On any given day, the San Antonio Fire Department responds to more than 1,000 calls from people across the city seeking emergency assistance.
Many of those calls come from so-called high-volume utilizers – a group of around 220 citizens who call 911 for emergency assistance as many as 14 times a month – for concerns ranging from a toothache to paranoia, SAFD Chief Charles Hood said at a conference Monday. Responding to these calls, which are often from people suffering from mental health symptoms, may prevent public safety officials from responding to fires, drownings, and situations that may be more critical, he said.
Hood gathered with area first responders and hospital representatives at the Southwest Texas Regional Advisory Council (STRAC) offices to introduce a regional collaborative effort that aims to connect people seeking emergency services with the right type of care.
“This is a billion-dollar problem in our community, in addition to the fact that [before this collaborative effort], we weren’t taking people to receive the right type of care,” said Eric Epley, executive director at STRAC, a network of hospitals and first responders who maintain the regional trauma and emergency health care system for San Antonio and the surrounding 22 counties.
The Southwest Texas Crisis Collaborative (STCC), a division of STRAC, is a San Antonio-based initiative focused on ending the overutilization of emergency services for people who are chronically ill, homeless, or have a mental illness.
“Psychiatric patients who are being brought to the emergency room are not going to get the best type of care” for the issues they are struggling with, Epley said.
STRAC manages a 24-hour regional communication center, MEDCOM, which helps first responders assign patients to facilities based on available space and symptom type and severity. San Antonio Police Chief William McManus said his department’s Law Enforcement Navigator Program, which has worked directly with MEDCOM to correctly refer patients to 14 area hospitals since October 2017, has saved the department time and has saved lives.
Partnering hospitals provide regular updates on the number of available beds for mental health treatment stays. The MEDCOM platform ensures that when responders encounter a person in mental crisis, they send the patient to the nearest hospital that provides the needed treatment.
Within a five-year period, 63,000 people detained by SAPD were in need of mental health treatment, McManus said. Now, if someone appears to be having a mental health crisis at the scene of a crime or other emergency, first responders give them the treatment they need instead of taking them to jail, he explained.
Hospitals providing regular MEDCOM updates include University Hospital and Nix Hospital. Both facilities have busy downtown emergency rooms that respond to crisis calls, particularly those from the area around Haven for Hope. In July, 124 emergency calls came from Haven for Hope, Hood said.
“If I can prevent responders from transporting someone from Haven for Hope who can be treated in a clinic or a psychiatric facility, that will save lives in this city,” Hood said.
Dr. Rose Rodriguez, director of psychiatric emergency services at Nix Behavioral Health, told the Rivard Report that its 16-bed psychiatric emergency inpatient facility downtown is consistently full, and that a planned 15-bed expansion, while helpful, will do little to put a dent in the need for expanded psychiatric emergency services throughout the city.
“We are always full. If you do the math, we see several hundred [patients] a month,” Rodriguez said. More than 1,000 people need psychiatric services each month, she added, noting that each patient receives a physical assessment to rule out the need for immediate medical assistance.
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STCC’s initiatives receive financial backing from area nonprofits, including Methodist Healthcare Ministries (MHM), whose $5 million donation will be distributed over five years. MHM, the San Antonio Area Foundation, area hospitals, and Bexar County are helping fund expanded services for one of the city’s most vulnerable populations.
Marc Raney, MHM’s interim CEO, said the collaborative effort will help expand and improve quality and access to care, regardless of a person’s ability to pay.
“Our hope is that this unprecedented collaboration will help people see what we already know about San Antonio: Through collaboration and partnership we will do all that we can for as many as we can,” Raney said.