Rhode Island Outreach – Extending care beyond the crisis

A distraught mother, living in another state, calls Newport Mental Health’s crisis line because she can’t reach her adult son living in Newport. She explains his history with mental illness and fears the worst; she doesn’t know what to do and asks for our help.

NMH dispatches our Rhode Island Outreach (RIO) behavioral crisis response team. Working with information from the mother, the RIO team checks his apartment (no answer). They find the landlord and learn he’s been evicted. They drive through Newport, checking places with free wi-fi. He’s located, helped to find a room at a shelter, given a follow-up appointment at NMH, and encouraged to call his mom so she knows he’s okay. He’s now a client of NMH, back on his medication, and getting regular check-ins from RIO and his NHM case manager.

We’ve written about RIO before, describing their role as a behavioral crisis response team. But they do so much more – after the initial crisis, they follow up and engage with the client for as long as it takes to get them stabilized, preventing future crisis calls.

Hurdling Over Traditional Barriers to Care

For people experiencing a mental health or substance use crisis, there can be many barriers to care, from the emotional (fear of being committed to the hospital, fear of arrest, distrust of authority figures, or general confusion) to the functional (not knowing who to call, lack of transportation, lack of insurance). RIO removes the functional barriers by coming to the person, wherever they are; transporting them to additional help when needed; and not requiring insurance or payment.

The other barriers require more nuanced strategies. The team arrives in a regular van, so it doesn’t look or feel like a medical or law enforcement intervention. They wear polo shirts and ball caps. The staff is also diverse, and all are trained as peer counselors. “We try to build a rapport,” says Patarja Spann, director of Rhode Island Outreach. “Not only are the staff trained in techniques for de-escalation and communication; we have lived experience, which helps us relate to the clients and earn their trust.”

RIO works with each person for as long as it takes for them to accept that they need help. They may spend hours on the initial call. RIO actively collaborates with community organizations, both local and statewide, and connects people to services provided by NMH, CODAC, Turning Around Ministries, the

Dr. Martin Luther King Jr. Community Center, Hope Recovery Center, and others either by transporting clients directly in real-time, or making an appointment and following up to ensure they attend the appointment. And yes, sometimes clients are transported to the hospital, but this number is small.

The RIO team tries to be as visible as possible in the community. Spann describes their role as being “immersed in the environment of the person.” Every morning they visit the MLK Community Center’s free breakfast, talking to people and asking what they need/how they can help. Later, you might find them in Queen Anne’s Square, or visiting neighborhoods or gathering places in all six Newport County towns, as well as Bristol, Warren, and East Providence, again talking to people, distributing information, and simply asking, “How can I help you?” Two vans are on the road from 7 a.m. – 11 p.m., seven days a week.

RIO Diversions Reduce Costs

We know that prevention costs less than treatment. For every dollar spent on a Certified Community Behavioral Health Clinic (such as Newport Mental Health) saves two dollars in emergency department costs. RIO catches people experiencing a behavioral or substance use crisis and diverts them from the emergency department; as the program grows, EDs will see fewer behavioral crisis clients.

Increasingly, Newport County police departments are working with RIO to respond when 911 calls are of a behavioral health nature rather than a criminal one. The goal is to get people the treatment they need and prevent unnecessary involvement in the criminal justice system. This saves money and ensures that law enforcement is available for the important work they do to protect our community.

“The partnership Tiverton Police Department has established with Newport Mental Health has been instrumental in many cases where an individual needed immediate mental health support and was able to receive that support right away,” says Lieutenant John LeDuc, Community Policing Unit Supervisor, Tiverton Police Department. “In numerous cases, Newport Mental Health’s immediate response, or presence on scene, has helped avert situations that may have led to an arrest, due to their professional assessment of a person’s mental instability.”

RIO is also growing in its role as first responder for calls to the new 988 suicide and crisis line. You can also reach them in Newport or Bristol County by calling Newport Mental Health’s crisis line 401-846-1213 ext. 1 (ask for RIO). You can call for yourself or someone you know.

It’s Time to Go Statewide

RIO is a pilot program based at Newport Mental Health. It rolled out in stages in the second half of 2023. From July to November, RIO averaged 354.6 initial encounters and 206.6 follow-ups per month, for a total of 4,311 contacts in five months. Based on the needs we see in the community, RIO could (and should) be expanded to handle up to 1,000 calls a month in this coverage area.

This is an incredible program that has had an immediate, positive, measurable effect in Newport County. It should be available in every city and town in Rhode Island. As a pilot program, RIO is funded by a standalone grant from the State. It’s time to promote it to a fully funded, state-recognized program that works in tandem with the new 988 behavioral helpline.

Together, we can get help to Rhode Islanders in crisis when and where they need us.

Jamie Lehane is president and CEO of Newport Mental Health in Middletown. Peace of Mind, which is co-written with Kristan McClintock, runs in The Daily News and online at newportri.com.

This article originally appeared on The Providence Journal: Rhode Island Outreach – Extending care beyond the crisis