Quietly operating out of an unassuming building in Dorchester County, the Eastern Shore Operation Center of the Eastern Shore Crisis Response Service is saving lives. Phone counselors at the Center’s Eastern Shore Crisis Response and Resource Helpline work 24 hours a day, seven days a week to help prevent suicides, homicides, unnecessary hospitalizations, arrests or detention, and to reduce dangerous or threatening situations involving individuals in need of behavioral health services.
According Lynn Gurley, LCSW-C, Clinical Coordinator of the Eastern Shore Operation Center, “The program has grown progressively each year. This is in part due to people with chronic mental health issues using us instead of going to the hospital and the word is getting out and people now know what we do.”
Sponsored by The Eastern Shore Crisis Response Services of the Affiliated Santé Group, the crisis response helpline serves the nine counties of the Eastern Shore from Cecil to Worcester counties offering telephone support for individuals and family members in crisis. The crisis response helpline has three daytime counselors who work from 7:30 a.m. to 4 p.m. All counselors are trained clinicians and must have a Bachelor’s Degree in Health and Human Services, plus have five-year crisis response helpline experience. In addition, all phone counselors participate in a special training program which uses a curriculum developed by Gurley specific to the crisis response helpline services offered through the agency.
Through a grant from the Rural Maryland Council, the agency just added a new counselor position to cover 4 p.m. to midnight, Monday through Friday as evening call volume has been steadily increasing. The new evening position will replace after-hours staff who worked from home during the week. The position also allows the crisis response helpline to increase its response to incoming calls, as well as outgoing follow-up calls and client satisfaction surveys.
There are seven after-hours contractual phone counselors with the crisis response helpline who work on weekends and holidays from 8 a.m. to midnight. The Baltimore County Crisis Center provides crisis response helpline counselors from midnight to 8 a.m. daily.
According to Carol Masden, LCSW-C, Director of Eastern Shore Crisis Response, “The key to the crisis delivery system is the helpline. During fiscal year 2016, our Eastern Shore Operations Center, where the crisis response helpline operates, assisted 6,361 callers, up 25.8 percent from fiscal year 2014. Wicomico, Cecil, and Dorchester counties were the counties with the highest number of new calls in fiscal year 2016.”
She adds, “With our most recent changes there are no disruptions in services to the nine counties we serve. We are available 24 hours a day, seven days a week in Caroline, Cecil, Dorchester, Kent, Queen Anne, Somerset, Talbot, Wicomico and Worcester counties.”
According to Gurley, one of the key services that the crisis response helpline offers is counseling at the time of the call. The phone counselors assess the situation using a six-step Crisis Intervention Model. The first step is to assess the situation and identify the problem, this includes assessing the person for safety issues, including suicidal feelings, whether the person is a danger to others, determining whether mental health issues are present, as well as whether there is a medication/alcohol or drug use issue. The phone counselor can also walk the caller through exercises and suggest supports that can help the caller with managing the crisis he or she is experiencing at that moment.
Gurley states, “We express empathy to the caller, brainstorm ideas for services which can benefit them, and make a plan with them for next steps. This includes getting a commitment from the caller that he or she will follow through with the plan we set up. Our model is person-centered, so each caller is a part of making the plan.”
Services provided through the crisis response helpline include connecting callers to behavioral health appointments in facilities across the Shore. Callers get an appointment to these providers with 24 to 48 hours of calling the crisis response helpline. The crisis response helpline is also a source of information and referral to callers who may need to get a new mental health provider because they are new to the area or referral to a homeless shelter if the person is homeless.
Each caller has an Electronic Case Record which enables phone counselors to follow up with callers on the same day for any unresolved issues. The phone counselors also follow up with callers to be sure they have gone to scheduled appointments with providers. Web-based scheduling interfaces with the Electronic Case Record to accomplish this tracking. Once a client is stable and has received services, the crisis response helpline case is closed.
Phone counselor Katherine Harrison states, “A significant percentage of our helpline calls come from parents and foster parents who are struggling with children suffering from severe behavioral health issues, which are oftentimes the result of past trauma. We can provide counseling on the phone, and assist with linking them to outpatient behavioral health treatment if needed. If we can’t be successful on the phone, we can then dispatch a Mobile Crisis Team to the home. The ultimate goal is to prevent hospitalization, but sometimes that is where the client needs to be.”
