Virtual crisis care: how real-time telemedicine counseling can improve outcomes and save resources
The country’s mental health crisis is weighing heavily on first responders. Real-time access to a virtual behavioral health professional can facilitate de-escalation efforts, prevent involuntary dismissals, and save law enforcement resources.
Estimates show that up to 20% of calls to the police involve a mental health or addiction crisis, and this number appears to be increasing over time. With the ongoing opioid epidemic and the COVID-19 pandemic contributing to an increase in mental health crises across the country, law enforcement is feeling the pressure as they are often the first responders to these crises.
When law enforcement is called in, the mental health situations they encounter vary each time. Rates of depression have tripled since the start of the pandemic, according to public health researchers, while suicidal ideation is also on the rise. At the same time, access to consistent and affordable mental health care is only available to a small proportion of Americans, leaving law enforcement to fill the gaps in an unsustainable system.
According to a recent survey, more than 80% of long-time law enforcement veterans said they have seen an increase in mental health issues over the course of their careers. A similar number indicated that the total time spent on mental health-related calls has increased significantly over time, in part because these calls often take much longer than traffic calls, theft reports, disputes household and other common situations.
The need for more training in mental health intervention is well documented, but agency resources are scarce and officers cannot be expected to act as fully trained clinicians in addition to perform their other duties. The result is often a high number of involuntary incarcerations which consume enormous amounts of time, human resources and money.
While law enforcement agencies should be commended for doing whatever it takes to ensure individuals have immediate access to mental health care, they need a better way to address the problem. This is where telemedicine begins to fill the gap.
With telemedicine mental health crisis management, law enforcement officers can use a telemedicine tablet to connect with a trained counselor, who can thoroughly assess the situation and make informed recommendations on next steps. . This approach has been proven to avoid unnecessary involuntary dismissals, improving outcomes for the individual in crisis, while significantly reducing the time and effort of law enforcement personnel.
In 2020, South Dakota launched a telemedicine pilot in partnership with Avel eCare and a private donor. The Virtual Crisis Care (VCC) program equips sheriff agencies with iPads to support on-demand, 24/7 access to a behavioral health care team.
VCC is another tool for law enforcement to better serve their communities and help those in mental health crisis. Telemedicine has become an important technology for connecting people to highly skilled healthcare providers on demand. It’s time to extend its value to law enforcement agencies, which play a vital role in managing behavioral health crises in the community.
Access to virtual mental health care is not limited to rural areas, but the impacts it can have on these regions are particularly noticeable.
For example, in South Dakota, where only a few facilities offer mental health care to inpatients, transportation for involuntary confinement can take up to seven hours of driving, as available facilities are located in extreme geographic corners. of the State, which is arduous both for the officials in charge and for the person transported.
With VCC, on-site law enforcement officers can request a video security assessment before beginning a multi-hour journey. The telemedicine call can take anywhere from 15 minutes to an hour, depending on the person’s medical condition and ability to engage with the mental health professional.
The mental health professional documenting the encounter then speaks with officers on site to recommend a course of action. If the mental health professional determines that the person is safe to stay at home, they connect them with a community health resource for follow-up. The officer has the ultimate decision on which course of action to take based on his direct knowledge of the situation.
The results of this strategy are extremely encouraging. Of 181 encounters during the pilot that are expected to result in involuntary confinement, only 19 ended up with someone in need of immediate hospital care. More than half of the 181 calls involved suicidal thoughts and 15% involved aggressive behavior.
“Using VCC through Avel eCare, we noticed significantly different results than what we usually see,” Butte County Sheriff Fred Lamphere commented. “It’s less inconvenient for the purpose of the call, less stressful for the agents and less costly for the agency. We need all the help we can get to maximize our resources and treat people in mental health crisis. Telemedicine is a simple and effective way to achieve this goal.
The Avel eCare pilot is looking to expand to other South Dakota counties in 2022 and potentially other states soon. Whether operating in rural or urban areas, law enforcement agencies have the potential to use telemedicine technology as a cost-effective and highly effective way to diffuse tense situations, conserve resources and improve outcomes for people in crisis.
Brian Erickson is Vice President and General Manager of the Behavioral and Specialty Health Clinic at Avel eCare, one of the first and largest telemedicine care providers in the nation to begin offering provider-to-provider services via telemedicine. Since 1993, Avel physicians and clinicians have provided exceptional virtual care to millions of patients in rural and underserved communities across the United States.