Myra Dzembo’s family had just returned to the area from time abroad. It could have been the move, she thought, that led to her son acting out to the point that she was concerned for his safety.
Looking for help, she found the then-new Parsons Child and Adolescent Mobile Crisis Team.
Teams, generally consisting of social workers and mental health counselors, respond to youth in mental health crises. They assess the situation, calm both parents and the child, and ensure the child gets needed services — all where the crisis is happening, often in the home.
“The clinicians,” Dzembo recalled, “were very good with my son. They talked to him and he wanted to show them all kinds of stuff. He really bonded with them quickly.”
The team helped make a safety plan for the boy and he didn’t have to go to the hospital — which had been Dzembo’s first thought.
“When your son is having so much trouble, you just want to help him so much,” the mom, who now works with the team as a family advocate, said. “Just to have them there talking to us, just really helped calm me down and calm the family down.”
The child and adolescent team — covering Schenectady, Albany and Rensselaer counties — started in 2007.
Parsons Child and Family Center is now taking that approach and expanding it to a select group of adults. They’re hoping to expand it further in the future.
The adult team started last October and covers five counties: Schenectady, Saratoga, Rensselaer, Warren and Washington. Albany County has long had its own adult mobile crisis team.
The child and adolescent team also recently expanded to Saratoga, Warren and Washington counties.
The goal, organizers say, is to get those suffering mental health crises into the proper care in the community — and out of hospital emergency rooms and jails wherever possible.
“Hospitals traditionally have been the safety net for these clients,” said Joanne Schneider, executive program director for the child and adolescent team, “and what we’re trying to do is operate in the community as a safety net, so they don’t need to go to the hospital unnecessarily.”
The adult team is being implemented in stages. The first stage focuses on those with the highest risk of psychiatric hospitalization, Parsons officials said. Those include individuals recently discharged from state psychiatric hospitals or state prisons and those under assisted outpatient treatment orders.
The adult team is generally dispatched through calls to hospitals in the county and runs between noon and 9 p.m. The hours cover about 75 percent of activity. The hope is to expand the hours in the future.
Officials at the hospital, the “gatekeepers,” determine the best course of action, whether it’s calling in the mobile team or police.
If it’s a situation that calls for the mobile crisis team, the team then goes to the site of the crisis. The team, usually consisting of two people, assesses the risk to the person and risk to others. They also look for other possible risks, including substance or alcohol abuse.
“We kind of gauge what the situation is — What’s the environment? What’s the context of the crisis?” said Melissa Jenks, program director of the adult team. “That looks different county to county, but that could be anything from homelessness and not having access to certain resources, to obstacles with their mental health services.”
“We figure out what the context of the situation is and how we can intervene to help,” Jenks added.
If they determine that the individual can be maintained safely in the community, working with the team, then they’ll put together a safety plan.
The adult team works with the individual, but can also work with those the individual identifies as their support system, including friends or family, Jenks said.
If they determine the client can’t be maintained in the community at that moment, the team will follow up at the hospital to make sure providers get to work with them there, Jenks said.
Albany County’s adult mobile crisis team is the longest-running team in the state, according to Stephen Giordano, director Albany County’s Department of Mental Health. The program, paid for by a mix of county and state funds, has now been running for 30 years. “We’re very proud of that,” Giordano said.
The team responds to about 900 to 1,000 calls each year, he said, from individuals, the community and police.
The end result, Giordano said, is that between 45 percent and 50 percent of all the calls get diverted away from emergency rooms and to community services.
“Many of the folks that we end up responding to, some of them we may know from prior work, some of them just need some counseling and support in the community and once we work with them for a little bit, the crisis goes away,” Giordano said. “Many of them just need a referral to a good program in town and the crisis is resolved for the moment.”
That doesn’t mean the team won’t be called back, he said. But if the person is deemed a danger to themselves or to others, police the crisis team and an ambulance will take that person back to a local hospital, Giordano said.
“But anything short of that, we try to keep people out of jail, we try to keep people out of the hospital,” Giordano said.
Weapons complicate matters. When those are involved, Giordano and the others said, they back off and let police respond.
One such call to a mobile crisis unit came in April from the mother of a Rotterdam man with a documented mental health history, police said then. The man wasn’t taking his medication and had two knives.
Police later said the presence of the knives made the call a police matter. Ultimately, Rotterdam police were unable to defuse the situation and police said William Clark stabbed at both officers before one opened fire, killing Clark.
Getting word out
In the first few months of the five-county adult effort that includes Schenectady County, work has focused on first letting agencies, mental health clinics and residential programs know about the team. The hope is to make the mobile team call a natural one, Jenks said.
The number of calls has steadily increased, nearing 175 for the limited first phase of the program. The new children and adolescent program in Saratoga, Warren and Washington counties has served about 100 since January.
The hope is to emulate the success of the initial children and adolescent program, which has served 5,000 children and families since its start in Schenectady, Albany and Rensselaer counties nine years ago, officials said.
Saratoga County Mental Health Director Michael Prezioso said the new team is a welcome addition to services in the county, building on programs elsewhere.
“We are glad to work in partnership with the other counties involved and with Parsons,” Prezioso said.
Part of the adult program is a peer support specialist, similar to Dzembo’s advocate position on the child and adolescent team. Organizers say that specialists who have been though similar situations are an important part of the response process.
With the child and adolescent team, Dzembo said part of her job is simply to listen.
“I’ve been through it. I’ve been on the other side of it and came out,” Dzembo said, “so I’m able to give them a lot of hope because when you have the supports and you have the things that are in the community, you can get that help for the child and for yourself.”