988 vs. NH Rapid Response vs. 911: Exploring Mental Health Crisis Response Options

August 18, 2022

Jennifer O’Higgins, NH DHHS

Det. Rochelle Jones, Portsmouth PD

Heather Walker-McConihe, Community Partners

Eric Eason, Beacon Health Options

Transcript:

Michelle Wagner, NAMI NH (she/her): Good afternoon, folks we’re going to give just a few seconds for people to enter the zoom room, we have a lot of folks joining us today.

Michelle Wagner, NAMI NH (she/her): we’re glad that you could be with us.

Michelle Wagner, NAMI NH (she/her): So good afternoon I’m Michelle Wagner with NAMI New Hampshire and I work on the first episode psychosis early serious mental illness initiative, thank you for joining us for today’s webinar.

Michelle Wagner, NAMI NH (she/her): 988 versus New Hampshire rapid response versus 911 exploring mental health crisis response options today’s presentation is being recorded and you’ll be able to find it on the education page of on where then h.org.

Michelle Wagner, NAMI NH (she/her): there’s a short evaluation we’re asking folks to complete after today’s presentation you’ll also receive a follow up email with links to both the survey and the recording.

Michelle Wagner, NAMI NH (she/her): This is the zoom webinar so your camera and microphone or off.

Michelle Wagner, NAMI NH (she/her): The Q amp A feature is working, so please enter any questions you have there, we will save time at the end for Q and A. we originally were scheduled till one o’clock.

Michelle Wagner, NAMI NH (she/her): And our guests have agreed to stay on because we know they’re going to be a lot of questions. We had nearly 300 people registered for this webinar.

Michelle Wagner, NAMI NH (she/her): So, we’ll save time at the end to go through those questions Emily huff and I will work together to get them answered as best we can.

Michelle Wagner, NAMI NH (she/her): So, with us today are some individuals who play a variety of roles and New Hampshire’s mental health crisis response system.

Michelle Wagner, NAMI NH (she/her): We have Jenny O’Higgins who’s a senior policy analyst with a division of behavioral health at DHS.

Michelle Wagner, NAMI NH (she/her): We also have Eric Easton he is the account manager for New Hampshire rapid response access point at beacon health options.

Michelle Wagner, NAMI NH (she/her): We also have Heather Mcconaghy she is a mobile crisis support specialist that Community partners, and we have detective Rochelle Jones, who is the Community outreach coordinator at the Portsmouth police department, we welcome you all, thank you for joining us.

Michelle Wagner, NAMI NH (she/her): As folks know we have a new crisis response system, it is now nationwide nine eight rolled out last month and, most of us are confused as to how it works what number do we call when and why.

Michelle Wagner, NAMI NH (she/her): So, ah Emily, I’ll have you take down the slide opening slide and we’re going to start with our questions and Jenny I’m going to start with you.

Michelle Wagner, NAMI NH (she/her): Can you just tell us your role and briefly share how nine eight came to be and now how did Hampshire was already moving forward with this prior to the roll out last month.

Jenny O’Higgins, DHHS: tour, yes, thanks, Michelle so I’m Jenny O’Higgins I work for the Department of Health and human services I’m in the division for behavioral health.

Jenny O’Higgins, DHHS: And I work across all three of our bureaus so we’re looking to do some integrated care across substance use disorder and mental health throughout the entire lifespan.

Jenny O’Higgins, DHHS: One of the things that I do is facilitate our 980 coalition so we’re bringing together stakeholders from the Department of Justice, Safety, and Department of Education.

Jenny O’Higgins, DHHS: People with lived experience peers Community mental health centers on and on and on our crisis call centers even large group of stakeholders coming together to plan for nine a day.

Jenny O’Higgins, DHHS: And the reason that that you know came to be is at the federal level legislation was passed that changed the 10-digit national Suicide Prevention lifeline number over to a three-digit easy to remember number.

Jenny O’Higgins, DHHS: And the reason for that was to make sure that folks in crisis could remember a simple number to call.

Jenny O’Higgins, DHHS: Just like they do for 911 it’s an imperfect sort of comparison to have 911 and nine eight out there together because you’re not always going to get an in-person response for 90 days it is a, you know, a call line.

Jenny O’Higgins, DHHS: And, but it is it’s a nice way to think about having an easy number to remember when you’re experiencing emotional distress, you know substance use suicidality.

Jenny O’Higgins, DHHS: Really, calling for any reason, and with regardless of diagnosis to just have someone to talk to early.

Jenny O’Higgins, DHHS: And so, because of that federal change in the national line you know this this number changing over New Hampshire started to plan for what that would look like in our state.

Jenny O’Higgins, DHHS: prior to any of that federal legislation happening New Hampshire had worked on a 10-year mental health plan looking at what are the gaps in our system.

Jenny O’Higgins, DHHS: And what are we doing really well and how can we make sure that we have those pockets of excellence across the whole state, how can we serve people across the lifespan and across all of behavioral health.

Jenny O’Higgins, DHHS: And really well and so through the recommendations of that 10-year mental health plan and the governor’s Commission on alcohol and other drugs plan.

Jenny O’Higgins, DHHS: And some legislation in our state that required mobile crisis to serve children all of those are sort of background drivers for us to launch.

Jenny O’Higgins, DHHS: A 24 seven centralized access point and to be able to handle crisis call text and chat.

Jenny O’Higgins, DHHS: And that that access point would also be able to deploy mobile crisis teams throughout our whole state for those folks who did need an in-person response.

Jenny O’Higgins, DHHS: And, and so the easiest way to think about it, since all of that is already a little bit.

Jenny O’Higgins, DHHS: Complex I think the easiest way to think about it is that there’s this model out there that’s best practice and that’s called crisis now.

Jenny O’Higgins, DHHS: And the way that they describe it, that really helps me remember what we’re what we’re driving towards as a state is that everyone should have someone to call.

Jenny O’Higgins, DHHS: Someone to respond and somewhere to go right, and those are your three pillars of the crisis now model what we’re talking about today is that someone to call.

Jenny O’Higgins, DHHS: For mostly that’s the bulk of what we’re talking about and we’re going to get into a little bit about someone to respond, which is your mobile crisis teams.

Jenny O’Higgins, DHHS: or when you need law enforcement EMS or fire right and we’re going to talk a little bit about those things today, but that gives you a sense of the background and how we came to today that we have launched this new access point in New Hampshire.

Jenny O’Higgins, DHHS: Back in January and then with the changes coming at the national level we’re looking at how those things are the same and different and related.

Michelle Wagner, NAMI NH (she/her): thanks for that Jenny you talked about crisis now I know we have the links or crisis now Emily can put those in the chat for folks.

Michelle Wagner, NAMI NH (she/her): um and thinking about this, three pillars, so we have the call and response and then it’s the stabilization after that will be a piece that comes along with that project eventually Jenny correct.

Jenny O’Higgins, DHHS: Yes, so New Hampshire is looking at what should crisis stabilization in our state look like we do have location-based services it’s just that how crisis stabilization is defined we don’t quite have that in our state.

Jenny O’Higgins, DHHS: But we do, we do have some location-based services and as you’ll learn as we talk through what the access point can do.

Jenny O’Higgins, DHHS: They also do have the ability to book some follow up appointments at local community mental health centers to get that in person, so some of it would be mobile crisis teams, some of it would be connecting with your community mental health Center.

Jenny O’Higgins, DHHS: But the crisis, the true third pillar defined in crisis now is a future vision for New Hampshire and not a piece of what’s in place today.

Michelle Wagner, NAMI NH (she/her): Okay, great, thank you for clarifying that and Emily’s put some resources into the chat for us so Jenny when you and I talked it’s hard to figure out who’s doing what around this project and you clarify the stage role so, can you go ahead and share that with the folks here.

Jenny O’Higgins, DHHS: Sure, so the Department of Health and human services, you know, took in all of this information and feedback to put out the 10-year mental health plan.

Jenny O’Higgins, DHHS: And now we have the responsibility of working towards that future vision and implementing those recommendations for our system.

Jenny O’Higgins, DHHS: How we do that is very administrative as far as what our role is as administrators, we put out, you know competitive bids to figure out who is most qualified.

Jenny O’Higgins, DHHS: and able to do this work, to the best of their ability in New Hampshire right so who could bring these things forward in terms of what we’ve set up in the system today.

Jenny O’Higgins, DHHS: We have our community mental health Center system, and we continue to work with them and in and to figure out funding models that will allow for them to have robust services, and that includes the addition of mobile crisis teams.

Jenny O’Higgins, DHHS: In in certain areas of the state, some have had mobile crisis teams for a few years and in other areas of the State they’re brand new.

Jenny O’Higgins, DHHS: But that’s one piece, that the department works closely with the Community mental health centers who really do the direct service piece.

Jenny O’Higgins, DHHS: And then we have a contract with beacon health options that was also was through a competitive bid process, so we put out a request for proposals folks at vendors apply for those requests for proposals and we go through a process of.

Jenny O’Higgins, DHHS: determining who may be able to offer these services most robustly in our state.

Jenny O’Higgins, DHHS: In health options that won the bid for.

Jenny O’Higgins, DHHS: The APP the centralized access point with the ability to deploy mobile crisis teams, so they work very closely with the Community mental health centers to make that happen.

Michelle Wagner, NAMI NH (she/her): So, the state is the administrator and then there were service providers that do the actual work.

Jenny O’Higgins, DHHS: Yes, our other responsibility is to monitor this work and make sure that we’re all embarking on quality improvement long term so when you start something is brand new, especially if it’s really big and it involves a lot of culture shifts and it doesn’t start out working perfectly.

Michelle Wagner, NAMI NH (she/her): So, we had talked about that to the monitoring and the quality and then also advertising educating right, we can talk about that later in our discussion, but we want to come back around to those pieces for sure.

Michelle Wagner, NAMI NH (she/her): let’s switch over to Eric you’ve been the face of beacon for many of us, and here in new Hampshire can you explain your role and then define, we need a working definition of what crisis is because calling 911 is very different than calling 980 so, can you answer that for us.

Eric Easson (He, Him), Beacon Health Options: happy to yeah, it’s been my pleasure, Michelle, to continue working with NAMINH and the folks here in New Hampshire.

Eric Easson (He, Him), Beacon Health Options: My southern accent betrays that I’m not local or not from here, originally, but I am local now and I’m here locally, because.

Eric Easson (He, Him), Beacon Health Options: My job is to be sure that I am the face of the organization that i’m out there, helping folks understand this process, helping them understand what the systems are in place.

Eric Easson (He, Him), Beacon Health Options: And hearing when things don’t work right, so that we can take it back and make sure that we’re addressing that and fixing things and improving things so that so that they do work, the way that we want them.

Eric Easson (He, Him), Beacon Health Options: The concept of crisis is really pretty foundational to the way that we do our work I get asked this a lot what, what do you define as a crisis and my answer to that is we don’t.

Eric Easson (He, Him), Beacon Health Options: The person who is calling this gets to define that for themselves and I often use a lot of analogies but suffice it to say that the two different people in the same situation may react to that situation very differently.

Eric Easson (He, Him), Beacon Health Options: and well, while one person they feel like they’re handling you know the situation just fine on their own, or with their existing support and resources.

