[Alliance Enews] Comprehensive Crisis Care Systems Reduce Costs and Unnecessary Hospitalizations

[Luke Sikinyi]

Alliance Note: Communities throughout the nation are working to improve their mental health and substance use crisis care services by creating and expanding alternatives to hospitalization to support more people experiencing these challenges. A recently released study<https://ps.psychiatryonline.org/doi/10.1176/appi.ps.20230232> of Arizona's crisis system has shown that not only did people experiencing a crisis prefer alternatives such as mobile crisis response and crisis respite facilities over the ER, over 60% of the people who entered the crisis system through these alternatives did not need crisis care within 30 days. Those who did need crisis services within 30 days still preferred (73%) to use alternatives to the ER.

The study backs up what many of us already know: having a robust crisis system with many alternatives to the ER increases access to needed support, improves health outcomes for people experiencing a crisis, and saves money by preventing unnecessary institutionalization in hospitals or jails/prisons.

The Alliance continues to push for a comprehensive crisis care continuum which relies less on hospitals and more on community-based crisis supports which help people recover and remain in their communities of choice. In New York, we are advocating for the implementation of Mental Health First responder pilots modeled after the proposed Daniel's Law. These pilots would send teams of EMTs, highly trained peers, and other mental health experts to crisis calls when there is no need for police. We are also pushing for the expansion of Peer Run Crisis Respite centers to offer more access to ER alternatives.

Join our efforts to fund these much-needed crisis alternatives by attending our upcoming 27th Annual Legislative Day next Tuesday March 5th!  See below to register for one of our buses coming from throughout the state. Read below to learn more about the recent study on the effects of a comprehensive crisis care system.

Join us to be part of the largest Mental Health COLA Rally of the year
and advocate for critically needed staff and services!

Raise your Voices for Voluntary Engagement, Diversion and Re-Entry Innovations!
See below for our complete list of advocacy priorities and the day's schedule

We have FREE buses leaving and returning to

Long Island, New York City, Buffalo, Rochester, Binghamton,
White Plains, the North Country and Nassau and Suffolk Counties!
Sign up for one of the buses using the link below.

Register Here to Get on the Bus!<https://docs.google.com/forms/d/e/1FAIpQLSc_jaKm04R2JF_MJ3bUlG8GGUalcxci3r_5rMQlUejwxW1tUw/viewform>


**One lucky rider on each bus will receive a full scholarship to our Annual Conference in September!**


First-of-its-Kind Study Reveals Potential Impact of Behavioral Health Crisis Systems on Reducing Costly, Avoidable Hospital Events
By Connections Health Solutions | PR Newswire | February 28, 2024

Findings indicate behavioral health crisis systems are a best practice for reducing emergency room and inpatient utilization

PHOENIX, Feb. 28, 2024 /PRNewswire/ -- Access to a comprehensive behavioral health crisis response system can lessen demand for more restrictive and costly emergency department and inpatient services, according to a new research study published in the journal Psychiatric Services. The study was conducted by a team that included researchers from Arizona State University Center for Health Information and Research<https://c212.net/c/link/?t=0&l=en&o=4102408-1&h=3343536119&u=https%3A%2F%2Fchs.asu.edu%2Fchir&a=Center+for+Health+Information+and+Research> and Connections Health Solutions<https://c212.net/c/link/?t=0&l=en&o=4102408-1&h=1856865758&u=http%3A%2F%2Fwww.connectionshs.com%2F&a=Connections+Health+Solutions>.

The study examined how people flow through the crisis system in Arizona, which over the past several decades has built a comprehensive infrastructure that heavily influenced the Substance Abuse and Mental Health Services Administration's (SAMHSA) national vision for crisis care ensuring people in crisis have someone to call (988 Suicide and Crisis Lifeline), someone to respond (mobile crisis response teams), and a safe place to go for help (specialized crisis facilities). The analysis revealed:

  *   The majority of individuals (57.4%) entered the crisis system through mobile crisis or crisis facilities versus the emergency department, indicating the crucial role these services play in crisis response.
  *   Of the subset of individuals receiving care at the Connections Health Solutions Tucson Crisis Response Center, most (63.3%) did not reutilize any additional crisis or emergency services within 30 days.
  *   Of individuals who did reutilize services, the majority (73.0%) utilized mobile or facility-based crisis services rather than emergency department or inpatient services, affirming the significance of crisis systems in preventing hospital utilization.

"In most communities, crisis episodes begin in the emergency department with few options for specialized treatment other than inpatient hospitalization," said study co-author Dr. Margie Balfour, chief of clinical innovation and quality at Connections Health Solutions and an associate professor of psychiatry at the University of Arizona. "This study shows that crisis systems can serve a large proportion of individuals in crisis, reducing the need for more restrictive and costly levels of care."

The researchers identified these insights by constructing over 40,000 care episodes that showed the path of individuals through the various crisis care settings, including mobile crisis, crisis facilities, emergency departments, and inpatient psychiatric units. By merging Medicaid claims data from the Arizona Health Care Cost Containment System (AHCCCS) with electronic health records from Connections Health Solutions, the researchers were able to show if and where reutilization occurred and analyze factors that potentially contributed to the reutilization of services.

"The results of this study demonstrate the impact of an advanced crisis system - better access, improved health outcomes, and lower cost for the most vulnerable members of the community," said Colin LeClair, chief executive officer of Connections Health Solutions. "The study further validates the outsized contribution that a value-based crisis provider can have on the use of inpatient and emergency department services. By implementing a value-based crisis system, counties and communities can improve the quality of care for individuals in crisis and create a more cost-effective health system."

The study concluded that lessening the demand for more restrictive and costly emergency department and inpatient services had additional potential benefits such as reducing emergency department overcrowding, lessening the need for inpatient beds, and improving patient experience - ultimately leading to a more accountable and patient-centered behavioral health system.

To read the complete study: https://doi.org/10.1176/appi.ps.20230232<https://c212.net/c/link/?t=0&l=en&o=4102408-1&h=2887023798&u=https%3A%2F%2Fdoi.org%2F10.1176%2Fappi.ps.20230232&a=https%3A%2F%2Fdoi.org%2F10.1176%2Fappi.ps.20230232>

First-of-its-Kind Study Reveals Potential Impact of Behavioral Health Crisis Systems on Reducing Costly, Avoidable Hospital Events (prnewswire.com)<https://www.prnewswire.com/news-releases/first-of-its-kind-study-reveals-potential-impact-of-behavioral-health-crisis-systems-on-reducing-costly-avoidable-hospital-events-302074306.html>


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