SANTA CLARA VALLEY

HEALTH & HOSPITAL SYSTEM

MENTAL HEALTH MOBILE CRISIS RESPONSE
JAIL DIVERSION PROPOSAL

MAY 1,1996

SANTA CLARA
HGALTH & HOSPITAL SYSTEM

MENTAL HEALTH
DEPARTMENT

Santa Clara Valley Health & Hospital System
Mental Health Mobile Crisis Response
Jail Diversion Proposal

Goal

To assist local police in evaluation and diversion ofmentally ill indi\dduals from incarceration and
the Criminal Justice System.

Procedure

Specially trained mental health staffwill be able to respond to police requests during hours of
operation to assist in evaluation, triage, crisis intervention diversion and referral to appropriate
mental health supports and treatments.

Target Population

M individuals police request consultations to, including, but not limited to, seriously mentally ill

individuals and citizens in acute distress requiring mental health evaluation, without which the
individual would be at risk ofincarceration.
Types of Cases:

The Mental Health Mobile Crisis Team workers will be available for the following cases:
•

All individuals currently open to the Mental Health qrstem

•

Evaluation for 5150 W&Icommittals that are not primarily related to drug and alcohol abuse

•

Domestic disputes traumatized crime victims

•

Consultation with OfiBcers or with the public on any case which may have mental health aspects, but
where direct contact with the subject is inadvisable. These would include situations where the subject

is i»tentially violent,too intoxicated to carry out an assessment,or known to the Crisis Team as an
individual whose problanatic behavior is not related to mental health issues.

Operational Procedure<s

Officer contacts the Mobde Crisis Team by telephone through the police radio dispatch
umt, requesting mobile response or consultation.

•

For safety, clarity ofrequest, and consultation detail, and efficient use ofresources
dirert communication between officers and mental health workers on the Mobile

Crisis Team is preferred. This necessitates either that the officers use telephones.
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or the mental health workers use a police radio. Without this capability

communication must be “third hand” through SJPD communications (dispatch).
The Mobile Crisis Team evaluates the request and determines the response appropriate to
the situation described by the requesting officer.

Multiple simultaneous requests are triaged and prioritized according to potential for loss
oflife or other high risk factors.

For those seriously mentally ill individuals who are currently clients in the Mental Health

System, and who are known to the case managers responsible for their ongoing care, the
Mobile Crisis team at ACCESS activates response through the client’s after-hours case
manager and coordinates with the ofHcer in the field.

For family problems involving children and adolescents, the Mobile Crisis Team at

ACCESS activates the Eastfield Ming Quong 24-hour mobile crisis team which provides
specialized services to this population, and coordinates with the officer in the field.

For situations where a emergency mobile response is appropriate, the Mobile Crisis Team
responds to the location designated by the officer in an unmarked county vehicle,
equipped with mobile phone, and meets the requesting officer.
The requesting officer accompanies the Mobile Crisis Staff during the intervention and
remains standing by until the situation is resolved.

If a transport is necessary, the requesting officer transports the individual to the location
recommended by the Mobile Crisis Team.

Using the car phone, the Mobile Crisis Staff calls back to the Mobile Crisis Home Base

reporting disposition ofthe client and receives any additional requests for mobile response ....
that have come in since their departure from Central ACCESS.

The Mobile Crisis Stafflogs each call and mobile response including disposition.
Geographic Target Area

Because oflimited resources, an analysis ofthe location of seriously mentally ill individuals shows

that the overwhelming majority ofat risk individuals live in the City ofSan Jose(see attached
map)in the Downtown,East Valley, and Franklin-McKinley areas and, as a first step, the
proposed mobile crisis intervention unit will respond only in this geographical area.
Attachment A -

Seriously Mentally HI Patients By Census Tracts. Number of Clients

shows the at-risk population predominantly being in census tracts in
Downtown; and East San Jose.
Attachment B -

Seriously Mentally 111 Patients bv Census Tract. Percent of population bv
census tract.

Attachment C -

A detailed map ofthe County showing the targeted census tracts.