Eric Easson (He, Him), Beacon Health Options: Another person may find that situation very overwhelming, and so, if we try to define that externally, we might treat them both the same way and they’re not both having the same experience.

Eric Easson (He, Him), Beacon Health Options: So, the easiest answer is that a crisis is self-defined, if you think that you’re in crisis, we accept that you are, and we will provide you with whatever support you need.

Michelle Wagner, NAMI NH (she/her): Great, thank you for that anyone have anything to add into that.

Michelle Wagner, NAMI NH (she/her): yeah, you did a really good job of explaining that because I think people are are unsure is what’s going on a crisis for me, should I call is it okay to call.

Eric Easson (He, Him), Beacon Health Options: You know, and we encourage folks if you’re not sure go ahead and call you know we’ll be happy to talk through and then you can get a feel for what kind of services, services and supports, we can offer you.

Eric Easson (He, Him), Beacon Health Options: And you can decide if that’s the kind of services and support that you need you know, but that is our purpose here is to is to provide that service and support folks and.

Eric Easson (He, Him), Beacon Health Options: You know a variety of situations, and we do have several options at our disposal, so we might be able to get you to something that is very appropriate given your your particular needs.

Michelle Wagner, NAMI NH (she/her): Great so let’s now talk about the details.

Michelle Wagner, NAMI NH (she/her): So, Eric who’s calling, why are they calling which number should they call these are all questions folks are having so, can you start us off with that.

Eric Easson (He, Him), Beacon Health Options: I’ve been trying to think of the best way to describe this in my head because it’s very complicated.

Eric Easson (He, Him), Beacon Health Options: Question like what is this what is 90 days, what is the local like what rapid response is, so let me see if I can define things from a top-down perspective and help people understand it a little better.

Eric Easson (He, Him), Beacon Health Options: 988 is essentially a new name for an existing service called the national Suicide Prevention lifeline for many years the number to reach that lifeline was one 800 273 TALK.

Eric Easson (He, Him), Beacon Health Options: While that number remains in effect there’s now a new national three-digit number 988 which works similar to 911 in that you dial that number and you’re connected to the network.

Eric Easson (He, Him), Beacon Health Options: Now that we’re it’s very important when we say 90 days, we’re not talking about one call Center somewhere in the nation where you’ve got a room full of people answering the phone.

Eric Easson (He, Him), Beacon Health Options: 988 is a network of local call centers and I don’t know the number of them, but they’re in excess of you know 30 4050 call centers around the country.

Eric Easson (He, Him), Beacon Health Options: That are all part of this network here in New Hampshire there are actually two call centers that operate as a part of that network.

Eric Easson (He, Him), Beacon Health Options: One is headrest, and one is the rapid response access point that we have beaten up rate.

Eric Easson (He, Him), Beacon Health Options: So, when we began operating that service back in January we developed the local number, which is the 833716477 number that you see in the chat there, that is our local call Center.

Eric Easson (He, Him), Beacon Health Options: That direct number continues to operate for people who want to call us directly but understand that if you dial 988 here in New Hampshire.

Eric Easson (He, Him), Beacon Health Options: You will be connected to some call Center somewhere possibly here in New Hampshire or somewhere else in the country, who can provide you with the support that you might need in that moment.

Eric Easson (He, Him), Beacon Health Options: The question really boils down to what you feel is most appropriate and honest in your situation.

Eric Easson (He, Him), Beacon Health Options: What you can best remember to do to get help, and so I want people to understand that there really is no wrong door there.

Eric Easson (He, Him), Beacon Health Options: So that’s kind of the overall structure, and I know it’s a bit of a plate of spaghetti but it’s about the best way that I can think to describe it, we can talk more about that, to help people understand a little bit better.

Eric Easson (He, Him), Beacon Health Options: As far as who is answering the phone obviously because we’re talking about a number of different call centers you’ve got a slightly different mix of people from place to place, but here in New Hampshire.

Eric Easson (He, Him), Beacon Health Options: All the people who answer phones for our crisis lines are people who have either.

Eric Easson (He, Him), Beacon Health Options: The who have experienced either serving those in mental health crisis or who may have lived experience in crisis.

Eric Easson (He, Him), Beacon Health Options: Or perhaps we both have some people, who have both lived experience and have been service providers, for people in crisis, so all the people answering the phones and the techs and the chats.

Eric Easson (He, Him), Beacon Health Options: All have that level of expertise and experience, and they bring that experience to bear and provide support to folks helping them kind of under helping us.

Eric Easson (He, Him), Beacon Health Options: Talk through that with folks and understand what their needs are what their concerns are.

Eric Easson (He, Him), Beacon Health Options: And then, helping them understand what their local options might be that could be a variety of things that we’ve kind of touched on already some services that we might link them to locally in the Community, we could.

Michelle Wagner, NAMI NH (she/her): If.

Eric Easson (He, Him), Beacon Health Options: You know the need arose, link them to other services such as 911 law enforcement fire you miss things like that.

Eric Easson (He, Him), Beacon Health Options: But we do a really good job of generally being able to support folks on the line by really doing nothing more than providing that warm support and helping them work through their problems with that with that work on the phone.

Michelle Wagner, NAMI NH (she/her): So, you said that it isn’t a license clinician that’s necessarily that you’re going to talk to on the phone.

Eric Easson (He, Him), Beacon Health Options: Not necessarily we have some who are licensed clinicians and there are always license conditions available in case their expertise is needed.

Eric Easson (He, Him), Beacon Health Options: So even if you’re on the line with someone who isn’t a license clinician if they feel that they need to involve a clinician they can we have ways of.

Eric Easson (He, Him), Beacon Health Options: Networking with each other, while we’re on the job and getting support and having them offer their expertise as well.

Eric Easson (He, Him), Beacon Health Options: But what we find is that that level of expertise is usually not needed because really someone in a crisis, what they need more than anything is a connection.

Eric Easson (He, Him), Beacon Health Options: And the best way to make a connection is generally to understand what it’s like to be on the other end of the line right that’s why we find that people with lived experience tend to do this work, really, really, well.

Michelle Wagner, NAMI NH (she/her): Can you just talk about the training that folks get in order to staff, the line.

Eric Easson (He, Him), Beacon Health Options: sure, we do take them through several training courses it’s there’s about two weeks’ worth of classroom training and then some additional weeks of.

Eric Easson (He, Him), Beacon Health Options: The kind of see one do one teach one model that you think of in the hospital where you work under supervision you work alongside someone and then you.

Eric Easson (He, Him), Beacon Health Options: kind of demonstrate that you’re able to do the work, but we train folks in a variety of things, of course, there’s the basics of how to operate the phone system, how to you know manage the software and how to document.

Eric Easson (He, Him), Beacon Health Options: But there’s a lot of work that we do with how to meet someone where they are, how to provide nonjudgmental support.

Eric Easson (He, Him), Beacon Health Options: How to really understand the right ways to ask questions in a way that makes people understand you’re very interested.

Eric Easson (He, Him), Beacon Health Options: We call them open ended questions I myself am a clinician and that’s the way that we discussed them bsaut that just means that we’re asking questions in a way that invites collaboration that invites people.

Eric Easson (He, Him), Beacon Health Options: to share information it doesn’t feel pushy it doesn’t feel like we’re being accusatory in any way.

Eric Easson (He, Him), Beacon Health Options: we’re genuinely interested in trying to understand what’s going on and exploring that and letting the person who made the call leave that encounter so that they’re the ones making the decisions for themselves that’s ultimately our goal.

Eric Easson (He, Him), Beacon Health Options: is to lead people to making the best choice for themselves, we don’t believe in forcing choice upon people unless we just feel like there’s absolutely no alternative there, unless the person is not joining with us in some way on the call.

Michelle Wagner, NAMI NH (she/her): right, that will take us into our 911 portion because there are times when we do need to take it further right.

Eric Easson (He, Him), Beacon Health Options: Sometimes.

Michelle Wagner, NAMI NH (she/her): yeah, sometimes that does happen, so can you give an example when someone calls Eric what’s that going to look like for the person who’s placing that call when information is going to be gathered.

sure.

Eric Easson (He, Him), Beacon Health Options: I can speak for what happens when they reach the beacon answer point understand that the experience might vary a little if you reach a different answer point so depending on how you access the system mileage may vary, people say.

Eric Easson (He, Him), Beacon Health Options: But when our staff, and so the call you know we will need some basic information like your name and your phone number and possibly your address things like that, just so that we.

Eric Easson (He, Him), Beacon Health Options: haven’t we’ve established where you are in case, we get disconnected we could reach back out to you understand that any of the information that we ask is optional.

Eric Easson (He, Him), Beacon Health Options: You don’t have to give your name, or you can give a fake name you don’t have to give your number, you could give a fake number.

Eric Easson (He, Him), Beacon Health Options: You know that might handicap us later for trying to get back in touch but it’s really again your choice about what you feel comfortable to share.

Eric Easson (He, Him), Beacon Health Options: Will just ask you, you know how I can help you what’s going on today, what is it that you need help with.

Eric Easson (He, Him), Beacon Health Options: And we’ll listen, and we’ll let you lead that conversation, and we will ask the questions that we feel at any given point help us kind of steer our own decision making in what what might be a good service for you.

Eric Easson (He, Him), Beacon Health Options: So again, like, I mean we really rely on the collar themselves to define that experience for themselves, for in the large part.

Michelle Wagner, NAMI NH (she/her): Great, thank you for that folks are concerned when they call that there could be called tracing does that happen at all ever.

Eric Easson (He, Him), Beacon Health Options: We don’t have the ability to do that it’s not possible, so if you don’t give us a phone number.

Eric Easson (He, Him), Beacon Health Options: We don’t make your phone number, the only I will say, the only exception to that is that if you text us.

Eric Easson (He, Him), Beacon Health Options: The text does share your phone number, so if you’re contacting us via text your number does come through because that’s how text messages work.

Eric Easson (He, Him), Beacon Health Options: However, if you’re chatting it doesn’t give us your location if you’re on the phone.

Eric Easson (He, Him), Beacon Health Options: It doesn’t give us your location and to be fair, having your phone number doesn’t give us your location, it just gives us your phone number and we don’t have the ability to then turn around and trace that number we don’t have that capacity in our call Center.

Michelle Wagner, NAMI NH (she/her): So, can we talk about geolocation a little bit.

Eric Easson (He, Him), Beacon Health Options: Sure, the only way that we integrate geolocation in any way is that if a person has agreed to receive mobile crisis services which does happen.

Eric Easson (He, Him), Beacon Health Options: Pretty frequently, then we will ask them for an address to which they need the team dispatched that doesn’t necessarily have to be their home address it could be.

Eric Easson (He, Him), Beacon Health Options: An alternative meeting location, maybe they want to meet the always want to say waffle house let’s have some time.

Eric Easson (He, Him), Beacon Health Options: Maybe they want to meet at the McDonalds down the street and that’s fine, and so we will input that address into the system.

Eric Easson (He, Him), Beacon Health Options: And then use that address to locate a team on our GEO located map that is closest, so the geo location is really more on our side of things.

Eric Easson (He, Him), Beacon Health Options: to match with the address that that the caller provides voluntarily, whatever that address may be so we’re not pinging your location, so to speak, we can’t pick you up on the map, or we don’t see your little dot moving around.

