Providing the right care in the right setting

Michele Anderson, Public Safety Communications Manager

Tuesday, July 17, 2018 at 10:16 a.m.

With the ultimate goal of providing the right care in the right setting for people experiencing behavior health issues, the Spokane Fire Department (SFD) has partnered with Frontier Behavioral Health to staff a Behavioral Response Unit. The program is funded through a grant from Providence Medical Group.

The program will help divert people experiencing less acute behavioral issues from the Emergency Department so they can be connected to more appropriate community resources. In turn, this will allow more time for the Emergency Department staff to provide the highest level of care to the most acute medical and behavioral health patients.

SFD has seen an increasing number of responses for behavioral-related issues since 2014, which mirrors national trends and creates significant demand on community emergency care resources. Currently, SFD averages more than nine behavioral related responses each day. Through the first half of this year, the department saw even greater growth in these responses with nearly a 20% increase compared to the first half of 2017.

“These trends require us to look at how we respond to these events differently,” says Spokane Fire Chief Brian Schaeffer. “Prior to this new program starting, all patients were transported by ambulance to local hospital emergency departments. Pairing a fire department paramedic with a mental health counselor to assist with people who are not acutely ill only makes sense. We have the opportunity to connect these individuals with the resources that are best suited to help them and provide better, more efficient care. This collaborative approach to helping people experiencing behavioral issues in our community is innovative and not seen in other parts of the State.”

The Program started on June 11 and during the first month of operation, the team responded to 36 requests for help. Nineteen of the people the team encountered were referred to more appropriate behavioral health services and avoided being transported in an ambulance to a local hospital emergency department.

“While the program is still in its early stages, we anticipate that we will continue to see improved access to services and care for people experiencing behavioral issues,” adds Schaeffer.

One program goal is to achieve a 50% hospital diversion rate in behavioral health patients that the new team encounters. Frontier Behavioral Health and SFD are also tracking additional metrics to see what other impacts this program has on both program and calls for each agency.

The Behavioral Response Unit will be assigned to behavioral health calls as an additional resource to other SFD response units during the hours of 8 a.m. to 6 p.m. Monday through Thursday. Upon arrival on scene, the initial responding paramedic and the Behavioral Response Unit paramedic will collaborate to determine if there is a medical cause for behavioral symptoms that may still require transport to the hospital. If both medics agree that there is not an emergent medical cause that needs to be addressed, both medics will collaborate with the mental health clinician to determine whether or not the patient is an appropriate candidate for diversion. If it is decided that the patient is a good candidate for diversion, the Behavioral Response Unit will release the other fire department resources to return back in service (allowing them to be available for other calls for service). The Behavioral Response Unit Team will further assess the individual and identify the most appropriate resource for diversion at that time.

A video, including interviews, about the Behavior Response Unit can be found here.