Credit: (AP Photo/Damian Dovarganes, File)People who have recently experienced a mental health crisis may soon have access to transitional housing across three counties as an alternative to waiting in emergency rooms for care.
Known as “crisis diversion homes,” these transitional units are expected to serve five adults who have a serious mental illness for up to 30 days, according to the state Department of Human Services. As many as 240 people are expected to be served each year at the three homes.
The Center for Family Services, a statewide nonprofit, received over $1.2 million in state and federal funding to open a crisis diversion home in Warren County, while the nonprofit Legacy Treatment Services received over $2.4 million to purchase homes in Mercer and Gloucester counties.
These housing units being pushed by the state and nonprofit leaders are part of efforts New Jersey is making to ease the burden on hospital emergency departments trying to address acute psychiatric emergencies.
“The expansion of a crisis system — and filling all the gaps in that system — is [not] only going to serve both the state’s bottom line but it’s going to be much better outcomes for the people needing those services,” said Mary Abrams, a senior health policy analyst at the state Association of Mental Health and Addiction Agencies.
Across the country, an average of 774,508 adults visited hospital emergency departments for mental-health-related issues each year from 2018 to 2020. That accounted for 12.3% of all emergency department visits made by adults, according to a March 2023 report from the Centers for Disease Control and Prevention.
“Part of the dilemma with many of the folks who’ve experienced these crises is either the absence of housing or very unstable housing,” said Dr. Frank Ghinassi, the president and chief executive officer for Rutgers Health University Behavioral Health Care.
Someplace to call ‘home’
All of the “greatest treatment planning in the world” — whether it’s medication or supportive counseling or case management — is very difficult to deliver if a person doesn’t know where they’re going to sleep that night or get their next meal, said Ghinassi, who also serves as the senior vice president of the behavioral health and addictions service line at RWJ Barnabas Health.
Response teams will assist those who don’t pose a threat to themselves or others
Most of the people getting services in these crisis diversion homes will be referred by the crisis stabilization centers, once they are built, and the 988 mobile crisis teams.
The 988 mobile teams are currently being developed and are intended to work with the existing 988 Suicide and Crisis Lifeline call centers. Once in place, the teams will respond to “non-life threatening” mental health and substance use calls without police officers or other emergency personnel, when it is deemed safe to do so. The teams are expected to be up and running in June, according to Valerie Mielke, the assistant commissioner for the state Division of Mental Health and Addiction Services.
Immediate aid
The “crisis receiving stabilization centers,” which have not yet been built, would provide services to adults in need of immediate in-person intervention and stabilization for a behavioral health crisis, according to a request for proposals issued by the state. These centers are intended to be alternatives to traditional crisis services by diverting people away from emergency departments and inpatient treatment. Additionally, they would aim to operate like a hospital emergency department that accepts people walking in from the street, along with people being dropped off by police officers and firefighters, according to the proposal. The centers are also intended to reduce police encounters, arrests, incarcerations and 911 calls.
The total funding for the centers is well over $37 million, according to the request for proposals. Three of the centers will be located in Morris, Bergen and Essex counties. Additionally, one center will be located in either Middlesex County or Monmouth County and one will be in Camden County. Based on the experience of these kinds of programs in other states, New Jersey anticipates that most people who receive these services will be homeless or have co-occurring psychiatric and medical conditions.
“Part of the issue is that we just don’t have an alternative place for them to go when they leave here,” said Lewis Nelson who is chair of emergency medicine at Rutgers New Jersey Medical School in Newark. “Any way that we can relieve the pressure on the system would be great.”
NIMBY issues
Meanwhile, Legacy Treatment Services is still looking for homes to purchase in Mercer and Gloucester counties, according to Christine Kirkbride, the interim chief executive officer at the nonprofit. Health care professionals working at these homes would include an advanced practice nurse and behavioral health technicians, among other staff members, she said.
“Anytime you do a housing program, we have to be very careful with where in the community we place the homes,” said Kirkbride. “A lot of neighborhoods tend to have NIMBY issues and don’t want residential programs in their neighborhoods.”
The services available at the housing units will include clinical assessments, case management, assistance with getting benefits, temporary housing, symptom and medication management and counseling, according to the news release.
“Getting them [people with behavioral health issues who are struggling with housing] somewhere where they are safe, secure and have staff supporting them and linking them to the appropriate resources is a huge first step in getting them stabilized for the long road,” said Kirkbride.
The crisis diversion homes are a voluntary program, according to Mielke, and adults have to be willing and interested in participating to be served there. People will not be committed, Mielke said.
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