Eric Easson (He, Him), Beacon Health Options: The the information we have about your location is what you provide us with and that will remain static unless you update us.

Michelle Wagner, NAMI NH (she/her): So, this is different than 911.

Eric Easson (He, Him), Beacon Health Options: It is yes.

Eric Easson (He, Him), Beacon Health Options: It is.

Michelle Wagner, NAMI NH (she/her): So, folks need to know that, because there’s concerns about people having access to location and information and so you’re telling us that’s not the case.

Eric Eason (him, him), Beacon Health Options: That is not the case now that there has been a much larger national conversation, and I will acknowledge that that conversation is occurring, I will also acknowledge that there.

Eric Easson (He, Him), Beacon Health Options: could be a change in the future, I don’t know that but as of right now, it is deeply ingrained in culture of the national Suicide Prevention lifeline that we do not do Okay, because we want to.

Eric Easson (He, Him), Beacon Health Options: help people understand that they have an option to receive services and not be subject to that kind of tracking and tracing.

Jenny O’Higgins, DHHS: Oh.

Michelle Wagner, NAMI NH (she/her): Go ahead, please Jenny.

Jenny O’Higgins, DHHS: I just want to jump in just to just I think Eric continues to say, and I just want to reiterate to that the primary goal the lifeline and the New Hampshire rapid response.

Jenny O’Higgins, DHHS: is to provide support for people in emotional distress when they need it most, and everything they do is person centered so based in choices and really meant to provide care care in the least.

Jenny O’Higgins, DHHS: restrictive way possible right, so the national Suicide Prevention lifeline has always tracked some data around if any of the lifeline calls require a connection to emergency services like 911.

Jenny O’Higgins, DHHS: Currently, fewer than 2% of lifeline calls do require that connection back to 911 and.

Jenny O’Higgins, DHHS: And while there may be safety and health issues on a phone call that may warrant a response from law enforcement enforcement or emergency medical services.

Jenny O’Higgins, DHHS: And the the 988 coordinated response with 911 is intended to promote that stabilization and care for that individual, but again in the least restrictive manner possible.

Michelle Wagner, NAMI NH (she/her): Thank you Jenny and I just want to clarify terms here because we’re throwing out the term lifeline and New Hampshire rapid response Eric can you just clarify New Hampshire rapid response versus New Hampshire rapid response access points semantics here, but what does that mean.

Eric Easson (He, Him), Beacon Health Options: It is semantics when when I say New Hampshire rapid response i’m talking very specifically about the teams that respond to the Community, the mobile teams and when I say the rapid response access point.

Eric Easson (He, Him), Beacon Health Options: that’s our service, the contact Center where we answer phone calls, text messages and chats.

Michelle Wagner, NAMI NH (she/her): and

Jenny O’Higgins, DHHS: Go hey think of that Michelle as a full system, so when we say New Hampshire Rapid Response we mean the access point that is called text chat, and we mean the mobile crisis teams that can respond in person.

Michelle Wagner, NAMI NH (she/her): Okay okay great and when you’re talking about the lifeline Jenny vs the rapid response access point.

Michelle Wagner, NAMI NH (she/her): yep can we get clarification around that Eric to had talked about nine ad and the lifeline being one in the same Is that correct.

Jenny O’Higgins, DHHS: So 988 is the the crisis suicide and prices lifeline that is a national response so this national resource that the national Suicide Prevention lifeline has been in existence.

Jenny O’Higgins, DHHS: With a coordinated network of 200 centers across the country for 35 years.

Jenny O’Higgins, DHHS: That lifeline number was 10 digits it has collapsed the network into the three digit number to be easier to remember to help people in crisis have easier access to those services it’s a national resource.

Jenny O’Higgins, DHHS: And in New Hampshire part of our planning is to work, to make sure that when calls are answered by New Hampshire centers they get the same services are our New Hampshire folks can get the same services that you could, if you called rapid response.

Jenny O’Higgins, DHHS: Whether HeadStart in Lebanon answers that call or whether beacon health options answers that call we want New Hampshire folks to have access to the enhanced services.

Jenny O’Higgins, DHHS: Meaning mobile crisis or local follow up appointments with your community mental health Center.

Jenny O’Higgins, DHHS: However, because 988 crisis suicide crisis lifeline is a national resource, there are some challenges and how calls are routed that mean not every call may get a new Hampshire based Center.

Jenny O’Higgins, DHHS: And that’s where it becomes more confusing and we continue to get into some of the clarity of that.

Jenny O’Higgins, DHHS: If you call rapid response, or you call 980 you are getting a connection to a trained counselor who is there to help you in that emotional distress.

Jenny O’Higgins, DHHS: There you can’t go wrong, making the phone call our only clarification is around, and if you don’t get a new Hampshire based Center can you get a mobile team if that’s what you were calling for.

Jenny O’Higgins, DHHS: And that’s the vast majority of calls aren’t going to need that you’re going to need someone to talk to.

Michelle Wagner, NAMI NH (she/her): And you said train counselor, can I just clarify to trained individual that you’re going to get a few call either of those no.

Jenny O’Higgins, DHHS: that’s good national language that sorry I know there’s so many language.

Jenny O’Higgins, DHHS: Difference right and so Eric has already described to you, who answers the phone the national language and the lifeline they use the word trained counselor, but that does not mean like masters level clinician or anything, in particular, it means an individual with crisis call training.

Michelle Wagner, NAMI NH (she/her): So when we’re talking nine a day and lifeline we’re talking a national Program.

Michelle Wagner, NAMI NH (she/her): yep right when we’re talking rapid response access point we’re talking New Hampshire.

Jenny O’Higgins, DHHS: Yes, the one distinction is that the national network has New Hampshire based centers.

Jenny O’Higgins, DHHS: So as a part of your national network, you have HeadStart in sitting in New Hampshire you have beacon that are either in sitting in New Hampshire New Hampshire trained.

Jenny O’Higgins, DHHS: folks and so you the national network has call centers that are in our State that can still provide our in state enhanced services it’s just the complications of national routing today.

Jenny O’Higgins, DHHS: That means that we can’t say 100% of calls that come from New Hampshire will be answered in new Hampshire and part of that is because the routing is all based on area code.

Jenny O’Higgins, DHHS: And so, your routing if you’re calling from a 603 area code you’re very likely to be connected with the new Hampshire Center.

Jenny O’Higgins, DHHS: But if you’re in new Hampshire and you’re calling from a cell phone with an area code of another state, you will be routed to the area, the crisis Center of that state, so if I call from my Arizona exchange, I will get an Arizona call Center.

Michelle Wagner, NAMI NH (she/her): Okay, so let’s try to tease this out for folks if I have a sister in California who’s experiencing a mental health crisis but i’m here in new Hampshire.

Michelle Wagner, NAMI NH (she/her): Can I call the who do I call.

Jenny O’Higgins, DHHS: You can call 988 and you can call rapid response.

Jenny O’Higgins, DHHS: To for your own emotional distress, this is the reason that we kind of just say, making a call you can’t go wrong with having someone to talk to.

Jenny O’Higgins, DHHS: The concern is, if you need in person services, but the lifeline, as I said, has been in existence for 35 years they have always taken the calls they received if their color is in Hawaii or Alaska or wherever.

Jenny O’Higgins, DHHS: They sit with that person and they look for the resources that they need right and that will still be true today I think what we’re trying so.

Jenny O’Higgins, DHHS: desperately in new Hampshire to get clarity around is that we’ve been talking a lot about.

Jenny O’Higgins, DHHS: The new you know mobile crisis teams and if you’re looking to get someone out to your home or your the crisis that you’re new or your family members experiencing really warrants having someone come to you in person.

Jenny O’Higgins, DHHS: And that’s where we’re saying that calling rapid response gives you access to that every time.

Michelle Wagner, NAMI NH (she/her): So, just to clarify, so we have rapid response access point and headrest both answering calls for folks in new Hampshire are they also taking calls that come in from through the 988 number people may be calling from other states that get bounced to an operator in new Hampshire or.

Jenny O’Higgins, DHHS: All of that yes, those are our two centers that answer lifeline calls through nine eight they’re part of the national network and all calls are routed by area code of your phone number.

Jenny O’Higgins, DHHS: So when you get when you call from a 603 number, you are your first routed to new Hampshire call centers your backup is also a new Hampshire based call Center.

Jenny O’Higgins, DHHS: So if you if they’re unable to answer the phone within a short period of time they bounced the call because they want all the calls to be answered quickly.

Jenny O’Higgins, DHHS: So they will your your first two options are our beacon and headdress right here in your state.

Jenny O’Higgins, DHHS: it’s if, and the same is true for every other state if you’re sitting in California and you’re calling 980 you’re getting a California based Center first if they’re unable to answer you do go to a national backup.

Jenny O’Higgins, DHHS: The good news is the phone gets answered every time and everyone has great training.

Michelle Wagner, NAMI NH (she/her): So never a busy signal never on hold.

Jenny O’Higgins, DHHS: No, you only you just did they answer the phone within the first, I think that I think that performance indicators 20 seconds.

Eric Easson (He, Him), Beacon Health Options: Yes, there is, I will say and Tony not to contradict but I will say that the way that the routing works is in times of.

Eric Easson (He, Him), Beacon Health Options: High call volume, they could end the call with a call Center for several minutes while they await an answer and then, if it doesn’t answer it rolls to the next one, so there could potentially if there’s a really high call volume at any given time.

Eric Easson (He, Him), Beacon Health Options: It could sit in a queue for just a couple minutes while they wait for a call agent, the answer, but then, if not, it will roll to the next one.

Eric Easson (He, Him), Beacon Health Options: it’s not happening very often, but it is possible, I do want to be clear about that.

Michelle Wagner, NAMI NH (she/her): And so, if a call does get picked up by an operator outside of New Hampshire either because there was high call volume and I got bounced or I’m in New Hampshire, but I have an Arizona area code.

Michelle Wagner, NAMI NH (she/her): Can I still get back to new Hampshire to get help here.

Eric Easson (He, Him), Beacon Health Options: it’s a little complicated.

Eric Easson (He, Him), Beacon Health Options: um there is a mechanism to transfer nationally from one call Center to another based on area code, which is how that that transfer would happen.

Eric Easson (He, Him), Beacon Health Options: However, there are also are policies in place and because there are certain best practice expectations that a person in crisis is really not.

Eric Easson (He, Him), Beacon Health Options: In the best place to be bounced from one person to another, and so there are limitations placed by the nsp all around.

Eric Easson (He, Him), Beacon Health Options: When it’s appropriate to transfer someone and generally they say that when when a person is actively in crisis that’s not the time to transfer a color.

Eric Easson (He, Him), Beacon Health Options: So it’ll be a bit of a judgment call on the part of the the person who’s answered the phone who’s providing support and it may be the case that they feel that transferring to get local resources might be appropriate.

Eric Easson (He, Him), Beacon Health Options: But again, it will be a judgment call based on those specific scenarios.

Michelle Wagner, NAMI NH (she/her): Okay, so um.

Michelle Wagner, NAMI NH (she/her): If I have concerns i’m.

Michelle Wagner, NAMI NH (she/her): call any of those numbers 988 though 1833710 number right that we have in the chat.