Harrison recalls, “There are success stories, however, every day. I was recently able to de-escalate a child who was experiencing a behavioral health crisis over the phone, and he was able to go to school and ended up having a good day.”
Lindsey Tolley, another phone counselor with the helpline, states, “We are seeing more and more clients struggling with the co-occurring issues of substance use disorder and a mental health issue. It is more common now for family members to call on behalf of a minor or on behalf of their adult children in regard to substance abuse.”
Additional services provided by the crisis response helpline include coordination with law enforcement and other emergency personnel when more serious mental health issues arise. Eastern Shore Crisis Response provides ongoing Crisis Intervention Team training for law enforcement about mental health and substance use issues. In some cases, when a call comes in that involves a dangerous situation, the phone counselor will dispatch the Mobile Crisis Team and law enforcement at the same time.
The Eastern Shore Crisis Response Mobile Crisis Teams are available between 9 a.m. and midnight seven days a week, 365 days a year. Approximately one half of the calls through the crisis response helpline require the Mobile Crisis Teams to be dispatched. Teams are available in all the Eastern Shore counties but Worcester County, which already has a mobile crisis team in place.
Masden comments, “In FY 2016 the Mobile Crisis Teams responded to 2743 dispatches to provide immediate crisis interventions, psychosocial assessments and referrals, helping individuals, families with mental health crises, substance abuse, and intellectual disabilities.”
According to Masden, most callers present with more than one behavioral health issue and the crisis response helpline deals with clients with chronic mental health issues. In fiscal year 2016, the top three focal issues for callers were chronic mental illness, depression, and situational crisis. The agency reported that 22.4 percent of new calls were related to substance abuse and/or co-occurring disorders. Services are provided to people across the lifespan, with ages ranging from age young children to adults aged 99, who may be suffering from a mental health issue such as dementia, now referred to as neurocognitive disorders.
The crisis response helpline cannot provide transportation assistance for callers or give medical or legal advice or ongoing therapy to callers. According to Gurley, “Our mission is to respond to crisis calls and ensure the safety and well-being of the person in crisis until such time as the individual has been stabilized, provided with needed support and information and referred to appropriate community resources for continuity of care.” She adds, “There has been positive feedback from our satisfaction surveys for the crisis response helpline and we are utilizing the feedback for continuous quality improvement.”
A number of agencies partner with Eastern Shore Crisis Response to provide care to crisis response Helpline callers, including Mid-Shore Behavioral Health Services, which provides referrals, shares cases and provides peer review for Eastern Shore Crisis Response. Mid-Shore Behavioral Health is also a pass through entity for funding the agency. Masden states, “Mid-Shore Behavioral Health is our champion. The staff advocated for us with the Department of Health and Mental Hygiene and the Behavioral Health Administration when our call volume increased exponentially and we needed to fund additional positions. They also secured funding for us to enhance our Call Center, creating a phone que system which is more consumer friendly. This enhancement helps us better serve our neighbors when they are most fragile.”
Masden adds, “In Cecil County, the Cecil County Core Service Agency helps to fund the Cecil County Mobile Crisis Team, as well as funds a portion of the Call Center staff.”
Through collaborative partnerships with hospitals, outpatient mental health clinics, substance abuse services and peer support programming, Eastern Shore Crisis Response has built a strong community program. For immediate support, access the Eastern Shore Crisis Response and Resource Helpline at 888-407-8018.
The Affiliated Santé Group (Santé), a dynamic and leading provider of crisis psychiatric care and system management services to public and private entities, is the largest provider of crisis services in Maryland. Santé, a nonprofit entity, also manages mental health outreach and psychiatric recovery services. It has been delivering mental health care to individuals and families and pioneering new treatment modalities since 1974. As a nonprofit, the organization welcomes donations to assist with the growing operational expenses associated with the volume of calls that the crisis response helpline is experiencing. For further information about the Affiliated Santé Group, visit www.thesantegroup.org.