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Documents:
• Indigo Project Needs Assessment

• Crisis Care Action Plan

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By the first of the year, a team of mental health professionals could be available in Del Norte County to help someone experiencing a crisis get the care they need while avoiding the emergency room or jail.

That’s Shiann Hogan’s hope, and her employer, the Del Norte Behavioral Health Branch, has the grant funding to make it a reality. The main hurdle she foresees, however, will be staffing.
“The goal of this mobile crisis team is to be operational 24-7, 365 days a year,” she said. “And if we’re going to meet that staffing capacity, we need to add to our workforce.”

The Behavioral Health Branch received a state Crisis Care Mobile Unit grant and spent the last eight months developing an action plan for getting it off the ground. This evening, about a month after that plan was finalized, Hogan will give a presentation to Crescent City Councilors.

Hogan’s presentation comes after Crescent City Police Chief Richard Griffin urged Councilors to oppose State Senate Bill 402.
Introduced by California Senator Aisha Wahab (D-Fremont), SB 402 would keep police from becoming first responders to a mental health crisis in most cases.

Griffin told Councilors on March 7 that he was working with the Del Norte County Behavioral Health Branch on getting the mobile crisis response unit up and running. He said he felt Wahab’s bill would get people hurt.

“I understand that mental health is not a crime for most instances,” Griffin told Councilors on March 7. “But I understand the reality of being a law enforcement officer responding to these for almost two decades and I know what it’s going to do in this county. We don’t have the resources. We don’t have the funding that LA has, that San Francisco has, Sacramento, and the reality is this is not going to work in this county.”

Other stakeholders that have been working on implementing the mobile crisis response team include Del Norte County Sheriff Garrett Scott, Sutter Coast Hospital, District 2 Supervisor Valerie Starkey and Daphne Cortese-Lambert, Del Norte Mission Possible’s director of homeless services.

Stakeholders also include tribal Yurok and Tolowa Dee-ni’ Nation tribal representatives, Del Norte Unified School District, the Del Norte Healthcare District and Open Door Clinic.

The creation of a mobile crisis response team comes after a report from the Indigo Project found that an over-reliance on law enforcement and limited service options for those in crisis contributed to a revolving door at the jail and the “large utilization of the emergency department for mental health and substance use related crises.”

Between 2019 and 2021, there were more than 1,000 emergency room visits that resulted in a primary mental health diagnosis, according to the report. This accounts for 5.6 percent to 7.3 percent of total ER encounters.

In 2019, law enforcement responded to more than 200 calls for someone experiencing a mental health crisis. In 2021, that number was 361, according to the assessment.

According to Hogan, for the past eight months the Del Norte Behavioral Health Branch has been working on an action plan for the mobile crisis response team. They finalized that plan last month. The team’s overall goal is to reduce the number of people experiencing a crisis, Hogan said.

“It’s providing crisis services to where they’re at — at their home or on the street, where ever it may be,” she said. “It’s building the community capacity to respond to crises.”

Getting such a unit in place and implementing an overarching support system that ensures clients get the help they need beyond their initial moment of crisis is projected to cost roughly $1 million a year, Hogan said. That was the number the Indigo Project arrived at in its needs assessment, though Hogan said the county is going through its fiscal studies.

She said the cost can fluctuate depending on how the county staffs the unit. The state is also implementing a new benefit for MediCal clients that includes mobile mental health crisis
response, Hogan said.

“At the state level it sounds like we’ll go through some kind of rate-setting process with them on what we would get reimbursed for a mobile crisis (unit),” she said, “taking into account the rural county’s need for staffing.”

Over the next few months, Hogan said Behavioral Health will meet with law enforcement, particularly dispatchers, to create a protocol to delineate who should respond to a call as well as cross training should Behavioral Health staff be on a call and find they need law enforcement assistance.

They’ll also be purchasing equipment, including a van — Hogan said they’re getting quotes for the van now — and radios, computers and other equipment.

The mobile crisis response unit would have its own designated phone number for people to call when they need help, Hogan said. Dispatchers would also be able to patch into the system if someone called 911 or the 988 suicide prevention hotline.

But there’s a challenge when it comes to figuring out what the mobile crisis response unit’s staff would be doing, she said.

“We only have about two crises a day,” Hogan said. “In their down time they would do follow ups to people who had been seen in crisis. The intent is we may see somebody on Monday and hopefully on Tuesday or Wednesday we’d follow back up with them to see how they’re doing, whether in person or by phone.”

With its partners, the Behavioral Health Branch is also pursuing funding to create a broader system to support the mobile crisis response team, Hogan said. These funding sources would help determine who responds to a crisis, what happens in the field and where those patients should go for further care.

“Historically we had what we call same-day service during business hours,” Hogan said. “What we’d like to do is become involved with mental health urgent care. It would operate the same way, but its true and only focus would be mental health emergency care with its own dedicated unit.”

According to Hogan, the Crisis Care Mobile Unit grant only pays for the equipment, vehicle and other infrastructure to implement the program. The Behavioral Health Branch is also partnering with Sutter Coast Hospital to pursue a grant from the CARESTAR Foundation to staff the unit.

Historically, the county and hospital had explored the possibility of creating a crisis stabilization unit at the emergency room, a separate space within the department for someone experiencing a mental health crisis to get the care they need.

The community didn’t have the capacity to sustain such a unit, Hogan said. But other possibilities the state and county are exploring include obtaining an Emergency Psychiatric Assessment Treatment and Healing (EmPATH) grant through the state Mental Health Services Oversight and Accountability Commission, she said.

“This is funding hospitals can apply for to create, what I would call a milieu that would exist at the hospital,” Hogan said. “It would be something where someone could come into an emergency room setting. They would see they have a need for mental health (care) and they would move into an EmPATH unit. It’s structured in such a way that’s much different than an ER setting.”

Hogan said the EmPATH unit would be more comfortable with couches and other areas that are “psychiatrically focused” while staff determine whether a patient has a crisis care plan available and if they’re able to return back to the community.

Staff at an EmPATH unit would also help the client connect with follow-up services, Hogan said.

Also addressed in Indigo’s needs assessment is a crisis respite home. This is for someone who doesn’t need to be admitted to a psychiatric hospital, but needs additional support to stabilize their mental health crisis. This home would provide 24-hour staffing and is another program the county is pursuing funding for, Hogan said.

“With that one, we’re looking at funding under Innovation Funds Mental Health Services Act funds,” she said. “It looks at innovative new things that support overarching behavioral health needs and we think maybe a crisis respite home is a possibility for those funds. We’re exploring that and gathering information about how other communities have done that type of project.”


The Crescent City Council will meet at 6 p.m. this evening in the Flynn Center, 981 H Street. For access to a livestream, visit www.crescentcity.org.

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