Michelle Wagner, NAMI NH (she/her): And if things have escalated and you recognize that more help is needed than just a conversation as we’ve talked about text chat.

Michelle Wagner, NAMI NH (she/her): or a call often will resolve, whatever the issue is, and we should talk a little bit about appointments because you end up giving appointments to people um.

Michelle Wagner, NAMI NH (she/her): yeah then mobile crisis comes in right so can we talk a little bit about that, and can you talk about if someone’s affiliated with the Community mental health Center or not, what that looks like.

Eric Easson (He, Him), Beacon Health Options: Sure, so when we when we start thinking about resources when we’re having a conversation with anyone in crisis we’re doing an assessment of not only what their their immediate concerns are what the things are that they’re struggling with.

Eric Easson (He, Him), Beacon Health Options: but also what their available resources are, and that includes the people.

Eric Easson (He, Him), Beacon Health Options: And the agencies and the material resources that they have who can provide support or or that are available for support.

Eric Easson (He, Him), Beacon Health Options: So, in other words, that would be an understanding of do you have an existing provider If not, does or happen to be a provider in your area that might be able to help you now or according to your acuity in the very near future.

Eric Easson (He, Him), Beacon Health Options: Do you have a family member or friend or trusted loved one someone who can help you get from here to wherever you need to be or who can support you in the moment, while you will wait.

Eric Easson (He, Him), Beacon Health Options: Help so we do you know and even like do you have transportation to get where you need to go Those are all things we have to think about when we’re making an appropriate treatment decision.

Eric Easson (He, Him), Beacon Health Options: And so, all of those factors really influence what we do now, ultimately, the person gets to decide for themselves, but based on that information, we will say.

Eric Easson (He, Him), Beacon Health Options: Well, you know, given the circumstance and dad and given your available availability of this thing or that thing we suggest that you might consider the service.

Eric Easson (He, Him), Beacon Health Options: When we think about services, we can do a number of things, obviously we’re providing a service just by talking to folks and supporting them and helping them think through things.

Eric Easson (He, Him), Beacon Health Options: Often that’s enough and that’s really about 75% of the time or more that’s all that people need is to just call us and to talk through things and to understand and kind of think through what’s going on.

Eric Easson (He, Him), Beacon Health Options: and come up with a plan for themselves so they’re able to use their own resources to manage maybe they’re going to reconnect with an existing provider, maybe they’re gonna give a friend to call and have them come over and be some support that’s really what they need right now.

Eric Easson (He, Him), Beacon Health Options: However, in some cases they do need something a little more and that’s when we start exploring some of those alternatives like.

Eric Easson (He, Him), Beacon Health Options: Mobile crisis or a same day or next day appointment referral, so we do have the ability to do both of those things with the local community mental health centers.

Eric Easson (He, Him), Beacon Health Options: which cover the entire state, so there is statewide coverage for mobile crisis there statewide access for Sunday next day appointments.

Eric Easson (He, Him), Beacon Health Options: And we’re able to based on you know the address that folks are providing to tell them what their local agency might be order to find a local team to respond.

Eric Easson (He, Him), Beacon Health Options: For their crisis when we think about which of those is most appropriate.

Eric Easson (He, Him), Beacon Health Options: Again, it depends on a variety of factors, but one thing we need to consider is how significant are your concerns at this moment.

Eric Easson (He, Him), Beacon Health Options: Do you have the capacity to wait for a little while for someone to show up or do you have the capacity to wait for a little longer to possibly make it to an appointment tomorrow.

Eric Easson (He, Him), Beacon Health Options: A lot that’s very individualized it’s very individualized decision that needs to be made.

Eric Easson (He, Him), Beacon Health Options: And then we’re able to make the appropriate referral based on that, again we try, really, really hard to keep people out of the ER and to keep people from having to engage with 911.

Eric Easson (He, Him), Beacon Health Options: And so I think it’s around like Jenny said about 2% or less are we engaging with 911 we’re also sending people to the er in a very limited capacity and Jen generally when we do it’s only because.

Eric Easson (He, Him), Beacon Health Options: their capacity to remain safe in their current situation is just not there they’re really not in a place where they feel like they can wait for mobile to come show up or they’re not able to wait for that appointment to get there, the next day.

Michelle Wagner, NAMI NH (she/her): And Eric when you’re talking about those next day appointments is that, whether you are.

Michelle Wagner, NAMI NH (she/her): Receiving services at the Community mental health Center or not.

Eric Easson (He, Him), Beacon Health Options: It is available to anyone.

Michelle Wagner, NAMI NH (she/her): Okay okay great so this it’s a sounds like an art form as much as it is a science.

Eric Easson (He, Him), Beacon Health Options: there’s a bit of art to it, yes.

Michelle Wagner, NAMI NH (she/her): Right and 911 seems to be more clear cut, this is a different system, a new system, and I think that’s part of what we’re talking about here we’re trying to develop the system so there’s been changes as we’ve gone along.

Michelle Wagner, NAMI NH (she/her): Eric can you say you turn things over to mobile crisis can you say what that looks like on beacons and you’ve decided, whoever is taking the call says yes we’re going to need to deploy or send out of mobile crisis response team.

Michelle Wagner, NAMI NH (she/her): Which is now statewide right we have team statewide can you say on the the call centers and what that looks like and then we’ll go over to heather.

Eric Easson (He, Him), Beacon Health Options: yeah absolutely we have an electronic documentation tool that we’re typing notes as we’re chatting on the phone or via text or whatever.

Eric Eason (He, Hm), Beacon Health Options: And we will generate that report, and we will go into our dispatching system locate the most the available team that’s closest to that person’s location.

Eric Easson (He, Him), Beacon Health Options: Send that information to them and let them know that there’s a person in distress, who is asking for mobile crisis dispatch.

Eric Easson (He, Him), Beacon Health Options: And then, at that point, the team has a way of acknowledging and accepting that dispatch so that we can confirm, on our end that that has.

Eric Easson (He, Him), Beacon Health Options: been handed to them so we’re not just sending it out to the universe and saying hey somebody should be giving you a call.

Eric Easson (He, Him), Beacon Health Options: we’re actually waiting to get that confirmation back that Yes indeed, you know heather a Community partners, maybe has said i’ve got this dispatch i’m going to be picking it up and acting on it.

Eric Easson (He, Him), Beacon Health Options: And then that’s handed off to the the mental health Center if we don’t get that confirmation will move along and look for another team that might be available, which may not be quite as close, but hopefully still close enough to respond.

Eric Easson (He, Him), Beacon Health Options: And we do have certain processes in place that if, for some reason it’s very busy or I don’t know there’s something unusual and there’s just not a team available locally.

Eric Easson (He, Him), Beacon Health Options: We can talk about possibly having a team engage from further away, but via Tele health or if that’s also not an option, then we might discuss if an er or next day appointment is more appropriate in that situation.

Michelle Wagner, NAMI NH (she/her): Great, thank you for that so now heather would be the team receiving that call to be deployed out to a crisis situation so heather, can you tell us who you are and your role at Community partners.

Heather McConihe- Community Partners: Yes, so I am an intentional peer support specialist on the mobile crisis team for Community partners.

Heather McConihe- Community Partners: So I am part of the team that is handling these dispatches also these rapid access appointments and then doing follow up with these people if they would like it.

Heather McConihe- Community Partners: into like Eric said he’ll send the dispatch through that system that we use and will accept it.

Heather McConihe- Community Partners: We get like details about the call on beacons end and then one of us will make an outreach call to the person that’s in crisis and introduce ourselves and just kind of talk a little bit about what’s going on, let them know that they can expect us to arrive and about how long.

Heather McConihe- Community Partners: Then we will show up.

Michelle Wagner, NAMI NH (she/her): Can you tell us what kind of calls are coming in who’s calling who are you going out for and where are you going to.

Heather McConihe- Community Partners: we’re so we’re getting a lot of different calls it’s really anyone it’s people across the lifespan people that have been longtime consumers as the mental health system.

Heather McConihe- Community Partners: people that are new and looking for services, maybe they’ve been looking for services for a while and they’ve been wait listed and things have.

Heather McConihe- Community Partners: been escalated for them and they’re needing support in the moment.

Heather McConihe- Community Partners: And in terms of where we’re going we’re going to all different kinds of locations, we have what’s called secured locations and unsecured locations.

Heather McConihe- Community Partners: Secure location is going to be something like a school a hospital a police department.

Heather McConihe- Community Partners: Something where there’s other people there and it’s like a safety thing and then an unsecured location is going to be like somebody’s home or somewhere out in the Community, maybe where there’s not you know other people.

Michelle Wagner, NAMI NH (she/her): Thank you for that when you and I were talking about your role and what mobile crisis does you talked about the attitude that you approach situations with because I think.

Michelle Wagner, NAMI NH (she/her): What we’re hearing with this system is there’s a lot of concern, there’s concern about confidentiality, there’s concern about safety, there’s concern about getting your needs met, there’s concern about incarceration, how do you all approach situations with mobile crisis?

Heather McConihe- Community Partners: Absolutely, so we really try to go into every call looking at the caller as credible, intuitive and able to collaborate.

Heather McConihe- Community Partners: So it’s very much like avoiding coercive measures, you know safe decision making and trying to minimize iatrogenic harm.

Heather McConihe- Community Partners: Which I’m sure we all know, is unintended consequences that happened as a result of decisions that providers make in the course of treatment and so it’s really more of an attitude of like working with the person whether than doing for them if that makes sense.

Michelle Wagner, NAMI NH (she/her): Right, and so I asked her iatrogenic harm? That’s harm that we inflict in the process of trying to help someone we actually create more harm.

Michelle Wagner, NAMI NH (she/her): And I think when we’re looking at this 988 system what we know is this could be the first time that someone’s actually reaching out for mental health help right so it’s important that the outcomes be positive.

Michelle Wagner, NAMI NH (she/her): Right, and so this training that you got, can you tell us where that training came from.

Heather McConihe- Community Partners: yeah so I believe it’s administered by the State it’s the rapid response access point core training and so there’s, there’s about 18 hours it’s three different six-hour sessions.

Heather McConihe- Community Partners: And then there’s a whole bunch of other trainings there’s like 40 plus hours of training, that we do just for the system and those three trainings were they were awesome I really enjoyed them, it was very much akin to I’m so sorry.

Heather McConihe- Community Partners: It was very much the things that were presented in this training we’re, in my opinion.

Heather McConihe- Community Partners: Very much akin to the values that intentional peer support already encompasses, and so it was really excited to be seeing these concepts presented to people that are in other roles, besides peer support clinicians you know other providers whatever and if it was really.

Heather McConihe- Community Partners: It was really about, just like you know shifting shifting that focus from what we’ve always done, and just being I don’t know I guess just being like differentiating from being I a focus to like treatments.

Michelle Wagner, NAMI NH (she/her): Right right so avoiding I after agenda card we don’t want to create harm, we want to help people.

Heather McConihe- Community Partners: Yes, I really am really not really trying to avoid employing colors of measures like wherever possible.

Michelle Wagner, NAMI NH (she/her): And I don’t think you touched on the the Van heather can you.

Heather McConihe- Community Partners: talk a little bit about that because.

