NORWICH – Preventing the need for trips to the emergency room or costly inpatient hospital stays for individuals who are experiencing a mental health challenge will be the focus of a new approach in the four counties – Chenango, Delaware, Otsego and Schoharie. 
With Bassett Medical Center's recent announcement to discontinue its inpatient psychiatric and crisis service, the four county directors have turned to the Neighborhood Center, Inc. to develop a mobile crisis service to be coordinated in each county. The model will include supportive services for individuals who are experiencing a mental health challenge; to assist in them in successfully remaining in the community.
 The Mobile Crisis and Assessment Team (MCAT) proposal will require the approval of NYS Office of Mental Health (OMH) and talks are already underway as to how to educate the community regarding these changes. OMH has made $1.2 million dollars available annually to the counties and local dollars will not be used to support the program. In the MCAT model, three team members will be in Otsego County and one each in Delaware, Chenango and Schoharie counties.
The design and operation of the MCAT has been tailored to meet best practices for crisis intervention. Providing a community based response for individuals experiencing mental health crises tends to decrease utilization of acute services such as hospital emergency departments; decrease the demand for law enforcement responses; decrease incarceration rates for individuals with mental illness; and increase the rate at which individuals are connected with outpatient mental health services.
Historically, local emergency departments (EDs) are seen as access points for inpatient psychiatric care. Individuals with mental health concerns often seek services in such settings. However, addressing mental health issues in ED settings is ineffective unless an individual is truly in need of inpatient psychiatric care. The use of such facilities for non-emergent crisis events can be both costly and traumatic. If an individual truly needs inpatient care, the likelihood of an admission can be greatly improved when that admission is supported by an MCAT assessment and recommendation.
Our experience (based on program data) demonstrates that most individuals in crisis do not require hospitalization. Rather, mental health needs are better met in the least restrictive environment with the provision of community based services. Moreover, a crisis assessment completed where the crisis is occurring is likely to be more effective and comprehensive; taking into account social and environmental issues, and utilizing various home and community resources to resolve issues and avoid a need for more intense and restrictive services.
This proposal reflects changes in the greater health care system where emphasis is on working toward achieving increased efficiencies while also achieving improved health outcomes. Movement away from costly inpatient care toward outpatient treatment and support in the community will promote recovery and wellness for individuals and their family members who are managing a behavioral health condition.
Chenango County will begin to transition to MCAT June 1, 2014. The phone number will be (844) 732 - 6228.