thoughts?

NPO

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The idea of these teams is not new. They have existed for years if you look for them. Kern County has a MET Team (Mental Emergency Treatment I think). It's a county resource that responds to 911 and non 911 calls for service. They respond a Mental Social Worker and are dispatched by county sheriff.

I think the inclusion of a firefighter paramedic on the San Francisco team is absolutely ridiculous.
 

CCCSD

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Those MET teams have an assigned Officer or have one respond. It’s a joke. These new teams are going to get their asses kicked and then dump it on the Police.

Sweep up and incarcerate the dopers and bums. Use the old state hospitals.
 
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In San Francisco there used to be a unit out of (DPH) I think that would transport drunks/junkies to the hospital. But that was after the police or medics got there and called them. Can't remember what it was called...some catchy acronym like SWEEP or HELP or something like that. I'll think of it. Probably went by the wayside when DPH medics became SFFD medics.
 

Tigger

Dodges Pucks
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The idea of these teams is not new. They have existed for years if you look for them. Kern County has a MET Team (Mental Emergency Treatment I think). It's a county resource that responds to 911 and non 911 calls for service. They respond a Mental Social Worker and are dispatched by county sheriff.

I think the inclusion of a firefighter paramedic on the San Francisco team is absolutely ridiculous.
Who does medical clearances then? We have a program here with a deputy and social worker, they either rely on the ambulance to evaluate the patient or assume that they're fine and do no medical assessment, which has led to some pretty serious issues with overdose patients.
Those MET teams have an assigned Officer or have one respond. It’s a joke. These new teams are going to get their asses kicked and then dump it on the Police.

Sweep up and incarcerate the dopers and bums. Use the old state hospitals.
Where does it say that law enforcement won't be involved in this model?
 

NPO

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Who does medical clearances then? We have a program here with a deputy and social worker, they either rely on the ambulance to evaluate the patient or assume that they're fine and do no medical assessment, which has led to some pretty serious issues with overdose patients.

In cases where emergency treatment is required or medical transport is needed They will request an ambulance. however if they just need medical clearance prior to being admitted to an inpatient psychiatric facility, the MET Team will transport to the county hospital.
 

Tigger

Dodges Pucks
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In cases where emergency treatment is required or medical transport is needed They will request an ambulance. however if they just need medical clearance prior to being admitted to an inpatient psychiatric facility, the MET Team will transport to the county hospital.
Unfortunately our county program has had issues with patients becoming unstable on the way to a hospital for a med clearance. Had some sort of medical assessment been completed prior to transport, this would not have happened and the team would not have to sit on the side of the road for a long time awaiting an ambulance.

I've worked on these programs. Sending a paramedic in some fashion adds significant value both in terms of medical clearance and providing pharmacological treatment to patients that are cooperative but in need of assistance and the out of control patient that these teams somehow seem to find themselves with fairly regularly.

We have three models locally to include the above with no medical provider which I work with frequently in my current job. They self add to calls in the county or can be requested by law enforcement (not EMS). The city has a different program with a paramedic, police officer, and MSW also responding together. They generally respond by themselves or at any public safety entity's request. Once they arrive, they'll cut everyone else loose.

Finally I helped develop a program at my old job where a paramedic with additional mental health and crisis training (provided by the community college) would respond solo to mental health calls and meet law enforcement on scene. They could be requested for direct response by dispatch or added by on scene EMS or LEO. We'd do a clearance and then a tele-health conference with a crisis behavioral stabilization facility and come up with a disposition. Usually we would just transport to the crisis facility in an SUV but sometimes we could direct admit patients to inpatient psych facilities. The key here is that we have a pretty extensive medical screening tool that patients must pass to "skip" the ED. That was developed with the facilities direct input and so far in the past four years there has been a single sentinel event in which a calm and otherwise well appearing patient with suicidal ideations kicked the windows out of the SUV (it has a cage but no window bars) and attempted to escape on the highway. When law enforcement arrived the paramedic was ready to sedate the patient with meds carried on board and the patient was later transported by ambulance. The response vehicle has olanzapine, geodon, ativan, and ketamine to facilitate medicating various patient presentations.
 
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Where does it say that law enforcement won't be involved in this model?

Unfortunately, I think the motivation here is less a more efficient response to a chronic and expensive problem than it is a political gesture, and therefore poorly thought out and perhaps inefficient. It's coming out of an initiative to move resources away from the police and so the idea is to take the cops out of these types of calls.

The reality is that the cops will end up going to a lot of these calls, tho not all of them just like they don't go to a lot of them now. A lot of these patients will end up needing an ambulance anyway, but at least a lot of them that would have gone by ambulance won't now. I see this helping the ems way more than the cops even tho the police budget is where this is coming from.
 

Tigger

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Unfortunately, I think the motivation here is less a more efficient response to a chronic and expensive problem than it is a political gesture, and therefore poorly thought out and perhaps inefficient. It's coming out of an initiative to move resources away from the police and so the idea is to take the cops out of these types of calls.

The reality is that the cops will end up going to a lot of these calls, tho not all of them just like they don't go to a lot of them now. A lot of these patients will end up needing an ambulance anyway, but at least a lot of them that would have gone by ambulance won't now. I see this helping the ems way more than the cops even tho the police budget is where this is coming from.
Sure but the article doesn't mention changing law enforcement response at all. Seems a bit premature to say that the crews are going to get assaulted...

Most of our behavioral health responses are referrals from law enforcement and I don't see that changing any time soon.
 
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Sure but the article doesn't mention changing law enforcement response at all. Seems a bit premature to say that the crews are going to get assaulted...

Most of our behavioral health responses are referrals from law enforcement and I don't see that changing any time soon.
Right...they don't have any less or more chance of encountering a potentially violent patient...but this is part of the 'defund' or really, re-allocate police resources sentiment. That is defined by an intention to not send police to these calls. And it's San Francisco. That what has happened in Portland and Seattle has not happened there is surprising to me.
 

Tigger

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Right...they don't have any less or more chance of encountering a potentially violent patient...but this is part of the 'defund' or really, re-allocate police resources sentiment. That is defined by an intention to not send police to these calls. And it's San Francisco. That what has happened in Portland and Seattle has not happened there is surprising to me.
If patrol officers are already on scene I don't really see the use of PD running these teams and providing dedicated officers, it does not provide that much help over a "regular" cop in my experience.
 
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If patrol officers are already on scene I don't really see the use of PD running these teams and providing dedicated officers, it does not provide that much help over a "regular" cop in my experience.
I think we agree...but thats the intention of this pilot program...to not involve the police at all right from the dispatched call. And there is no police presence on these teams.
 

Tigger

Dodges Pucks
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I think we agree...but thats the intention of this pilot program...to not involve the police at all right from the dispatched call. And there is no police presence on these teams.
We shall see how this goes. Everyone always seems to think these teams will always be busy with "direct referrals," most agencies find this to not be the case.
 

RocketMedic

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Anything’s better than tying up a 911 intensive care asset on mental-health calls.
 
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