In December 2005, the Texas Department of State Health Services kicked off a plan to redesign mental health Crisis Services in the state.

Using service data available from the 39 local mental health authorities around the state, surveys of emergency rooms, law enforcement, elected officials and consumer groups, DSHS was able to provide data to illustrate the inconsistencies and inadequacies in crisis services. The 80th Legislature appropriated $82 million for the FY08 and FY09 biennium to be used entirely for Crisis service enhancement and development.

Locally, the Betty Hardwick Center received about $245,300 in FY08 and $305,000 in FY09 in allocated funds to be used for crisis services. State and local objectives for Crisis Redesign include:

• Rapid response.

• Local stabilization when possible.

• Jail diversion and reduced burden on local law enforcement.

• Decreased utilization of emergency health care resources.

Planning for the use of these funds involved a great deal of stakeholder involvement. We have standing Mental Health Task Force meetings, Planning and Network Advisory Committees and Jail Diversion Committees, all of which provide input and recommendations on an ongoing basis.

DSHS identified two priority areas for all MHMR Centers to address with the new funding — enhancement of crisis hot line services and mobile crisis outreach services. The Betty Hardwick Center enhanced the local crisis hot line by contracting with a new hot line provider who is accredited by the American Association of Suicidology, Avail Solutions Inc.

Avail has been working since April. They are staffed with professional mental health workers and counselors, and the hot line has handled an average of 405 calls a month. The center also established a new Mobile Crisis Outreach Team to reduce our response time for on site for crisis assessments in the community. The Mobile Crisis Outreach Team started in September 2007, and to date, the team has responded to approximately 351 calls for crisis assessment, and the staff have delivered 555 hours of face to face crisis intervention.

Additionally, the Betty Hardwick Center was able to use the remaining new funding to open a new 12 bed crisis respite facility. The Center contracts with The Wood Group Inc. The respite facility serves as a much needed service providing residential supervision and support. Often, this option is a viable alternative to state hospitalization and for people in need of diversion from contact with law enforcement. Since opening in February 2008, the new crisis respite facility has been successful in stabilizing 214 people in mental health crisis in the community.

DSHS also approved a Center proposal for competitive grant funding to create a local crisis stabilization unit at Acadia Hospital. The Betty Hardwick Center partnered with Acadia Hospital and local physicians to create a five bed indigent psychiatric unit to be used as a local alternative to the state hospital.

This new crisis stabilization unit opened in June, and has already helped to stabilize 66 people, allowing these people to benefit from hospital care in Abilene rather than having to be transported by law enforcement to the distant state hospitals. Having this new local capacity for indigent psychiatric hospitalization has been very beneficial to our clients and their families. We’re extremely fortunate to have a local inpatient facility such as Acadia Hospital that is willing to participate with us in this type of partnership. Our community’s Crisis Redesign plan will be continually reviewed, and the service improvements will continue to be assessed for their effectiveness for adjustments to be made as needed. We invite anyone with interest in mental health crisis services to contact the center at (325) 690-5100, and would welcome input into our evaluation of the crisis services.

Jerry Freshour, BA, MPA, is a program administrator for Crisis Services at the Betty Hardwick Center.