People who experience a crisis related to their behavioral health are often met by teams poorly equipped to respond to their disease, including police or emergency room teams. Now, Johns Hopkins Medicine and 14 other hospitals across Maryland have received $45 million in funding to start an initiative aimed at reducing unnecessary emergency department use and police interactions for substance use and mental health crises.
The five-year initiative, called the Greater Baltimore Regional Integrated Crisis System, will launch January 2021 and will serve Baltimore City, Baltimore County, Howard County and Carroll County in Maryland.
“It’s our responsibility as health care leaders to use evidence-based best practices to design systems that address needs beyond those that are immediate, says Kevin Sowers, M.S.N., R.N., F.A.A.N., president of the Johns Hopkins Health System and executive vice president of Johns Hopkins Medicine. “This is about changing and improving how our society engages with people and families experiencing a behavioral health crisis. These individuals deserve compassionate care provided by experts who understand their needs. This new effort will allow us to manage the crisis situation while getting people the help they need to address what got them to that point in the first place. This is how you protect the health and dignity of the patient while supporting families and keeping our communities safe.”
The initiative will provide a hotline with trained professionals who can provide assessments, de-escalation, and help schedule same-day appointments in real-time using technology that shows treatment bed availability and open appointments across hospitals and community-based providers. The regional hotline will also have the ability to deploy mobile crisis teams, available round the clock, to respond to people experiencing crisis, help them safely stabilize and connect with ongoing health care services.
“Many crisis situations can be managed within existing outpatient clinical settings, if people are able to immediately access such care,” says Mustapha Saheed, M.D., medical director of The Johns Hopkins Hospital Department of Emergency Medicine and assistant professor of emergency medicine at the Johns Hopkins University School of Medicine. “This initiative will support outpatient behavioral health providers to offer walk-in or virtual appointments for people who need immediate assessment, de-escalation, or treatment services. This is an important component of effective crisis intervention and response.”
Annually, more than 58,000 emergency department visits in the four counties are related to behavioral health crisis. The new initiative builds upon the current behavioral health crisis system and aligns with the Crisis Now model, a nationally recognized framework for comprehensive care.
Behavioral Health System Baltimore, the non-profit Local Behavioral Health Authority for Baltimore City will oversee this initiative. The Johns Hopkins Hospital, Bayview Medical Center and Howard County General Hospital will help lead the initiative for Johns Hopkins Medicine including providing the care models needed to grow and sustain the program, identifying and building the work groups responsible for designing and improving infrastructure, helping to ensure success and sustainability and ensuring that patients and communities have access to appropriate crisis services.
“No state, no county, no community is immune to the behavioral health crisis. That includes Howard County, where we have seen increases in the numbers of adults and children who come through our doors with behavioral health needs, oftentimes after struggling to access services in the community, says Elizabeth Edsall Kromm, Ph.D., M.Sc., vice president, population health and advancement at Howard County General Hospital. “We are excited to be partnering to create a response system across the four counties in Maryland. This program will allow us to better meet the needs of anyone experiencing a behavioral health crisis.”
“The need for real time open access to behavioral health care has never been greater than it is today. People living in our communities often end up with many of their needs misunderstood and unmet. This collaboration will enable us to improve access to care across the continuum by creating a system of response that provides the right care, at the right time, in the right place by the right professionals,” says Kai Shea, LCSW-C, senior director of care management at Johns Hopkins Bayview Medical Center.
The initiative is funded by Maryland’s Health Services Cost Review Commission Regional Partnership Catalyst Grant Program. To sustain the program beyond the initial five-year funding, the group hopes to secure local government funding, expand existing support from the commission and establish an insurance reimbursement model to cover care interventions provided by the initiative. The group says, if the initiative proves effective, they hope it will become a model for the rest of the state and even the nation.
Greater Baltimore Regional Integrated Crisis System Participating Hospitals
- Carroll Hospital (LifeBridge Health System)
- Grace Medical Center (LifeBridge Health System)
- Greater Baltimore Medical Center
- Howard County General Hospital (Johns Hopkins Medicine)
- Johns Hopkins Bayview Medical Center (Johns Hopkins Medicine)
- Johns Hopkins Hospital (Johns Hopkins Medicine)
- MedStar Franklin Square Medical Center (Medstar Health System)
- MedStar Good Samaritan Hospital (Medstar Health System)
- MedStar Harbor Hospital (Medstar Health System)
- MedStar Union Memorial Hospital (Medstar Health System)
- Mercy Medical Center
- Northwest Hospital (LifeBridge Health System)
- Sinai Hospital (LifeBridge Health System)
- Saint Agnes Hospital (Ascension Health System)
- University of Maryland Medical Center (UMMS Health System)
- Univ. of Maryland St. Joseph Medical Center (UMMS Health System)
- Univ. of Maryland Medical Center Midtown (UMMS Health System)
