Alternative diversion to behavioral health crises in northeastern pennsylvania. - monroe county is a high-need service area in rural pennsylvania

Police are often the primary responders to behavioral health emergencies. The public safety answering point (psap) reported that to date in 2022 there were 49 suicide attempts and 650 calls that came through for other behavioral health concerns. To better meet the needs of individuals in monroe county and divert unneeded response from law enforcement, thomas jefferson university and monroe county's mobile crisis provider, resources for human development (RHD), are proposing to partner with the local psap and police departments to establish an alternative dispatch program and enhance RHD's infrastructure to respond to mobile crisis needs using best practices outlined in national guidelines for behavioral health crisis care: best practice. The total population of monroe county in 2020 was 169,273 individuals, with a racial composition of 76% white, 17% black, 2% asian, 3% two or more races, with 18% identifying as hispanic and 2% as two or more ethnicities. Individuals primarily speak english (85%), followed by spanish (~10%), indo-european (~5%), and asian/islander (1.5%). Individuals identify equally as male and female. The median age is 43.3, with 63% of the population between 18-64 years of age. The median household income is $68,734, with 10.7% living below poverty line (U.S. Census bureau, 2020). While RHD's goals for crisis expansion extend beyond supports for mobile crisis response, the following goals and objectives will drive the focus of this grant program: 1. Enhance mobile crisis response team to meet national guidelines for behavioral health crisis care: best practice for monroe county, 2. Minimize law enforcement involvement and involuntary transport by developing an alternative dispatch program where mobile crisis will respond to behavioral health crises without law enforcement, unless special circumstances warrant inclusion, 3. Maintain countywide metrics for mobile crisis, psap, 988, and law enforcement behavioral health calls, 4. Help identify service needs, service gaps, and opportunities to improve equity in monroe county by applying a community crisis mapping model (e.g., crisis intercept mapping), and 5. Increase qualified workforce capacity by developing and implementing evidence- based training opportunities for mobile crisis response staff, psap, and first responders. The proposed project team, specifically thomas jefferson university and RHD, have collaborated on numerous federal grants to improve crisis intervention services in monroe county. The pennsylvania office of mental health and substance abuse services, local psap, and 3 borough police departments have agreed to support the proposed project activities and contribute to the collection of all relevant key performance indicators, including both individual level data as well as aggregate figures (i.e., average number served per 8-hour shift). While IT is difficult to determine exactly how many residents of monroe county will be impacted by these initiatives, we based our projections on RHD's annual number of unique mobile crisis interventions and accounted for growth in years 2-4 due to grant project activities. We anticipate that we will serve 2,785 unduplicated people in the 4 years of the project.