St. Joseph County mental health crisis team coming along, still sent on fraction of calls (2023)

Marek MazurekSouth Bend Tribune

SOUTH BEND — A few months after some members of the community expressed skepticism, St. Joseph County and city officials say they’ve made progress on how mental health crises are handled in the county.

Officials with Oaklawn mental health center said their mobile crisis response team is becoming more fleshed out and better integrated into the county’s 911 dispatch system. Oaklawn is also taking the lead on a new behavioral crisis center, expected to be completed next spring and open around the clock, which officials believe will improve outcomes for those in crisis by giving them a place to receive treatment.

At the time of Dante Kittrell’s death in late July— an incident in which a suicidal South Bend man was shot and killed after a lengthy standoff with police and sparked calls for a more robust mental health response system — Oaklawn had a mobile team in its infancy that operated weekdays between 8 a.m. and 5 p.m.

Oaklawn’s goal, however, has been to ramp up its response teams. By next spring, Kelli Liechty, the center’s vice president of access and crisis services, anticipates the mobile crisis team will be available 24 hours a day.

“We have expanded our hours. We have full phone support 24/7, but we have the ability to mobilize 8 a.m. to 8 p.m. Monday through Friday right now,” Liechty said, adding that the team is still able to resolve about 80% of the calls it receives with intervention over the phone.

Connecting with dispatch

Beyond expanded hours, Oaklawn has made progress with the St. Joseph County 911 Dispatch Center to have certain mental health calls patched through to the mobile crisis team, rather than police. Nancy Lockhart, the dispatch center’s deputy director of operations, said the process for dispatchers to send calls to the mobile crisis team is moving forward slowly, with callers who are deemed to be nonviolent and unarmed making up the calls 911 passes along.

From Oct. 3 to the present, Lockhart said, 51 calls came through the 911 that were identified as eligible to be handled by the mobile crisis response team. Of those, only six were transferred to Oaklawn or the national 988 suicide prevention hotline because the caller became violent during the course of the 911 call, the caller specifically requested police or the third party witness who called in the mental health crisis left the scene, meaning dispatchers could no longer guarantee that the individual was not armed or acting violently.

In the near future, 911 dispatchers are hoping they can begin sending Oaklawn’s team to more emergencies involving suicidal callers, but those protocols have yet to be fleshed out, Lockhart said.

“We got to get it right for those people that need us. That’s our whole focus,” Lockhart said. “That’s why we want to be very careful and methodical about how we do this.”

For calls where an induvial is known to have a weapon, law enforcement will still be the primary responder, though Oaklawn’s team could co-respond, Liechty and Lockhart said. Liechty said the mobile crisis response team continues to work with area police departments about what calls Oaklawn's clinicians can help with and how police and clinicians handle situations in the field.

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“From my lens, we’re learning about that through other calls and other interactions together,” Liechty said. “The situation with Dante [Kittrell], that was just a horrendous situation that is so complex and is so hard. I think we are learning from less intensive interactions how to work together and what we can do and what support we can offer.”

Oaklawn and the 911 center are also still debating whether there should be an Oaklawn clinician working full-time in the center. Lockhart feels a clinician would be better and more quickly able to discern which calls the mobile team could handle, which ones it couldn’t, and which would be best for both the mobile team and law enforcement to respond to.

“Our endgame has always been very clear: We want a mental health clinician in 911. That way we can do better, quicker collaboration for anyone of those folks that need an active rescue,” she said.

Leichty, however, said she’s still working out if having a clinician in the dispatch center is the best use of Oaklawn’s resources.

Crisis center

Another key component in emergency mental health care is the soon-to-be completed behavioral crisis center, currently being built with American Rescue Plan funding in the existing Epworth Hospital on Niles Avenue.

Officials say the behavioral crisis center, sometimes referred to as the crisis stabilization center, should be completed in the spring and will be run by Oaklawn, though Beacon Health System will be a partner in the enterprise. The crisis center will have 14 beds and provide a space for people in need of mental health care.

Though the crisis center was announced last year, it’s not often talked about as part of the county’s mental health response apparatus. Yet mental health workers as well as city and police officials have expressed support for the center as a vital resource to keep people out of jail or the emergency room.

“Unfortunately, the default places now for when our first responders have someone in crisis is either the county jail or the emergency room,” said South Bend Mayor James Mueller. “Oftentimes neither place is the appropriate our best place for them to get the help they need.”

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The St. Joseph County Council last year earmarked $2.7 million in federal American Rescue Plan money to pay for construction and the first year of operation.

In his State of the City address earlier this year, Mueller announced the city had set aside $5.8 million to be spent on mental health-related projects. Some of that sum will go toward the crisis center, though Mueller said the specific cost estimates haven’t been worked out yet.

St. Joseph County Health Officer Dr. Bob Einterz, who will act as coordinator for the crisis center, said the goal is for a combination of county and city COVID funding and other grants to keep the center funded for three years. At that point, the hope is that money for mental health infrastructure will be made available by state legislation.

While funding for the crisis center and the crisis response team are not immediate concerns, hiring enough mental health clinicians to staff the expanding response team and the crisis center has been a challenge, mirroring the trend of a declining number of healthcare workers in general.

“This will require a diverse workforce. Everything from psychiatrists to nurses to mental health technicians to peer counselors and all of the support personnel to make the operation function,” Einterz said.

In the long term, Einterz feels, a psychiatry residency program at a local hospital could go a long way to training mental health workers locally. But he’s still confident St. Joseph County can find the clinicians necessary if the right resources are made available.

“For sure it will be a challenge,” Einterz said. “It will not be easy, but I’m confident that we’ll find the people we need if the funding is there.”

Email Marek Mazurek Follow him on Twitter:@marek_mazurek

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