Over the past decade, the Horizon Foundation has worked with many local and statewide community partners to improve access to mental health services. And together, we have a lot to be proud of: we piloted and then expanded 1:1 school-based mental health services to all Howard County Public Schools. We funded local behavioral health providers and community organizations. We helped establish and secure funding for the state’s 988 Crisis Lifeline. We hosted Mental Health Film Festivals and this year, we funded a new cohort of grantees who are preparing to co-host their own arts and storytelling showcase to combat negative stigmas against mental health.
“We know we have made great progress to make mental health services more accessible, and generally to treat the topic of mental health as a priority in our community,” said Nikki Highsmith Vernick, president and CEO of the Horizon Foundation. “And yet, we know we have so much more work to do.”
Our county’s most recent health assessment survey shows that mental health challenges continue to rise, especially for our youth, people of color and low-income households. And while calls to the state’s 988 helpline continue to rise as well, it is still not used, and behavioral health services deployed, enough as a resource – sometimes with tragic consequences.
Earlier this year, a young man with autism named Alex LaMorie was tragically shot and killed by police officers during a mental health crisis at Patuxent Commons, Howard County’s new mixed-income, mixed-ability housing community. While we don’t know all the details of how this event occurred, we do know that mental health crisis services were not dispatched to Alex when he needed them.
“There’s a number of areas where things could have gone differently – he could have gotten help,” said Melissa Rosenberg, Executive Director of the Autism Society of Maryland. “We look to the police to handle many things, but we need a response that’s specific to mental health.”
Rosenberg also said that a high percentage of people with autism have contact with law enforcement before the age of 25 and have challenges.
“We get calls from families often who have encountered challenging situations,” she said. “Not because of intent, but because of difficulties that people with autism have with social communication and situations that can escalate quickly due to misunderstanding and a lack of training.”
It’s clear that much more work needs to be done on a systemic level to reduce law enforcement responses to any kind of mental health crisis, which will take time and a lot of trust building with communities. The proof is in 988 – while it exists and is operating well, with mobile crisis teams available to be dispatched to individuals who need them, there needs to be more outreach to communities so they know 988 is there for them as a resource. There also needs to be policy changes for stronger coordination between 911 and 988 across the board, whereas currently, 911 diversion efforts differ by jurisdiction.
“In Baltimore City, if an adult calls 911 and expresses wanting to harm themselves, they will be transferred to a 988 counselor. But there are a lot of behavioral health calls that come to 911 that are not that clear cut,” said Adrienne Breidenstine, Vice President of Policy and Communications at Behavioral Health System Baltimore (BHSB). “There could be more triage happening that reduces police involvement, but that takes more conversation. 911 is for emergency, quick response. 988 will spend the time with someone because it’s a counselor – they are trained differently. So, these systems are set up differently but there needs to be really strong connectivity.”
Rosenberg agrees. “Improvements need to be made to educate both sides and to get more people to 988,” she said.
The Horizon Foundation, BHSB and others are members of the Greater Baltimore Crisis Response System, a network of behavioral health crisis response services serving Baltimore City, Carroll County and Howard County that coordinates a range of services for Greater Baltimore residents with the goal of ensuring that the right resource is dispatched at the right time. It uses the Crisis Now model, which contains three critical components for people experiencing a mental health crisis: having a place to call (988); having someone to answer (988 call center counselors and mobile crisis response teams); and having a place to go.
Breidenstine said although we have the first two pieces set up, we need to close the knowledge gap and build more trust with the system, so more people know about what 988 can do. Survey data from Baltimore City shows that only a third of adults know about 988. The good news is that among those that do, they would be willing to call if they need it. And data also shows that when people call, they have a good experience and would call again.
“We still need that third piece, too,” she said. “We need a regional crisis stabilization center where people in crisis can go, that’s not the emergency department or jail. We need investment in a physical space.”
In addition to trying to close the revenue gap to fund a crisis-stabilization center for the region, Breidenstine said that BHSB will be advocating for more revenue to go towards 988 call centers as they will need more resources as calls continue to increase.
Local efforts continue as well. The coordination and connectivity between 911 and 988 is one of the areas being discussed at Howard County’s new Task Force on Disability Inclusion, Safety and Crisis Response, which Rosenberg co-chairs and on which Vernick and Breidenstine participate. It was set up after Alex LaMorie’s death to not only examine the incident itself, but to work towards solutions to improve our crisis response system in a way that works better for everyone, including people with disabilities.
“There are many organizations and individuals around the country doing great work,” said Rosenberg. “We want to work together instead of being siloed. We want to work with law enforcement so we can have different outcomes for people with disabilities when interacting with police.”
“The Horizon Foundation is honored to be working side-by-side with all of these groups to make sure everyone in our community can be safe and get the mental health support they need,” said Vernick. We honor the memory of Alex and hope together, we can ensure our mental health crisis response system is effective, sustainable and gets people help when they need it.”
