NH redesigns rapid response
Help comes with many names—crisis intervention team, mobile crisis unit, or rapid response.
Whatever the term, the outcome means behavioral health professionals quickly providing access to care.
According to the National Alliance on Mental Illness (NAMI), 2,700 U.S. communities have teams connecting people in crisis to police, mental health care providers, and hospital emergency personnel.
NAMI cites a reduction in risk of arrest while receiving mental health services as one benefit.
In 2022, the Department of Health and Human Services (DHHS) and the Bureau of Behavioral Health implemented the Rapid Response Access Point. A call center run by Boston-based Carelon Behavioral Health, dispatches a mobile crisis team where needed.
Cynthia Whitaker, Psy.D., MLADC, is president and CEO of the Greater Nashua Mental Health Center and a dually licensed psychologist and master licensed alcohol and drug counselor.
Whitaker, also an affiliate faculty member at Antioch University, led an October Zoom discussion on changes to the state’s system including its rapid response.
She discussed the three pillars of crisis response; how the current system relates to those pillars; and differentiation among the crisis response entry points—calling 211, 988, or NH’s Rapid Response Access Point (833-710-6477).
Whitaker said in January 2022, all 10 community mental health centers were equipped with a mobile crisis team and those resources are now without restrictions state-wide.
By July, the Suicide Hotline 988 was rolled out. While Whitaker said 988 is helpful in a crisis, she advised calling the 833 number to obtain a state specific resource.
“If you are having a crisis in Manchester and those teams are tied up, you’ll get a team from Nashua,” she said. “They deploy based on who can be there within an hour. An hour is a long time. But dispatchers are trained to determine how long a person can wait and where teams are that may be able to respond quicker.”
The Crisis Now Framework is comprised of the three care pillars: someone to talk to, someone to respond, and somewhere to go.
The call center determines if a crisis team needs to be deployed or if the situation can be de-escalated with a same day or next day appointment scheduled with a provider. Should a team get deployed, the individual may be taken to a crisis response center for no more than 23 hours of stabilization.
Whitaker feels there is a need for greater development because the state has only two crisis centers in Plymouth and Derry. Plymouth is solely a peer support center and takes referrals only from the crisis team. Derry has both clinical and peer support with walk-in and general referral capacity.
However, Whitaker noted the DHHS has expansion plans for additional crisis centers.
In addition to 988 and the state’s direct line, Whitaker discussed 211, which connects to The Doorway system. That resource is a low barrier access point for substance use and recovery support as well as assistance with issues like food insecurity, housing, childcare, and employment resources. Translations are available in 150 different languages.