Mental health crisis team goes mobile

By Scott Swanson
Lebanon Local

Law enforcement officers respond to a late-evening call concerning an individual who is undergoing mental health therapy and is feeling suicidal. The individual is not responding well. Family members are concerned.
An officer makes a call, and shortly thereafter a van rolls up containing two members of the Linn County Mental Health Crisis Response Team.
They take charge and, after a while, the patient is back on track, avoiding a trip to the hospital.
Though the incident above is fictional, it is representative of many of the behavioral health crises the Mental Health Crisis Response Team handles throughout Linn County – usually in person.
Though the Crisis Response Team program is not new (it’s existed for more than 30 years), it is undergoing changes that will make it more visible to the public – and more responsive, said Tanya Thompson, program manager and a previous team leader. She said that the federal and state governments have provided funding to boost the team’s services “to support a more robust effort.”
Previously, the team would respond to emergency rooms, jails and its own walk-in clinic in Albany, but now it has wheels.
That would be a brand new mobile van that will soon be wrapped with the county’s logo and other identification and will become a mobile office “so people will actually be able to recognize us in the community,” said Nova Sweet, who has led the team for the last year and a half and has worked for county Mental Health for six years.
What’s also new is that the team can now respond to police calls, she said.
“Seven days a week, from 8:30 to midnight, in teams of two. It used to be that we stopped doing that at 5 and we wouldn’t do it on weekends. But now we’re set up to do it till midnight, seven days a week.”
Sweet, who’s led the team for the past year and a half, said they typically hit the road three to eight times a week to visit individuals who need help.
“That’s us going into the community and reaching out to either folks (with visits) that were planned ahead or that the call is happening that day.”

For approximately the past year, the team has made regular visits to both Sweet Home and Lebanon in an effort to provide “preventative” mental health care – which means working in advance to build relationships that allow team members to respond more effectively when things go south, Sweet and Thompson said.
“All the law enforcement agencies have access to our pager number up until midnight,” Sweet said, adding that there’s also “our direct email that can put a ‘heads up, can you do outreach?’ kind of thing.”
“We try to go to the shelters or we do go to the shelters regularly and just be present,” Sweet said. “Just the folks that live there, they start recognizing our faces, and come up to us and chat about things.”
Team members regularly visit the Lebanon Soup Kitchen at the First Christian Church and the breakfast served three times a week at St. Martin’s Episcopal Church, as well as at Sweet Home’s new homeless shelter.
“We go there once a week or as needed,” Sweet said, adding that they’re working on getting a “space” set up at the free lunch “so people can start understanding why we are at their table. It’s been kind of awkward, just walking in there and people don’t really know who you are.”
The team also works closely with Dala Johnson, community services officer for the Lebanon Police Department.
“She’ll send us an email, respond, call us, whatever,” Sweet said, adding that she has made a point of meeting with all of the shifts in the Police Department “to explain how we can interface with them, and just share the information directly.”
“I think Lebanon has been used to not having anybody there for them. So they’ve had to get used to that. It’s just building that communication and trust between the agencies.”
Dick Knowles of Sweet Home, current chair of the Linn County Mental Health Advisory Board, said that a mobile response capability “has been needed for a long time.”
“This is just the tip of the iceberg,” said Knowles, who’s been a member of the advisory group for 20-plus years and was a longtime administrator in psychiatric care facilities in the Bay Area of California.
He said that having locations, such as the Soup Kitchen or the homeless camp, gives the team a chance to focus their efforts.
“We’re all new at this,” he said. “But if things transpire the way we hope, this will provide a place for people to go, those who are homeless or in some type of desperate situation, where they can find help in crisis.”
Another advantage of the outreach, he said, is “wherever you go in the community, there’s someone who knows you and when you really get in trouble, somebody’s going to help.”
Those with whom the team is connecting now are “just the tip of the iceberg,” Knowles cautioned.
“From my perspective, it’s ‘thumbs up, go for it.’ We’ve needed this for a long time.”
Dave Butler, of Lebanon, also a member of the county advisory board, and founder of the nonprofit Lebanon Area Mental Health Alliance, has been focused on mental health since one of his sons committed suicide in 2017.
Since 2018 he has organized suicide awareness walks, held in September in Lebanon.
Butler said the increased outreach and visiblity for the crisis response team is “a good idea.”
“A lot of people who are struggling don’t want to call hot-lines.”

