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After a twice-monthly meeting members of the county-tribal crisis team took time for a group photo. BRIAN BASHAM/DL NEWSPAPERS

Local crisis team is always on call

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There’s no good time for a mental health crisis — they happen when they happen.

That’s why the crisis response teams that serve Becker County and the White Earth Reservation are available 24 hours a day, seven days a week.

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The crisis hotline is always answered. The idea is to help people in crisis as soon as possible, and hopefully avoid an escalation of symptoms.

The teams consist of two mental health practitioners on the ground, supervised by a mental health professional, often by phone.

And the teams serve both children and adults.

One of those practitioners is Dave Erickson, coordinator of services at Stellher Human Services.

“It’s very rewarding,” he said. “It’s some of the most rewarding work that I’ve done in my 15-20 years in the field.”

Spring and autumn tend to be busier times of the year, but there’s no way to predict demand from the crisis line.

“Some weeks we don’t have any calls and some weeks we may have 15 or 20 calls,” he said.

A crisis team visit may take an hour or it may take five hours, depending on the situation, he added.

Sometimes one team member goes out, and sometimes two, again, depending on the situation.

“We all have our moments, and we can get lost in that moment,” he said. “We’re just another set of ears and a voice not so emotionally attached in that moment. It’s good for all of us to have someone there with clarity.”

If there is conflict between a parent and child, it’s helpful to have two team members, so each party can be talked to separately, their emotions calmed down, then everyone comes together to work out a plan, he said.

High demand

The program started with statewide grants in 2008, serving only children. Becker County and White Earth teamed up at that time to form a joint program. It operates on a $250,000 annual grant, but is looking to become more financially independent.

Professionals in the program found themselves doing a lot of work with parents and other adults, so the program was expanded to cover everybody in 2010, said Amber Nelson, a social worker with Becker County Human Services who leads the crisis response program.

“There was a lot of demand for it,” she said. “We were dealing with a lot of behavioral issues with young kids and teenage kids and getting a lot of parent calls.”

Now, she says, “the focus has really changed — kids who are suicidal or depressed are calling for themselves, for that phone support, and they’re calling for friends.”

Calls from parents worried about their children’s behavior are also common, Nelson said.

Parental consent is required before crisis team members go out and talk to a young person in their home. “We try to err on the side of caution when responding to kids. We want parents to know we’re coming out to the home — it’s usually not an issue with parental consent.”

After helping the child and family get through the immediate crisis, the team can help “set them up for the long-term to avert another crisis,” Nelson said.

How it works

The calls are answered by trained dispatchers employed by the Lakes Crisis and Resource Center. There are just two of them, each working one week on, one week off.

“You are calling a mental health line, not their domestic abuse line,” Nelson said.

If they are concerned about a caller potentially hurting himself or others, they sometimes call a 911 dispatcher for a location on the caller, and will send a crisis team if the situation warrants it.

“It is a confidential line,” she stressed. “The information does stay with the crisis teams — it doesn’t get passed along to other (mental health) providers they might be working with,” unless the client gives permission.

The crisis team also works closely with law enforcement on welfare checks. In some situations, the police make first contact, then the crisis team steps in.

The original crisis team visit triggers a 14-day stabilization guideline, “so teams follow up, maybe the next day, seeing if they follow up on referrals and recommendations,” Nelson said. “The follow-up can be short or long-term.”

“Our numbers are strong”

Three agencies are providing staff for the crisis teams: Stellher Human Services, Solutions Behavioral Health and White Earth Mental Health.

“They are the ones already doing the (mental health) work in the communities,” Nelson said.

Stellher handles calls from 8 a.m. to 5 p.m. weekdays in Becker County.

White Earth Mental Health covers the same time period on the reservation, and the three teams rotate to cover nights, evenings, weekends and holidays.

The crisis line averages about 10 phone calls a week, and teams go out on visits about 5 or 6 times a week, Nelson said.

Because of the 24-7 coverage, which is not offered everywhere in outstate Minnesota, “our numbers are very, very strong compared to other teams around the area,” Nelson said.

“People get in the routine of knowing they can always call — if they need someone, someone can always come,” she added.

That can be especially useful at the emergency room, where people with mental health issues can face 6-8 hour waits, while staff tries to diagnose and to locate a mental health hospital bed for them, sometimes causing their symptoms to escalate.

A crisis team visit in that situation can be helpful to all involved, Nelson said.

“Law enforcement also uses us,” she said.

“Teams can come out and do what they can do — it frees up officers to go back to work if it’s not appropriate for them to be there anymore,” she added.

A mental health crisis can be hard to define, so “the client defines it,” Nelson said. It’s not a housing or domestic violence issue, but it can be mixed with chemical dependency problems.

Telephone triage

“That’s why answering the phones involves triage to find out what the needs are — sometimes people just need to talk, as opposed to suicidal issues,” said Nelson.

Sometimes calls come from family members who are concerned and at a loss as to what to do to help.

The teams try to respond within 45 minutes to an hour after the call, Nelson said.

“We let people know we don’t have cherries (emergency lights) on our cars,” she said.

Sometimes calls have to be prioritized. “Just a couple weeks ago that happened,” she said. “Three calls came in kind of at once, and all three needed teams.”

Two calls came from the hospital ER and one from a private residence. “That one got priority because the hospital has staff,” she said.

Calls have increased in White Earth since the reservation mental health department was created.

“Not everyone knows we even have crisis teams — we could almost be going out every day, all day long,” she said.

“Having a White Earth crisis team has definitely helped having knowledge of the service — they spread the word.”

The teams meet twice a month to discuss calls, confer about any issues and discuss any necessary changes.

“The hospital, law enforcement, schools, the agencies providing the teams and county human services all worked together and just made their relationship stronger,” Nelson said.

A state Department of Human Services audit in August “said ‘you guys do a really good job of bringing everyone together,’” she added.

The crisis line number is 218-850-4357 or toll-free at 877-380-3621.

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