Heather McConihe- Community Partners: yeah absolutely our team our team was fortunate enough to get a an awesome van, and that is to take on dispatches.

Heather McConihe- Community Partners: When we go to unsecured locations we’ve had a couple of situations come up where maybe the person is homeless.

Heather McConihe- Community Partners: I think we had a situation come up where their apartment was very small and they just have like a lot of stuff and there was nowhere to actually like.

Heather McConihe- Community Partners: Talk to this person and try to support them, so we got this wonderful van that’s equipped with like.

Heather McConihe- Community Partners: You know plugs in and like wi fi, and all this stuff so that we can bring them to this batches and we have a place to have these appointments if the person doesn’t have a good place to talk.

Michelle Wagner, NAMI NH (she/her): Right great so we’re moving forward with this and we’re being smart about it.

Heather McConihe- Community Partners: yeah really thinking outside the box and presenting people with options, I really appreciate all of the options the alternatives to the hospital it really, really helps us meet people where they’re at.

Michelle Wagner, NAMI NH (she/her): Right and take good care of them.

Michelle Wagner, NAMI NH (she/her): yeah yeah and then mobile crisis doesn’t always work and sometimes 911 is the only option.

Michelle Wagner, NAMI NH (she/her): So.

Michelle Wagner, NAMI NH (she/her): we’re going to turn it over to Rochelle.

Michelle Wagner, NAMI NH (she/her): Actually, let me go back to Jenny can you explain Jenny what circumstances are when 911 is going to be necessary.

Jenny O’Higgins, DHHS: Or, so I mean you when, as a Community Member when do we need to call 911, we need to call 911 when we need police, fire or EMS on the scene right, so if we need if we need medical services if we need.

Jenny O’Higgins, DHHS: firefighters, or if we need, law enforcement, because of a medical emergency or crime or you know.

Jenny O’Higgins, DHHS: issues with violence and safety, those are the appropriate reasons to continue to call for emergency services right.

Jenny O’Higgins, DHHS: And these other services are meant to get you the care, you need when and where you need it for emotional distress and for.

Jenny O’Higgins, DHHS: You know, having thoughts and feelings of suicide, or you know substance misuse and, and these are the kinds of reasons that you might call these other services right and.

Jenny O’Higgins, DHHS: And right now I think we’ve been calling 911 because there hasn’t been somewhere else to Paul, not because it’s necessarily the best you know care that for those particular mental health related challenges, and so I think our first responders have had to have needed to go out.

Jenny O’Higgins, DHHS: For a lot of reasons that they weren’t weren’t necessarily trained for.

Jenny O’Higgins, DHHS: And, just like we wouldn’t want to respond to crime or a fire without training right so we’re trying to work and close partnership, because we’re trying to get to a place where.

Jenny O’Higgins, DHHS: we’ve got the right teams for the right situation that are trained and ready to handle that situation.

Jenny O’Higgins, DHHS: And if you so as a Community Member I would think you’d want to call you know 988 or rapid response for that emotional distress whether it’s for yourself or a family member.

Jenny O’Higgins, DHHS: I think that what you would want to continue to call 911 when you need EMS Police or Fire and that will remain appropriate in circumstances where there may be, it may be a behavioral health.

Jenny O’Higgins, DHHS: need but it’s too it’s escalated to a situation where someone’s life is at risk.

Jenny O’Higgins, DHHS: And you still you still may need an emergency response and as we’ve talked through even the in person responses of the behavioral health system.

Jenny O’Higgins, DHHS: Mobile crisis is meant to get to you, within an hour and sometimes in crisis seconds is too long you’re still you still need 911 in those circumstances where seconds would take too long, you need to dial 911.

Jenny O’Higgins, DHHS: And so, there are still going to be times too when we’re when rapid response or a 90 day lifeline is is talking to a person.

Jenny O’Higgins, DHHS: or a family member and they realized that there’s imminent risk for themselves or others, and it is a rescue line, and that is when we need our partnership with 911 to send for that rescue.

Michelle Wagner, NAMI NH (she/her): And so that’s a great segue into Rochelle.

Michelle Wagner, NAMI NH (she/her): So Rochelle, can you tell us who you are and your role at the Portsmouth police department.

Detective Rochelle Jones, Portsmouth Police Dept.: Of course I’m the Community outreach coordinator and our police department, so I do a lot of building relationships with the public and creating outreach programs, and you know I’m the liaison to a lot of different.

Detective Rochelle Jones, Portsmouth Police Dept.: agencies and support services on the leaves on the seacoast mental health and the leaves on to our recovery.

Detective Rochelle Jones, Portsmouth Police Dept.: DC via also for the school resource officer so there’s a lot of just all that Community connection, and so we really try to.

Detective Rochelle Jones, Portsmouth Police Dept.: Have programs in and reach out to people in conversations before there’s an emergency, so the first time that they have to call us.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, is it or when they do call us in crisis it’s not the first time they’re seeing us and there’s some familiarity there and there’s a connection there, but a lot of times.

Detective Rochelle Jones, Portsmouth Police Dept.: We are certainly seeing that people still call 911 and I think sometimes it is because they don’t know what to.

Detective Rochelle Jones, Portsmouth Police Dept.: Do this is still new and they’re learning so whenever somebody’s not sure about what to do and there’s any type of crisis, even if it’s a.

Detective Rochelle Jones, Portsmouth Police Dept.: You know squirrel you know stuck somewhere it’s like they’re going to call 911 because that’s so it’s been so ingrained in us since we were little.

Detective Rochelle Jones, Portsmouth Police Dept.: And so what we have been seeing personally in our department.

Detective Rochelle Jones, Portsmouth Police Dept.: And we love it we love having this option, you know I can’t stress that enough and police officers in general, because of some of the reasons that you already talked about but.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, we were left with limited options, a lot of times we show up and we’re really just asking somebody or determining do our training and experience.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, is this a situation where we can offer somebody somebody is saying that they’re going to do some self-harm and we’ll ask them do you want to go to talk to the hospital and talk to someone.

Detective Rochelle Jones, Portsmouth Police Dept.: And that’s really kind of been our our choice or offer and if somebody says absolutely not and we decided to situation.

Detective Rochelle Jones, Portsmouth Police Dept.: Where you absolutely kind of have to we can’t leave you with believe you were not comfortable with that because of what we’re now serving than we would have to take them in an involuntary emergency mission, you know.

Michelle Wagner, NAMI NH (she/her): So, Rochelle you can we.

Detective Rochelle Jones, Portsmouth Police Dept.: hospital now requires you know a lot of people yeah.

Michelle Wagner, NAMI NH (she/her): Can we switch over now to back in May, what happened, so we can talk about your 911 deployment.

Detective Rochelle Jones, Portsmouth Police Dept.: Oh sure.

Michelle Wagner, NAMI NH (she/her): yeah it’s made in the Portsmouth area you ultimately ended up being the officer who interacted with an individual, supported by a very large team so, can you tell us what happened and how you’re able to resolve that in a positive way.

Detective Rochelle Jones, Portsmouth Police Dept.: Sure, and I just also want to say to you that we’re thankful because we’ve been making a lot of referencing,  it is more referrals for.

Detective Rochelle Jones, Portsmouth Police Dept.: 988 as well, so when people do call me, and say okay next time this happens, like you definitely want to use this number or if it’s people that are repetitive see a lot of times that we will.

Detective Rochelle Jones, Portsmouth Police Dept.: will know kind of what the situation might be, call it 90 days as well, so we appreciate it yeah so.

Detective Rochelle Jones, Portsmouth Police Dept.: One of my responsibilities, I recently joined our seacoast emergency response team, which is a tactical SWAT team, but also we have a team on there that’s for crisis.

Detective Rochelle Jones, Portsmouth Police Dept.: Negotiations I’ve been through crisis intervention training as well, and a lot of other specialized trainings and I don’t know some point later, we want to ask about.

Detective Rochelle Jones, Portsmouth Police Dept.: or people want to know about how points to train now and it’s a lot different than when I started as far as base based training for mental health and recovery i’m a recovery coach as well, I went through that training so.

Detective Rochelle Jones, Portsmouth Police Dept.: I just joined this the emergency response team and a little bit about crisis negotiations is, it is very similar to what some people were already talking about.

Detective Rochelle Jones, Portsmouth Police Dept.: Just about asking questions like Eric was saying and non judgmental just trying to build a connection with somebody so it’s very different than what people think police.

Detective Rochelle Jones, Portsmouth Police Dept.: interviewing is where we’re usually asking a lot of questions to get answers to solve crimes, so why are you here, what are you doing.

Detective Rochelle Jones, Portsmouth Police Dept.: And that’s the opposite it’s really just to get somebody talking and about what’s going on in their crisis, and you know we’re supporting them and trying to help them find.

Detective Rochelle Jones, Portsmouth Police Dept.: A good, safe solution to this, so I just gone to a training and for crisis negotiation and one of parts of the training was actually you know somebody talking about.

Detective Rochelle Jones, Portsmouth Police Dept.: This particular situation that came up, so I was not called to this because I’m going to go shooter what happened, but there was a gentleman who was An Unsafe.

Detective Rochelle Jones, Portsmouth Police Dept.: unsafe place physically and mentally that there was a big concern about, and it was not in Portsmouth where we are, as in a neighboring city, so the officers that have been on scene.

Detective Rochelle Jones, Portsmouth Police Dept.: had been trying to connect with this person for about three hours and didn’t believe it, they weren’t getting anywhere.

Detective Rochelle Jones, Portsmouth Police Dept.: And he was pretty upset and he was actually requesting an officer that had he believed that some commonalities like I want to talk to this type of law officer.

Detective Rochelle Jones, Portsmouth Police Dept.: Which is, to me, is a green light about somebody is basically asking for connection I want somebody that I can relate to is kind of how that translates to me.

Detective Rochelle Jones, Portsmouth Police Dept.: I didn’t know anything about this person, other than what the officers believed that his name was, and so I went to the location and.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, I was my human self.

Detective Rochelle Jones, Portsmouth Police Dept.: Where I just got to introduce myself and said, you know I’m officer, you know.

Detective Rochelle Jones, Portsmouth Police Dept.: blinding say officer I just said I’m Rochelle, Rochelle from you know Portsmouth police and you asked for somebody like me, and here I am and.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, and I quickly kind of just went to what what’s going on, like what’s going on how did you get here, you know what happened and.

Detective Rochelle Jones, Portsmouth Police Dept.: And I it really was it was a situation where there’s a lot of other police officers, but there was kind of a barrier, where you know he wasn’t able to see that So if I kind of meet myself in a position he could just see me and concentrate on me.

Detective Rochelle Jones, Portsmouth Police Dept.: It was very distracting.

Michelle Wagner, NAMI NH (she/her): and

Detective Rochelle Jones, Portsmouth Police Dept.: You know what we were what I was seeing and behavior was pretty consistent with schizophrenia what I’ve what I’ve been taught, and so I received a really amazing training from NAMI and also from.

Detective Rochelle Jones, Portsmouth Police Dept.: Basically, from NAMI years ago always resonated with me if people are experiencing that there can be many voices being heard at once, and so I knew is very important.

Detective Rochelle Jones, Portsmouth Police Dept.: For him to just be able to concentrate on me and my voice is very important for me to close out the other chaos and just set the tone.