Attachment D -

Table showing seriously mentally ill patients by region. This table shows
that the East Valley, Franklin McKinley and Downtown San Jose areas
account for 48% ofthe seriously mentally ill population.

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Attachment E -

Seriously Mentally 111 Patients by Human Service Area map.
Project Volume

Current Use Information

EPS - Emergency Psychiatric Service reports the following;
A.

10-25 72-hour HoId/24 hours

B.

Average is around 12

C.
D.

60% ofthese are evaluated over time(up to 23 hours)and discharged from E.P.S.
57% ofall 72-hour holds brought into E.P.S. occur during the hours of3:00pm to 2:00am

E.

40% ofall Holds are from Downtown, East Valley area.

San Jose Police Department reports the following;

A.
C.

Average ofsix(6)5150 72-hour holds are taken to E.P.S. per 24-hours
They do not have precinct or areas patrolled that correspond with existing census tract

data.

Program Location

ACCESS Program, Central Mental Health Center, 2221 Enborg Lane, San Jose. The current 24hour hmted ACCESS staffing could augment the mobile crisis staffing; and would offer the best

offpdnf^^ back-up and support. This location cannot function as a secured emergency dropStafllng

After careful consideration it is recommended that this unit be staffed by 3 FTE Licensed
Psychiatnc Social Workers or Licensed Marriage, Family, Child Counselors(PSW/MFCC)across
7 days ofoperarion. The Mobile Crisis Team should also have some Spanish and Vietnamese

I^guage capability ifthe referring officer does not, although it is anticipated that less than 9% of

the requests would mvolve monolingual Spanish speaking individuals, and less than 5% would
involve monolingual Vietnamese speaking individuals.

The use ofpsychiatric residents as part ofa psychiatric rotation would not afford adequate

program coverage or comply with psychiatric residency requirements. The option ofhiring
psychiatnc residents at the prevailing wage of$55.00 per hour would not be cost effective.

Psychology and social work interns could be used to accompany paid staffto a crisis. TypicaUy

available from September to June ofeach year and our cunrent interns receive a’

$4,000/yearly stipend. Interns would assist the staffwith numerous tasks and, given our current
mixture ofinterns, they would augment the program’s bilingual - bicultural capabilities
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Psychiatric/medical backup could be offered by the current E.P.S. psychiatrist, on-call ACCESS
Medical Director, or Administrative Psychiatrist backup for the S.C.V.H.H.S. VMC Department

ofPsychiatry and Mental Health Department. Clerical coverage could be provided within existing

ACCESS Program resources.

JAIL DfVERSION MOBILE UNIT BUDGET

OBJECT 1

SEVEN DAYS A WEEK. EVENING COVERAGE ONT.Y

3 MFCCII(Step 3)5pm - lam x 7 days

Adjusted Salary:($46,270 x 3 = $138,810)
+ Total Benefits($17,679 x 3 = $53,037)-$191,847
X 1.5(7 day coverage)

= $287,770
= 14,040
= 31,233
= $333,043

+ shift differential

+ post coverage
TOTAL OBJECT 1

OBJECT 2

Supplies

= $16,652
=
8,000
=
3,600
= $42,252

1 Vehicle

3 car phones + monthly expenses
TOTAL OBJECT 2

GRAND TOTAL

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=$375,568

4

Other Issues

A Mobile Crisis Intervention Unit will be able to assist the police at the time ofa critical incidenthowever, most ofthe Mental Health Department treatment and housing diversion alternatives are at or

above capacity. The Mobile Crisis Team will need to have an increase in capacity for the following:
A.

Housing - i.e.

Respite housing alternative with capacity to house demented Older Adults
Increase capacity at Jacobs Center, Gouveia
B.

Emergency Assessment Center - Sobering Station

A secure 23-hour evaluation unit for detox of both drug and substance abuse
C.

Safety - Protection

To provide protection for and assure safety to the mental health team who will be

responding at night to unfamiliar locations, the requesting officer will need to stand by

until the situation is resolved.
D.

Transport

Transport ofthe individual to a location other thanjaU wiU need to be provided by a

resource other than the Mobile Crisis Team, ifthe requesting officer does not provide this
service.

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