Findings indicate behavioral health crisis systems are a best practice for reducing emergency room and inpatient utilization. 

Access to a comprehensive behavioral health crisis response system can lessen demand for more restrictive and costly emergency department and inpatient services, according to a new research study published in the journal Psychiatric Services. The study was conducted by a team that included researchers from Arizona State University Center for Health Information and Research and Connections Health Solutions.

The study examined how people flow through the crisis system in Arizona, which over the past several decades has built a comprehensive infrastructure that heavily influenced the Substance Abuse and Mental Health Services Administration’s (SAMHSA) national vision for crisis care ensuring people in crisis have someone to call (988 Suicide and Crisis Lifeline), someone to respond (mobile crisis response teams), and a safe place to go for help (specialized crisis facilities). The analysis revealed:

• The majority of individuals (57.4%) entered the crisis system through mobile crisis or crisis facilities versus the emergency department, indicating the crucial role these services play in crisis response.
• Of the subset of individuals receiving care at the Connections Health Solutions Tucson Crisis Response Center, most (63.3%) did not reutilize any additional crisis or emergency services within 30 days.
• Of individuals who did reutilize services, the majority (73.0%) utilized mobile or facility-based crisis services rather than emergency department or inpatient services, affirming the significance of crisis systems in preventing hospital utilization.

"In most communities, crisis episodes begin in the emergency department with few options for specialized treatment other than inpatient hospitalization,” said study co-author Dr. Margie Balfour, chief of clinical innovation and quality at Connections Health Solutions and an associate professor of psychiatry at the University of Arizona. "This study shows that crisis systems can serve a large proportion of individuals in crisis, reducing the need for more restrictive and costly levels of care.”

The researchers identified these insights by constructing over 40,000 care episodes that showed the path of individuals through the various crisis care settings, including mobile crisis, crisis facilities, emergency departments, and inpatient psychiatric units. By merging Medicaid claims data from the Arizona Health Care Cost Containment System (AHCCCS) with electronic health records from Connections Health Solutions, the researchers were able to show if and where reutilization occurred and analyze factors that potentially contributed to the reutilization of services.

"The results of this study demonstrate the impact of an advanced crisis system – better access, improved health outcomes, and lower cost for the most vulnerable members of the community,” said Colin LeClair, chief executive officer of Connections Health Solutions. “The study further validates the outsized contribution that a value-based crisis provider can have on the use of inpatient and emergency department services. By implementing a value-based crisis system, counties and communities can improve the quality of care for individuals in crisis and create a more cost-effective health system.”

The study concluded that lessening the demand for more restrictive and costly emergency department and inpatient services can ultimately lead to a more accountable and patient-centered behavioral health system.

To read the complete study: https://doi.org/10.1176/appi.ps.20230232

About Connections Health Solutions

For over 15 years, Connections Health Solutions has been helping communities architect and operate behavioral health crisis care systems that provide help to people when they need it most. As the leading innovator in immediate-access behavioral health crisis care, Connections strives to make behavioral health work better, delivering improved quality of care and cost savings across all behavioral health populations. Throughout the United States, Connections' crisis response centers and mobile crisis units serve as the hub of the crisis system, offering services to all individuals in need in the safest and least restrictive setting. The Connections Model, recognized by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Council for Mental Wellbeing as best practice, combines both medical and recovery-oriented treatment designed to get people connected to resources and back to their lives faster. For more information and crisis resources visit connectionshs.com.