Detective Rochelle Jones, Portsmouth Police Dept.: Of we’re going to have a conversation, because when I got there you know the big major request was, we need him, you know, out of this unsafe situation that he’s in and I stopped that and said.

Detective Rochelle Jones, Portsmouth Police Dept.: I’m just going to talk to this person, you know and it takes what it takes, and you do what you need to do in the meantime, but I didn’t want to.

Detective Rochelle Jones, Portsmouth Police Dept.: I didn’t want him to experience my anxiety which I was really afraid, so you know I just tuned everything out and I just talked to this person, and you know met him and his reality.

Detective Rochelle Jones, Portsmouth Police Dept.: Connected we didn’t talk about exactly about self-harm or any of that came up there’s just all the other frustrations that were going on, you know ideas to myself.

Detective Rochelle Jones, Portsmouth Police Dept.: I tried to deescalate him just by showing that everything was about this person and that moment I didn’t care about what else was going on, I care about him.

Detective Rochelle Jones, Portsmouth Police Dept.: And you know I explained who I was and what my position was so there was no concern that I was going to harm this person.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, we talked about what school we went to you know we talked about people in the Community, that we knew, I validated.

Detective Rochelle Jones, Portsmouth Police Dept.: His anger and frustration and concerns it absolutely I would be upset about that too, you know, and I was empathetic reflected, you know the segments, so that he understood that I was absolutely listening to him.

Detective Rochelle Jones, Portsmouth Police Dept.: And, at one point, like, I think I offered water and he didn’t want any water, you know and then um.

Detective Rochelle Jones, Portsmouth Police Dept.: You know I noticed that you were smoking cigarettes and so I’d asked you know the other officers, I said, well, it looks like you smoke cigarettes like that would be a good thing that could be a.

Detective Rochelle Jones, Portsmouth Police Dept.: connection thing here and I said how are we getting the cigarettes, you know to this person though it’s kind of like they’ve been throwing them down to where.

Detective Rochelle Jones, Portsmouth Police Dept.: You know this person was, and so I asked and other opposite of hold on to me and I said I want to try to hand this cigarette to this person, I want to you know get it to them no offense to anybody else you know, he was not.

Detective Rochelle Jones, Portsmouth Police Dept.: friendly when I came up to us, difficult and it was challenging but I was determined to connect with them and I didn’t care like I was just nonjudgmental about.

Detective Rochelle Jones, Portsmouth Police Dept.: And I think he saw that I think people can absolutely tell when you know you’re just trying to say something to get them to do something you can’t lay it’s like you just make.

Detective Rochelle Jones, Portsmouth Police Dept.: A consensus and they can see it, you have to be genuine and your connection with someone so you know I asked them do you want a cigarette you said yeah.

Detective Rochelle Jones, Portsmouth Police Dept.: Sure, so I got a cigarette you know, and I had another officer hold on to me and I just wind as close to them as I could and part of that was my safety.

Detective Rochelle Jones, Portsmouth Police Dept.: And the other part of his I didn’t really even know how he was going to react if you’ve grabbed me was he going to hit me, you know, so I wanted somebody to hold on to me.

Detective Rochelle Jones, Portsmouth Police Dept.: And like I said he was angry and so when I reached down to give them that cigarette and he had to kind of move to get closer to being and just kind of.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, took the cigarette out of my hand very gently and we looked each other straight line, and we were face to face, there was no.

Detective Rochelle Jones, Portsmouth Police Dept.: Uniform there was no what you’re wearing it was just we were to humans, you know, looking at each other and that was where.

Detective Rochelle Jones, Portsmouth Police Dept.: Things took a turn, and so I just continued to offer guidance, you know and offer some suggestions at the point I was like we really can’t be here forever and I really like to see you, you know.

Detective Rochelle Jones, Portsmouth Police Dept.: resolve this on your own terms, and you know, and I, I promised him that we would do this together, and that I wouldn’t leave him, you know and.

Detective Rochelle Jones, Portsmouth Police Dept.: And then he he did came up to a safe area and he actually walked to my cruiser and try to put himself in my car.

Detective Rochelle Jones, Portsmouth Police Dept.: which was amazing because he was he was afraid and he said listen like you know I think you know the police officer that hurt me I think they’re going to jump me, you know, and I said to the other officers we’re not going to do that right.

Detective Rochelle Jones, Portsmouth Police Dept.: And I said back to him, I said they’re telling me that that’s not going to happen and i’m not gonna let that happen and we’re going to do this together.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, and we did, and he got an accuser, and you know, and I told him, like, I have to take you to be evaluated.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, we everybody knew that this was going to take as long as it talks and everybody knew and even the you know the supervisors in charge knew that this was not going to be.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, a criminal acts like this person needs help you know So how do we get them there and how do we do that safely and so you know we just agreed that I would have somebody else in the car with me because I didn’t want to put them in handcuffs either.

Detective Rochelle Jones, Portsmouth Police Dept.: He was being cooperative you don’t get more cooperative than putting yourself in somebody police cruiser right, and so I was able to bring him.

Detective Rochelle Jones, Portsmouth Police Dept.: To the hospital and he had a request he there was a certain hospital that he said he’s absolutely not going to with me, you know and.

Detective Rochelle Jones, Portsmouth Police Dept.: And I said Okay, I will not take you to you know, but I do have to take you somewhere so let’s go, you know to another hospital, we did.

Detective Rochelle Jones, Portsmouth Police Dept.: And when we got to the hospital before we went inside but you get out and you know we hadn’t and then I walked with them and waited for his intake and.

Detective Rochelle Jones, Portsmouth Police Dept.: You know and sat next to him, and you know waited for him to tell me that I could go back to work, you know I said I’ll stay with you as long as you want me to are you like to work and.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, and he looked at me and he just said, thank you, you know, and I looked at him and I said no, thank you, thank you for trusting me, you know, and so we have been in contact.

Detective Rochelle Jones, Portsmouth Police Dept.: A few times, after that, but not so much right now, but you know, it was not what I was expecting when I’m going to work that day.

Detective Rochelle Jones, Portsmouth Police Dept.: And I was just very thankful to be able to have that connection to have had I can’t emphasize enough all of the trainings and support.

Detective Rochelle Jones, Portsmouth Police Dept.: Over the years, and you know with NAMI and just you know crisis intervention and these things, and so it’s it I also get to go around now and.

Detective Rochelle Jones, Portsmouth Police Dept.: I will be teaching about this and how I built that connection with this person and how we both.

Detective Rochelle Jones, Portsmouth Police Dept.: You know connected before other officers, which is very important to me, you have to be.

Detective Rochelle Jones, Portsmouth Police Dept.: Vulnerable like you know and and what I found, and what I found in my career I’ve been with Portsmouth for 20 years but I started working in the.

Detective Rochelle Jones, Portsmouth Police Dept.: With incarcerated people for five years before I became a police officer, and this is I’m born and raised in Portsmouth and.

Detective Rochelle Jones, Portsmouth Police Dept.: You know I’ve seen my friends go through mental health, like you know and family and we’re all touched by what I found is I may not experience the same thing that somebody else experiences.

Detective Rochelle Jones, Portsmouth Police Dept.: But we can connect on emotion, so I didn’t try and say you know hey like I know what that’s like I totally understand I just say I know what it’s like.

Detective Rochelle Jones, Portsmouth Police Dept.: You know, he was very upset about feeling discriminated against, and I said I know what it’s like to be discriminated against, I know what that feels like.

Detective Rochelle Jones, Portsmouth Police Dept.: By not only my female but, and you know I’m a person of color on this or I’m a police officer, sometimes we get you know and it’s just knowing that he could.

Detective Rochelle Jones, Portsmouth Police Dept.: share that and I think that was comforting you know, and I wasn’t judgmental and I had no intention of being you know they were in crisis; people are in crisis.

Detective Rochelle Jones, Portsmouth Police Dept.: Crisis looks different for everybody and it’s not for me to judge it’s not for me to try and put myself in their shoes, you know it’s just to meet on common ground and how do I get you to the professionals that are going to get you continue to help you county.

Michelle Wagner, NAMI NH (she/her): We need each other.

Michelle Wagner, NAMI NH (she/her): We get right, so the the crisis system needs 911 responders we need, law enforcement, we need them to show up in a compassionate and trained way, this is about connection it’s about relationships it’s about collaboration Eric, can you tell us.

Michelle Wagner, NAMI NH (she/her): Police Officers if they’re in a crisis, and they need, they need support, can they call 988 do they call the 833 number.

Eric Easson (He, Him), Beacon Health Options: They certainly can we’ve actually caused them to call the three three number there’s been some conversation I’ve been kind of trying to be in the chat so I apologize if I’m a little out of the loop but.

Eric Easson (He, Him), Beacon Health Options: There there’s been a lot of discussion around routing and how area code impacts that and so we’ve coached law enforcement to call the 833-716-477 number.

Eric Easson (He, Him), Beacon Health Options: Because, regardless of what number you’re calling from if you call that number you’ll get the access point every time and that way they’re called but yes, they are calling us at that number.

Eric Easson (He, Him), Beacon Health Options: letting us know their law enforcement we’ve got a kind of truncated process that we follow, to be sure that.

Eric Easson (He, Him), Beacon Health Options: we’re answering and processing those calls as rapidly as we can and we will get a team out to them or let them know you know if there’s any issue with getting to them, and you know that, within a few minutes.

Detective Rochelle Jones, Portsmouth Police Dept.: right and just say on the heels of that I went I recently went to the FBI school.

Detective Rochelle Jones, Portsmouth Police Dept.: For crisis negotiations and that was a.

Detective Rochelle Jones, Portsmouth Police Dept.: conversation to where there was officers that were there that had to go in and respond and had rapid response before another officer that was.

Detective Rochelle Jones, Portsmouth Police Dept.: contemplating some self-harm and just you know with the trauma thing Sean I talked about this already, but it was a successful situation that day, because you know we saved the life and there’s officers that do what I did every day, but in many, many times during the day.

Detective Rochelle Jones, Portsmouth Police Dept.: When we talk about the vicarious trauma and even though that moment was successful, I don’t think I realized the gravity of it until a couple days later, where I went.

Detective Rochelle Jones, Portsmouth Police Dept.: Why am I having these feelings, you know, and I connected with another officer who has similar incident, but it is prompted and.

Detective Rochelle Jones, Portsmouth Police Dept.: I’ll probably reach out to you folks in the future, to make sure that we have some, we have crisis intervention.

Detective Rochelle Jones, Portsmouth Police Dept.: When everything’s really big but it’s little things that do add up and that’s what I find when I interact with people there wasn’t one big thing that happened.

Detective Rochelle Jones, Portsmouth Police Dept.: These are little things that have continued over the years that haven’t been resolved or it’s one more little thing that that gets that ball rolling, and so it’s very important to.

Detective Rochelle Jones, Portsmouth Police Dept.: Take care of those little things as well.

Michelle Wagner, NAMI NH (she/her): This system is for all of.

Michelle Wagner, NAMI NH (she/her): US it isn’t just for those people it’s for all of us every one of us might need this system at some point in time.