“I do outreach myself,” he said, adding, “I’m not a mental health professional. I’m a father who lost a son.”
Mental health, he said, is often a “taboo” subject, and has been for “many, many, many years.”
“A lot of us in my generation were raised not to talk about our feelings, especially the men,” Butler said. “We raise our chldren a lot the way we were raised – that’s what we know. I realize now that some of the ways I raised my kids was not necessarily right, but that’s the way I knew at the time.
“My opinion is that mental health is just as important as physical health.”
Sweet said dealing with mental health situations often requires an extended process.
“I think the challenge for all of us is that people have free will and sometimes the people that we really want to help don’t want help. And so that tugs on all our heartstrings, so you do the best you can – you keep re-engaging.
“There’s just some folks that either we can’t step in and take away their legal rights, or they’re not there yet.”
Team members also regularly respond to hospitals when patients are feeling “suicidal or homicidal or can’t take care of themselves,” she said.
In addition to the unplanned or scheduled visits with individuals team members make, “there’s way more (visits) if you add hospitals,” Sweet said.
“Our regular responses to the hospitals is when there’s somebody suicidal, homicidal, or can’t take care of themselves. We go in and assess and figure out a higher level of care or safety plans to go home.
“We are consistently getting phone calls about people of concern and walking families or concerned community members through the steps of either filing a two-party petition to have investigators look into something or just coaching on what services are available.
“That’s kind of our gamut.”
In the year ending April 30, the team responded to 1,437 situations requiring “mobile” services and saw 768 unique clients (many clients require multiple interactions). About half were in the Albany area, but 23% were in east Linn County areas, and 15% were at Good Sam in Corvallis, according to county data. The other 15% were in undefined areas.
Samaritan Health’s hospitals in Albany and Lebanon both have emergency rooms equipped to handle mental health crises, but the nearest inpatient psych unit is at Good Samaritan Regional Medical Center in Corvallis.
Sweet said people who are struggling with mental issues will typically go to the emergency departments, then be transferred to Good Sam or to Eugene, Salem, or Portland.
She said she “loves” Lebanon’s emergency wing, completed in 2018, which includes three rooms specially designed for mental patients, where they can stay until they can be transferred to a psychiatric unit.
The rooms “on the quieter side of the emergency department, all have locking doors on a quiet hall. They can have cameras and all that good stuff,” Sweet said.
Thompson, a 25-year veteran of the Linn County Health Department, said psychiatric care is in short supply in Oregon.
“There is a shortage of higher-level-of-care site beds,” she said. “That’s something that I know we’re trying to communicate to both Samaritan and the state. Because what happens is there’s a logjam, like in the emergency rooms and in our communities.”
Another challenge is keeping their department adequately staffed, the two said.
“One of the bigger struggles we’re dealing with is workforce,” Thompson said, noting that as interaction with other agencies increases, so does demand for the program’s services.
Although the department includes staff with less education, outreach teams must include at least one member with master’s degree-level qualified mental health professional training and the other must have at least a bachelor’s.

Currently, the team has 11 daytime members and 10, including Sweet, at night, she said.
“Somebody who has 20 years of experience and, maybe, not a bachelor’s degree, can help us on a Q&A level, which is a lot, a lot, a lot of our work. I would say that anybody who has any sort of mental health background, education or experience, should try and apply.”
It’s a challenge, Thompson said.
“We’ve seen the increase of intakes and referrals, connections from the crisis team for ongoing services with people. So with a workforce where we can’t get those clinicians in place – again, we want to serve them, ongoing. And we’re doing the best we can and many of them are getting in much better than they would if they were in the private sector. But it is a struggle.”
“For those folks who are struggling, suicidal, but might have to wait four weeks to see a therapist, we’re just seeing them every week,” Sweet added. “We’re just, like, ‘We’ll take care of it.’ And our team really thinks outside the box; whatever we can do to make sure somebody’s getting their needs met. We’re doing it.”
County Mental Health workers also schedule regular appointments in both Sweet Home, at 799 Long St., and in Lebanon at 1600 S. Main St. Information on eligibility, resources and options is available by calling (541) 967-3866 (press 0), or at the walk-in clinic at 445 3rd Ave. SW in Albany.
Butler said people who are struggling psychologically need to open up to others.
“I was a volunteer firefighter here in Lebanon for 20 years. We’d go to a call, a bad call, and then get back to the station, pull up our bootstraps and move on to the next call. ‘Don’t let it get to you.’ Well, it gets to you.
“It’s something that’s just not talked about.”
He said he’s spoken on the subject to more than 200 local firefighters.
“Each of us has a backpack and every time we go to one of those calls that involves a child or something that gets to us, it puts a brick in our backpack.
“Those bricks don’t go away. One guy may not be able to carry that backpack any more, so maybe someone needs to take a brick out of his backpack.
“There’s a point in life where you have to stop and unload that backpack and start over. Talk to someone, unload, get it out there.”
The average person, Butler said, “does not know where to turn.”
“If you’re struggling, reach out. My son, he did not reach out.”