to case management. During the interview, the teams expressed their main goal when dispatching to a crisis call is to de-escalate and assess for needs. While CCOR and MIH also aim to de-escalate and assess for needs, they provide longer-term case management. This could be due to the populations they serve; MIH primarily serves more vulnerable populations that would benefit from additional support, and CCORs serve youth and their families. Caseloads for MIH and CCORs are therefore larger than those of the other teams. Folks who frequently call 911 are the outliers for most of the teams. Since some folks in the community call 911 more frequently, the teams have kept files on them and have cross communication with each other since the other teams might have frequent contact with them.
Every team has about 2-3 professionals who respond to crisis calls. These can include a Mental health Professional (e.g. MSW), Case Manager, Adult or Youth Peer, and specially trained police officer or firefighter. CCORs is the only team that sends three professionals: an MSW, a case manager, and an adult or youth peer. The Peers provide lived experiences that can be helpful with getting folks connected to services. These teams are either positioned and dispatched through one location or pre-positioned in more challenging areas of King County. The teams are adequately trained through hours of training around de-escalation and familiarized with local resources to quickly connect community members to housing, food, and legal support.
Addressing Underlying Challenges
The goal the teams have stated is to provide an option to address Seattle’s most vulnerable communities that does not lead to police arrest but an opportunity to get their underlying challenges addressed by connecting them to helping services. Getting people the help they need can be difficult due to stigma, bias, or inability to ask for help. The team’s approach encouraged folks to work differently, where a common theme was working alongside the client to create a shared goal of what to do next, what resources they need first, and if follow-up is needed. CARE, on occasion, will be called after a 911 call if they believe Social Workers will better help the client. While the client is ultimately in charge of whether they want services from CARE, they are incentivized not to be charged with something if they work with CARE. Having these teams as an option to address vital needs instead of incarcerating them can provide more adequate support by providing stabilizing resources.
Selected Quotations
Joe (SOUND – MRRKT): “Each staffing has a supervisor that is either a mental health professional or clinician MHP and the manager oversees the north is also MHP. In the south you have the same thing manager and each shift for days swing and night as a supervisor and all those supervisors have mental health professionals. So they’re responsible for overseeing each of the shifts. The shifts run eight hours.”
Jon – MIH: “We have very, very skilled practitioners, which is where you have to start. And they’re very experienced and they really know these situations very well. I think another one is being very patient centered, so we don’t have a specific destination or outcome or program that we’re trying to navigate people to. We go in, I think, very open-minded and willing to meet people where they’re at and offer solutions that work for them. So we’re not trying to cram every round peg into a square hole as it were.”
Amy – CARE: “So the CARE community crisis responder team consists of 24 first responders who can be dispatched from 9 1 1 to priority three and four person down in welfare check calls, either in tandem with police, in separate vehicles, independent of police in some circumstances. And then they also on view different calls when they’re in between add on different premises of somebody who naturally would fall in those categories. They can extend services. They have three supervisors, sort of the sergeant equivalent, an alternative response, there’s a training manager and then there’s a manager of the whole unit who’s like an equivalent of a lieutenant. They operate seven days a week, 10 hours a day. So that’s noon to 10:00 PM and they’re citywide now in Seattle.”
Zee – MCT: “…looking at the high end of the spectrum in terms of risks, whether it’s they call the call volume to nine one one is very high or they were armed with a weapon or their behaviors are just so erratic and so unpredictable that we’re worried that they’re going to get potentially to the point of violence. We will involve ourselves with those. So we end up touching about 1500 calls a year. So about 10% of the crisis calls in the city we do have follow up on.”
Dianne – CCORS: “So we have what we call pods, which are essentially teams. And each pod is on call one day per week across the Monday through Friday. And a pod consists of a mental health professional, a case manager, and a peer, either a parent partner or youth peer, sometimes both. And the mental health professional does a mental health assessment and helps with psychoeducation for the parent. The case manager works with the family around resources and maybe working with the family to advocate around the youth needs at school and developing some type of support plan at school. And then the parent partner and or youth peer can support the parent and or youth with their own lived experience and what things have been helpful for them, helping them with learning some coping skills for managing stress and emotions. We work with families around communication challenges and self-advocacy, that type of thing. And then we have an after hours team that works starting at five and over to eight in the morning every night. And then we have the after hours team that works Saturdays and Sundays and holidays.”