Michelle Wagner, NAMI NH (she/her): That leads me back to you Jenny improvements to the system we’re creating a system here when you’re creating something sometimes tweaking is needed, and we know that people need to collaborate and let us know how things are working and and what could use improvement.

Jenny O’Higgins, DHHS: Now, of course, I mean we can’t build a system and improve it without people with lived experience talking to us and letting us know they’re the same, how they experienced calling.

Jenny O’Higgins, DHHS: 90 days or rapid response how their family members felt when mobile crisis teams came did they never show up, I mean every the same as.

Jenny O’Higgins, DHHS: Our first responders if they’re calling, and they want a mobile deployment and it doesn’t work out how they wished it worked out.

Jenny O’Higgins, DHHS: I think some of it is going to be that we are we can’t get there in seconds or minutes like we talked about, and that can, and will continue to be a frustration for folks who really want someone on the likely.

Jenny O’Higgins, DHHS: I think that’s still a huge improvement over going to an emergency room and waiting hours or days, if we can you know have someone to talk to immediately.

Jenny O’Higgins, DHHS: But I think there’s you can at the same time that you can celebrate that the system’s improving you can also continuously say need, we need more, we need to improve it.

Jenny O’Higgins, DHHS: Further, it needs to be better or didn’t meet my needs, and we know already that it’s difficult to get language services it’s difficult to have someone who truly understands, you know trauma military veterans or.

Jenny O’Higgins, DHHS: You know, a youth experience when it’s an adult who’s answering a call all of these kinds of pieces where we’d like to have a foundation of equity and we need to get there and.

Jenny O’Higgins, DHHS: We also, though, need to continue just continuously monitor and hear from people about their current experience of the line and keep making it better and better right.

Jenny O’Higgins, DHHS: And I think it really does, I think you were just connecting on how all of us are a part of humanity, and we all need each other and it’s completely collaborative.

Jenny O’Higgins, DHHS: I don’t think we can build the system that we want if if people won’t tell us how it’s going, and if the partnerships weren’t in place, so we could work together to figure out how to do it better.

Jenny O’Higgins, DHHS: And when we have workforce shortages and we’re worried and concerned about the capacity of our behavioral health system, how do we think creatively to train up a peer workforce or Community Members to support one another.

Jenny O’Higgins, DHHS: Right, and so I think there’s a long way to go, still even though we’re proud that we’re getting there and and I would encourage people to make sure they share their experiences.

Michelle Wagner, NAMI NH (she/her): Even between agencies like law enforcement so police mobile crisis if there was a amiss somehow in a in an in a event for them to pick up the phone and call one another Jenny.

Jenny O’Higgins, DHHS: Yes, I mean so much of this is individualized so each color I mean I think Eric spoke to this earlier that two people could even be having the same challenge and not experiencing it in the same way.

Jenny O’Higgins, DHHS: And that’s going to be true about everyone having sort of different histories as well, so.

Jenny O’Higgins, DHHS: I might be impacted by something because of a trauma that I experienced and you don’t know that when i’m calling.

Jenny O’Higgins, DHHS: And so, if you experienced the same thing as me, you would handle it very differently right but, for me, this is very traumatic and it’s triggering.

Jenny O’Higgins, DHHS: And so, I think just in the same way that we would it make sure that every response is person centered.

Jenny O’Higgins, DHHS: We have to think about that, with each other’s relationships as stakeholders and departments, I have very different history of training and my professional background, then Rochelle right.

Jenny O’Higgins, DHHS: I don’t know what it means to be in law enforcement and so how we speak to each other we’re not always going to relate immediately either.

Jenny O’Higgins, DHHS: And so I think that it’s a lot of building a system together as giving one another grace getting to know one another and.

Jenny O’Higgins, DHHS: And we have to actually talk to get it right right, so it has to be that when something doesn’t go well, that we don’t say I’m never using that again.

Jenny O’Higgins, DHHS: Instead, we say how can I be a part of the solution to make it better for my state.

Jenny O’Higgins, DHHS: Right so I’m going to call I’m going to call the police department that the interaction wasn’t right I’m going to call you know the call Center I’m going to call the Community mental health Center.

Jenny O’Higgins, DHHS: I’m going to notify the seat way in whatever way makes sense for you to resolve that.

Jenny O’Higgins, DHHS: And I think every the most encouraging part in my role in seeing that the nine eight coalition work together or in working with rapid response and the Community mental health centers.

Jenny O’Higgins, DHHS: has been that everyone is so willing to keep working at it that’s the encouraging piece that’s the piece that gives me a lot of hope for our system we have a lot of people who want to get it right.

Jenny O’Higgins, DHHS: And who all have, for the most part, some amount of personal experience of their own of why they want to get it right right so they’re deeply passionate about it and they want to make it work.

Michelle Wagner, NAMI NH (she/her): And you’re in the process of creating a system to do just that, to make it simple for people to give feedback.

Jenny O’Higgins, DHHS: Yes, so part of our evaluation and monitoring of the system is, we want to know how we want to create easy ways to get feedback right so today, we have an email address that’s DBHcrisistransformation@DHSNH.gov.com

Michelle Wagner, NAMI NH (she/her): I believe Emily can put that in the chat for.

Jenny O’Higgins, DHHS: Emily will put that in there for us, but the email address was just.

Jenny O’Higgins, DHHS: Set up because we didn’t, we weren’t sure exactly how we would continue to get feedback from folks so that will not be the be all end all sort of long-term way to give feedback.

Jenny O’Higgins, DHHS: We had also had you know beacon health options had created a form on their website, but it was really meant to be more internal so that the Community mental health centers could give feedback directly to the access point.

Jenny O’Higgins, DHHS: When their connections weren’t working, you know as well as they would like and so we have you know we’ve been monitoring early implementation in those two ways the form on the beacon website that’s for the Community mental health centers to easily contact.

Jenny O’Higgins, DHHS: The access point and then through our email.

Jenny O’Higgins, DHHS: But more importantly than either of those sorts of written forms, or that we all continue to meet and talk all the time, and that I would encourage people to pick up the phone to to tell us about their experience and.

Jenny O’Higgins, DHHS: And then every time that there is, and you know that we’ve had a negative interaction, or just didn’t go quite as well as we wanted.

Jenny O’Higgins, DHHS: were able to sit, I mean Eric will listen to the phone calls himself personally and see how it went and where I went wrong and we will circle back with everyone that was involved and we’ll try to use that as a sort of case study to get a better.

Michelle Wagner, NAMI NH (she/her): And can we circle back to Eric to talk about what the two people who’ve been hired at.

Eric Easson (He, Him), Beacon Health Options: beacon, yes, so I now have two TEAM members Kara Washam and David Hudson.

Eric Easson (He, Him), Beacon Health Options: both of whom are hired as behavioral health liaisons and their job is to help me, of course, we talked we said earlier about how.

Eric Easson (He, Him), Beacon Health Options: My role, I think we said earlier about how my role was largely around relationships and so is there’s their role is really to be additional faces of.

Eric Easson (He, Him), Beacon Health Options: Our organization of this system in the Community they’re out in the in the communities hosting collaborative meetings with organizations.

Eric Easson (He, Him), Beacon Health Options: we’ve got a handful on the books already and we’re working on creating even more to get folks to the opportunity to join, but this will be open to the public, and so, as we get them scheduled and.

Eric Easson (He, Him), Beacon Health Options: off the ground, so to speak, in some areas we will start making that public through NAMi and through other organizations that might be able to help us support.

Eric Easson (He, Him), Beacon Health Options: Some advertising for that, so there is also that avenue, they also support the review like Jenny mentioned review of calls.

Eric Easson (He, Him), Beacon Health Options: investigating complaints and concerns and, of course, given the fact that this is a very interconnected network of various providers.

Eric Easson (He, Him), Beacon Health Options: Sometimes that concern is about us, sometimes that concern is about someone else but either way we investigate it, and we try to route it to the right person to get the appropriate response.

Michelle Wagner, NAMI NH (she/her): Great Thank you Eric and with we have just 15 minutes left here, I definitely I see that a lot of the questions got answered by you folks in the background here.

Michelle Wagner, NAMI NH (she/her): But I we didn’t really talk about youth, so an attendee said what happens when an underage child teenager calls 988 and has an active plan for suicide, but they refuse to go to the emergency room and or the family does not want to go to the er.

Eric Easson (He, Him), Beacon Health Options: it’s tricky.

Eric Easson (He, Him), Beacon Health Options: I intentionally avoided answering it in the chat because I didn’t feel like I could give it justice, I appreciate.

Michelle Wagner, NAMI NH (she/her): You bringing it live.

Eric Easson (He, Him), Beacon Health Options: So, I will say that we do we bring those folks on the phone.

Eric Easson (He, Him), Beacon Health Options: Do you have to juggle certain priorities one priority is certainly partnering with callers and their families and respecting their choice about their care, and that is a very important priority for us.

Eric Easson (He, Him), Beacon Health Options: But we also have a priority to protect life and protect safety and so if we find ourselves involved in a situation where we’re concerned that the life or safety of an individual might be at risk, be at a child or an adult.

Eric Easson (He, Him), Beacon Health Options: And we feel that we can appropriately partner with anyone involved to create an appropriate safety plan.

Eric Easson (He, Him), Beacon Health Options: Whatever that may look like, then we could potentially involve external agencies like 911.

Eric Easson (He, Him), Beacon Health Options: That would not be our choice if if we have it, but at times that’s when we talked about earlier Michelle that sometimes we’re not really given much of a choice in some situations because our priority is preserving life.

Eric Easson (He, Him), Beacon Health Options: We will do that at times even if that outweighs our priority to involve the consumer and let consumer choice drop.

Michelle Wagner, NAMI NH (she/her): right and as we’ve heard from Rochelle police departments are showing up in a trained and educated way many times.

Michelle Wagner, NAMI NH (she/her): So that’s a safe option, I think my my question is, can you can people under 18 call the line, what happens with that is it going to show up on the cell phone bill is my mother going to find out that I called.

Eric Easson (He, Him), Beacon Health Options: So I know that there are certain agencies that have the capacity, but we unfortunately don’t have the capacity to block it from showing up on the cell phone bill that will show up.

Eric Easson (He, Him), Beacon Health Options: I can’t make that promise if someone is looking forward the most anonymous option possible to engage with us, I would recommend going to the website and using the chat feature.

Eric Easson (He, Him), Beacon Health Options: Because there’s no record of that in a cell log whereas you would have the phone number or text chat in your so bill you wouldn’t have the chat information there.

Eric Easson (He, Him), Beacon Health Options: So that’s what we’re going to go ahead and.

Jenny O’Higgins, DHHS: I was just gonna say that crisis text line is a national resource, and the crisis text line does.

Jenny O’Higgins, DHHS: doesn’t show up on phone bills and is a very anonymous resource so for those of you who are specifically requesting that a non-anonymous resource that’s another place that you could point them.

Michelle Wagner, NAMI NH (she/her): And so, will you take calls from you can’t verify age on anyone calling right, so a person of any age can call.

Eric Easson (He, Him), Beacon Health Options: If you’re old enough, the other phone will talk to you.

Eric Easson (He, Him), Beacon Health Options: The only question of like they’re the the can set the implied consent of you calling as enough consent for us to chat with you.

