Homeless Mental Health Assessment Centers: The community feedback period for this project began on 8/9/2018 and ended on 10/9/2018

What is the problem that needs to be addressed? Please describe how it is related to mental health.

The need for law enforcement and hospitals to manage when they are dealing with the homeless population struggling with mental health issues in the field.  These agencies lack options for interfacing with mental health assessment, services, and treatment.  Unless an individual meets 5150 criteria, there are not many options for law enforcement dealing with a homeless individual on the streets.  Outside of involuntary holds, these homeless individuals with mental health issues struggle with not wanting to go to shelter or housing as it exacerbates their mental health issues or they have already been exited from the few shelters in OC. I propose establishing a mental health assessment and triage drop in center in each of the three regions of OC (North, Central, and South).  These centers would not be Crisis Stabilization Units as we currently have in Santa ana.  They would be places for law enforcement to bring homeless individuals needing mental health staff to follow up with them 24/7.  It would also have upright sleeping options for individuals dropped off in the evening hours to allow for somewhere to stay until linkage could occur the next day to HCA BHS Outpatient clinics, FSP, PACT, or shelter/housing.

Why is this a concern for Orange County? What can Orange County and other counties learn from this project?

The homeless population struggling with mental health issues are the individuals who tend to use other services like hospital ERs, or interact with law enforcement more than the rest of the homeless population.  They struggle with linking to services and end up detained or arrested by law enforcement, when mental health services could impact them and help both eliminate their law enforcement interaction and reduce law enforcement staff’s time dealing with situations that do not require arrest.  OC and other counties can learn how to assess and engage with the homeless population struggling with mental health issues, who tend to avoid linking to services.  If these individuals can be connected to mental health services before arrest, it could be shown to impact significant cost savings in law enforcement and courts.

What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?

There are limited options for law enforcement officers and deputies when dealing with homeless individuals both during the day and after hours and on weekends.  This could be incredibly impactful in connecting the most vulnerable homeless to mental health services.

What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.

There are outreach and engagement staff in OC who work to assess and link homeless individuals with mental health services.  There are no centers working with this population that work directly with law enforcement.  Officers can refer to BHS Outreach staff, but there is not a physical site for them to take a homeless individual needing follow up service whenever needed.

What is the project idea? Please describe how this project will operate.

Mental Health Assessment Centers in each of the three regions could be established to work directly with law enforcement and sheriff’s department in OC.  Officers would have a 24/7 site in each of the three regions to drop off any homeless individual needing mental health assessment and follow up.  As they would be open 24 hours per day, the homeless individual could stay onsite once accepted to allow for reduction of symptoms and development of a linkage plan to connect to BHS services through hca, and shelter if they wanted.  This will reduce law enforcement’s time spent engaging with homeless individuals with mental health issues, outside of emergency/crisis 5150 evals.  While at the center, HCA BHS clinical staff could evaluation and assess the situation, give them somewhere to be during the night, and provide immediate linkage to BHS Outpatient or intensive outpatient programs (clinics, PACT, FSP, or Outreach).

Additional Information

Respondent skipped this question.

July 24, 2018

10 comments

What is the criteria law enforcement would use to determine eligibility?

any level of mental health issue would be addressed at the sites. This would be somewhere law enforcement could bring a homeless participant needing mental health support, assistance, and follow up.

What would the referral process by law enforcement look like? Are there any other referring parties?

Could also be referred by county hca behavioral health and community outreach programs?

Couldn’t current CSU’s be tailored to provide these services to the homeless population?

This would not be a crisis site. The CSU works with individuals who have met 5150 criteria. These sites would not be for that, as they are already served through CSU and bhs CAT to hospitalization process. These sites could potentially refer someone on for 5150 eval if needed, but it would be for everyone else. Very few people experiencing mental health issues meet the harm to self/others 5150 criteria, but that is addressed through CSU/CAT

What would the learning objectives be? Cost savings within the courts and law enforcement are mentioned. How would this be measured?

Those are good, also – reduced law enforcement number of calls for homeless mental health issues and reduced costs for patrol response; increased numbers of homeless linkages to outpatient follow up services within BHS. Can be measured through monthly patrol call time spent on homeless mental health calls

Getting linked to HCA BHS Outpatient clinics, FSP, PACT, or shelter/housing can take more than one night, will these centers be able to bed these individuals for as long as it takes?

This would be the first step, but not a long term housing site. It would be under 24 hours to be there, and then linkage to BHS programs and shelter or housing if ready for that. Program could have outreach staff built in to work with BHS in facilitating immediate linkage the next business day to services.

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