A program designed to divert people experiencing mental health emergencies from jails and hospitals is expanding to provide services to children and adolescents.
Since 2018, Dallas’ RIGHT Care Program has deployed teams made up of a paramedic, a social worker and police officer when someone is experiencing a mental health crisis. Now, the program is testing out two teams that expand those services to mental health related 911 calls involving minors between 3 and 11 p.m. daily.
Scott Creasy, a social worker with Parkland Hospital, is part of a RIGHT Care team. On a typical shift, he’s joined by a paramedic from Dallas-Fire Rescue and an officer from the Dallas Police Department.
“We all come from different backgrounds,” Creasy said. “We all come from different expertise as far as social work goes goes…We have a vast amount of knowledge that we can pull on when we’re on scene, too, if we need to consult.”
How does a RIGHT Care team work?
The Rapid Integrated Group Healthcare Team, or RIGHT Care program was created to stabilize patients in the field and connect them to community-based services, when clinically appropriate. Earlier this year, the City of Dallas and Parkland Health – Dallas County’s safety net hospital – announced the six-month pilot program to expand RIGHT Care to minors.
“Every one of our partners…each have different policies when it comes to how a call for an adult looks and as well as how a call and approach for an adolescent looks,” said Marco Rodriguez, RIGHT Care manager for the City of Dallas. “When it comes to RIGHT Care answering these calls, obviously we want to have the staff that is more experienced in working with adolescents and juveniles.”
A RIGHT Care team can get involved in a call in two ways. The teams scan 911 calls as they come in to review and join whenever appropriate. But the teams can also be requested – through 911 calls, the person in crisis or a responder already on the scene. In addition, teams may be notified by police or schools to contact a potential patient.
Typically, on a call without a RIGHT Care team, Rodriguez said patrol officers try to deescalate the situation as much as possible and then determine if the person in crisis needs to go to the hospital for further evaluation.
However, when the RIGHT Care team is dispatched, the team’s police officer is the first to make contact to ensure the scene is safe. After the officer determines there are no weapons or danger, the paramedic and clinicians – like Creasy – join. The paramedic makes an assessment to ensure the patient doesn’t need to go to the hospital for medical needs and the clinician does a psychosocial assessment.
Rodriguez said the clinician’s role is to identify the best plan of action going forward – like taking the patient directly to a behavioral health clinic for same-day treatment, helping refill medication or determining if there are additional social needs that need to be addressed, like housing or food access.
“It's more of a holistic approach,” Rodriguez said. “They're trying to address the root of the issue instead of just taking someone to the hospitals or jails.”
People with mental health issues can often end up in county jails waiting for services, which some advocates have cautioned can lead to jails becoming the “default long-term care facilities” with severe mental illness.
Differences in caring for minors
Creasy said the goal of the pilot program is to connect kids and teens with care, but that comes with additional considerations.
“Sometimes when we’re coming out to this call, it’s not just the kid who’s in need,” he said. “It’s also the parents. It’s the family unit that we have to address for care.”
Rodriguez said families have already been providing positive feedback on the new pilot program. He said an important part of the program is being able to connect parents and families to resources.
“A lot of times, either the parents or the families don’t have experience in the mental health resources field,” Rodriguez said. “Sometimes RIGHT Care is the first point of contact with behavioral health resources for the entire family.”
That point of contact includes a lot of education – on things like what to do when someone is in crisis and the type of information needed when calling 911.
Rodriguez said many families have been relieved to know specialized teams are available to respond quickly to “ensure things don’t escalate.”
“Sometimes having that clinician there to speak to them and educate them in a way is maybe a bit softer or more relatable,” he said. “We think it is very helpful to reduce any trauma that may come with having a lot of law enforcement there.”
As North Texans raise concerns about immigration enforcement and access to resources, Rodriguez said that was something the leadership of the RIGHT Care program has discussed.
“Our RIGHT Care units aren’t asking those types of questions,” he said. “Whether someone has [immigration] paperwork or doesn’t – that would not stop RIGHT Care from going out and helping when needed. Residents should not be worried about those types of things when requesting a RIGHT Care unit.”
Why this pilot program?
Rodriguez said the program has had positive outcomes for the adult population. Year-over-year, he said the number of adults experiencing a mental health crisis who were apprehended by police without a warrant has decreased.
There’s been a spike in mental health emergencies for minors, according to Rodriguez – especially following the COVID-19 public health emergency. Last year, 248 minors were apprehended without a warrant during a mental health crisis.
He said isolation and lack of access to resources led to more concern about adolescents.
“It only makes sense to make sure we start addressing or looking at the even more vulnerable population,” he said.
In the first month and a half of the pilot, Rodriguez said the RIGHT Care teams answered 63 calls – of those, 59 were diverted from jails and a majority were also diverted from hospitals.
He said the city will continue to gather data as the pilot program continues. Then, as the end of the six-month period gets closer, the city and Parkland will evaluate the effectiveness and it should continue with more availability and teams.
Rodriguez said the pilot program will also be able to see how the teams work in moments of higher demand – like during the summer when schools are on break. He said the goal is to see if expanding the program would have a positive effect on the individuals in crisis, the families that need support and the broader community.
“We want people to know we’re here to help,” Rodriguez said. “And in many ways, besides just behavioral health, any resource, anything that families might need, RIGHT Care is set up to address… There’s someone that you can call when it might feel like there's no one else you can call.”
Abigail Ruhman is KERA’s health reporter. Got a tip? Email Abigail at aruhman@kera.org.
KERA News is made possible through the generosity of our members. If you find this reporting valuable, consider making a tax-deductible gift today. Thank you.