Eric Easson (He, Him), Beacon Health Options: The question of consent really only arises when we start talking about engaging you in other services because, certainly if we’re trying to send you for an appointment and.

Eric Easson (He, Him), Beacon Health Options: You know, are you old enough to drive yourself, do you have the capacity to pay, do you have the capacity to be responsible to make the choice to do that.

Eric Easson (He, Him), Beacon Health Options: So, then, we have to start having conversations about involving a responsible adult perhaps but there’s a lot that we can do without involving an adult just to provide that immediate support.

Eric Easson (He, Him), Beacon Health Options: Via phone text chat that does not require an adult and that does not require any kind of third-party consent to do that.

Michelle Wagner, NAMI NH (she/her): Okay, because Kelly asked what about reporting to DC wife for use the call that’s not happening.

Eric Easson (He, Him), Beacon Health Options: Only if there is a reportable concern if we had a reportable concern we would obviously report, but if we are just getting you know.

Eric Easson (He, Him), Beacon Health Options: We don’t let you see ya know the rates of that type of call or anything we report to DHS.

Eric Easson (He, Him), Beacon Health Options: Certain numbers of folks that call, but we actually don’t have a means of documenting or we’re not currently I should say reporting specifically whether that call was made with or without parental consent, because we don’t, we just approach every call as a call.

Michelle Wagner, NAMI NH (she/her): Absolutely so it’s safe for youth to call.

Michelle Wagner, NAMI NH (she/her): A couple more questions here you folks took care of a lot of these what happens when local mental health providers are too full to provide services within 24 hours.

Eric Easson (He, Him), Beacon Health Options: So, I think that that question is related to the same day next day appointment.

Eric Easson (He, Him), Beacon Health Options: And service, again I didn’t answer this one, because I think you know heather may have some important information for her perspective, what I can tell you from our perspective is that our understanding is that all 10 agencies do have the capacity to provide same day, next day access.

Eric Easson (He, Him), Beacon Health Options: Business Day same day, next business day access for appointments so it’s not necessarily a true 24 hours, it might be the next business day.

Eric Easson (He, Him), Beacon Health Options: But they, in some cases that’s not true, in some cases they are doing it for weekends, but I don’t know that that’s in every case.

Eric Easson (He, Him), Beacon Health Options: But they every Center does have the capacity to provide a level of urgent access.

Eric Easson (He, Him), Beacon Health Options: That is slot that is separate from kind of the the under I recognize that there isn’t a concern or problem about being able to enroll in services, and this is a separate service from that, so this comes from a separate pool of resources.

Heather McConihe- Community Partners: I’ll piggyback off of what Eric said and yeah so that is going to be very specific to each community mental health Center in our Community mental health Center.

Heather McConihe- Community Partners: Our team, this is, this is what we do, we are not a treatment team we don’t carry caseloads of clients, and so we have never not been able to get somebody in within that time frame.

Heather McConihe- Community Partners: We are seeing people on weekends if that’s convenient for them, and in terms of getting enrolled into long term services.

Heather McConihe- Community Partners: I can’t speak to that and give a definitive timeline one of the things that we can do under the system is after this initial dispatch.

Heather McConihe- Community Partners: And after this initial rapid access appointment request, we can follow people for up to 30 days and help bridge them to these long-term services and provide additional support in that time.

Michelle Wagner, NAMI NH (she/her): Great, thank you for that.

Michelle Wagner, NAMI NH (she/her): We didn’t talk about languages, what if I call and I don’t speak English, what if I’m hard of hearing. Jenny or so.

Eric Easson (He, Him), Beacon Health Options: I was just about to type start typing a response, so I can tell you again, I can tell you from beacon’s perspective.

Eric Easson (He, Him), Beacon Health Options: From beacons perspective for phone calls, we do use the language line for people who are non-English speakers.

Eric Easson (He, Him), Beacon Health Options: it’s not quite as good as it’s not as good as it’s just not as good as speaking someone’s language, but it is a good service to provide some support.

Eric Easson (He, Him), Beacon Health Options: The 988 network offers the option to connect directly to a Spanish language network and so someone who speaks Spanish in particular might prefer to use 988 and press the I think it’s two.

Eric Easson (He, Him), Beacon Health Options: Is the option to reach the Spanish sub network.

Eric Easson (He, Him), Beacon Health Options: So that might be preferable for some people who speak Spanish again this boils down to personal choice.

Eric Easson (He, Him), Beacon Health Options: As far as people who are deaf or hard of hearing typically if they’re going to engage with us, they might engage via text or chat.

Eric Easson (He, Him), Beacon Health Options: And if they do choose to engage with your phone, they can use the the relay services that already exists we’re able to you know utilize their services, just like any other phone call would.

Eric Easson (He, Him), Beacon Health Options: To be able to help communicate again I don’t want to speak for mobile crisis, but I know mobile crisis also has some capacity to provide support to folks who are non-English speakers? Heather, do you want to?

Heather McConihe- Community Partners: Absolutely so here Community partners, we do have an agency that we use that has translators.

Heather McConihe- Community Partners: And I haven’t had not in this role, but I have had times, where I’ve gotten caught up just in a situation where maybe that’s not available.

Heather McConihe- Community Partners: So, you know get creative with like Google translate or like the notepad on a phone whatever I need to do to connect with that person, you know we’re going to do.

Michelle Wagner, NAMI NH (she/her): Absolutely.

Michelle Wagner, NAMI NH (she/her): So, I just want to sort of come back around because I think I just want to be clear about the numbers who’s calling where when why what’s going to happen if I am in New Hampshire, and I want somebody to respond in New Hampshire I should call.

Michelle Wagner, NAMI NH (she/her): The three three number right.

Eric Easson (He, Him), Beacon Health Options: that’s one option I hate it.

Eric Easson (He, Him), Beacon Health Options: really does boil down to consumer choice I’m.

Eric Easson (He, Him), Beacon Health Options: Really, I think that’s important for people too.

Michelle Wagner, NAMI NH (she/her): Understand yeah.

Eric Easson (He, Him), Beacon Health Options: it’s not a wrong door it’s The important thing is to understand what you might get when you dial each number okay.

Michelle Wagner, NAMI NH (she/her): My run through that quickly, one more time.

Eric Easson (He, Him), Beacon Health Options: Regardless of the phone number you’re calling from if you call a 1-833-710-6477, you’ll reach the New Hampshire rapid response access point every time we will have the capacity to potentially link you to mobile crisis or urgent appointments, that is an option.

Eric Easson (He, Him), Beacon Health Options: If you call 988 days you will always get support, I can’t speak to the particulars of who might answer and what access they might have a local resource that may vary based on your phone number.

Eric Easson (He, Him), Beacon Health Options: So that is a consideration, there are also some other older numbers of legacy numbers that continue to operate and feed into the system in one way or another that’s a very complicated complex discussion.

Eric Easson (He, Him), Beacon Health Options: So, we could talk all day about this whole question but but that’s kind of the nuts and bolts of what I would say, people need to think about.

Michelle Wagner, NAMI NH (she/her): Okay, and we’re coming to the end of our time together, so I just want to go around and have folks quickly say what their takeaway would be in our discussion today and Jenny how about we start with you.

Jenny O’Higgins, DHHS: So, I think that just I think that the takeaway, from my perspective is that.

Jenny O’Higgins, DHHS: To you know call early call often that you will get you know someone to talk to, no matter what number you remember in the moment of crisis.

Jenny O’Higgins, DHHS: And and really that we want to make sure that people are feeling like they can call.

Jenny O’Higgins, DHHS: And whenever they need to, so I know that, like most recently, one of the things that’s really helpful about.

Jenny O’Higgins, DHHS: 988 being a simple number to remember is that I’m able to explain it to my five-year-old right when there when you need police or fire or a medical emergency you call 911.

Jenny O’Higgins, DHHS: When you’re feeling overwhelmed, and you or your emotions are too much for you to handle you call 988 that’s my that’s the easiest message to remember right.

Jenny O’Higgins, DHHS: There is some nuance in this talking to grownups about that, but I think that the simplest thing to remember is when you need police, fire or medical response to call 911 and when you’re feeling overwhelmed you call 988.

Michelle Wagner, NAMI NH (she/her): Perfect Thank you Jenny, detective Jones Rochelle we’re going to move over to you how about you.

Detective Rochelle Jones, Portsmouth Police Dept.: I think the takeaway is you know.

Eric Easson (He, Him), Beacon Health Options: For people too.

Detective Rochelle Jones, Portsmouth Police Dept.: Just be kind to themselves, you know and each other and just there’s nothing to be ashamed of if you need help it’s not a weakness and you know, to accept it, or ask for it’s certainly a strength and just know that we are out here we’re working together, you know to be better.

Detective Rochelle Jones, Portsmouth Police Dept.: As we respond to you, so all your feedback is certainly helpful too.

Michelle Wagner, NAMI NH (she/her): Thank you.

Michelle Wagner, NAMI NH (she/her): heather how about you.

Heather McConihe- Community Partners: um so my key takeaway is definitely going to be do not get hung up on the definition of the word crisis you define what your crisis is, and so, if you’re feeling like you need to call, call.

Heather McConihe- Community Partners: And the other thing that I would say is is that this access point system is really trying to shift the attitude in terms of consumer choice, like what I was talking to earlier about.

Heather McConihe- Community Partners: Working with rather than doing too and it’s really been wonderful to watch consent is a big part of the system, and so we just want to impart that to everybody.

Michelle Wagner, NAMI NH (she/her): Thank you heather.

Michelle Wagner, NAMI NH (she/her): And, before I get to Eric I’m just going to remind folks that we do have an evaluation for today and Emily will put that in the chat so folks can click on that link and fill out the evaluation Eric.

Eric Easson (He, Him), Beacon Health Options: I’m I’m trying to think of how to boil it down.

Eric Easson (He, Him), Beacon Health Options: So much to think about, but I guess.

Eric Easson (He, Him), Beacon Health Options: Regardless of which number, you call or how you do it, you know when in doubt just reach out that’s what I would say, because we really will help you know, whoever answers the phone or the text or the chat will do their best to help you find the resources that you need in that moment.

Michelle Wagner, NAMI NH (she/her): There is no wrong door just call and we’ll take care of you.

Eric Easson (He, Him), Beacon Health Options: Great.

Michelle Wagner, NAMI NH (she/her): Well, thank you all for joining us today.

Michelle Wagner, NAMI NH (she/her): We do ask that you take a moment to fill out that evaluation form, you can find the link in the chat.

Michelle Wagner, NAMI NH (she/her): After you fill it out, you’ll automatically get a certificate of attendance if you need one of those just a reminder, a recording of today’s discussion will be posted on the education page of onward and h.org.

Michelle Wagner, NAMI NH (she/her): You will receive an email after this presentation in the next day or so, which includes links for the survey and also a link to the recording on the website.

Michelle Wagner, NAMI NH (she/her): For questions or comments, please reach out to me at mwagner@naminh.org We thank our panel Thank you all so very much for being with us today, this was terrific great information was shared We appreciate you.

Michelle Wagner, NAMI NH (she/her): taking the time to be with us and sharing your personal experiences and we look forward to seeing all folks next month, when we talk about Suicide Prevention and high-risk groups until then do take care goodbye everyone.