Driving the future of mental health response

Dial 911, and the responding dispatcher might send one of three options: a police officer, a firefighter or an EMT. But what if no crime has been committed, no laws broken? What if there’s no actual burning building, just the feeling that everything is on fire? What if the medical emergency isn’t of the body but the mind?

Enter a fourth option: Anchorage’s Mobile Crisis Team (MCT), arriving not in a police cruiser, firetruck or ambulance, but in an inconspicuous SUV. Launched in the summer of 2021 and housed within the Anchorage Fire Department (AFD), MCT responds specifically to mental health emergency calls, such as suicidal ideations, schizophrenic or bipolar episodes, and even feelings of grief or loss.

Funded by roughly $1.5 million generated from a 2020 alcohol tax in Anchorage, MCT includes two units operating 10 hours a day, seven days a week. Each unit comprises a licensed clinician and a paramedic. The earliest of these units consists of clinician Jennifer Pierce, M.S. Clinical Psychology ‘17, G.C.R.T. Children’s Mental Health ‘17, and paramedic Michael Riley, A.A.S. Fire Service Administration ‘05.

What sets MCT apart from more traditional first responders is twofold, the first of which is time. EMTs may not have time to properly diagnose a problem that isn’t immediately apparent, such as a broken bone or bleeding wound. MCT, however, does have time to assess situations and form relationships with the people they serve, often sitting with them for hours and checking in on them days or weeks after the initial call.

The second is knowledge. Where police officers might misinterpret someone suffering a mental health episode as a dangerous criminal, MCT has knowledge of behavioral health, cultural nuances and community programs that can help avoid unnecessary incarceration or altercation.

“On an ambulance, you’re in, you’re out, on to the next call. You don’t have time to build rapport with people and figure out what is actually causing the crises,” said Riley. “Now we have time to learn about community programs and stay connected with community partners. We have time to stay engaged so when we’re working with an individual in crisis, we know the best place to send them for whatever moment they’re in.”

“We take it from a lens of sitting with the individual and working through whatever it is they’re experiencing in a collaborative way at their own pace,” added Pierce. “Maybe it’s as simple as them just needing their medication or someone to listen to them. So we bring a whole different focus and training, providing evidence-based interventions during stressful situations that de-escalate and are therapeutic.”

Riley and Pierce have unique insights into how MCT’s emergency response differs from the fire or police departments, having previously worked for AFD and Anchorage Police Department (APD), respectively.

Formerly an APD officer, Pierce desired a different way to help people. After experiencing an accident in the line of duty, she decided to make the career jump. She enrolled at UAA, earned her Master of Science in clinical psychology and is now working toward her Ph.D.

“I became a police officer because I really wanted to help people, but I felt like I could be doing more,” said Pierce. “What I appreciate is bringing my previous knowledge and understanding how police officers view things, but now having the time, patience and skills to actually help someone. It feels so much more satisfying at the end of the day to connect someone to the resources they need.”

Similarly, Riley was an AFD paramedic, arriving in the role after earning his Associate of Applied Science in fire service administration and spending time in firefighting and paramedic positions across Alaska and North Carolina. Although he was already in his desired field, the limited time and resources afforded to paramedics left him feeling like more could be done.

“The calls [MCT] responds to were calls I was already responding to in an ambulance, but I never felt like I had the right tools,” said Riley. “It felt like I was seeing the same people over and over. This recidivism can really fatigue you. But being in a unit where our sole responsibility is to make sure people are connected and we have all the time to do it is a big relief and has restored my hope in the system.”

Pierce’s first job in her new career was right across the street from UAA at Providence Alaska Medical Center, where she provided therapy and de-escalation for the Inpatient Mental Health Unit and Crisis Incident Debrief Team.

Serendipitously, Riley was also at Providence having conversations with the director of behavioral health to find a solution to the recidivism he was seeing. Riley pitched the idea of creating a high utilizers outreach program, integrating behavioral health specialists with AFD to reach out to individuals who use emergency services excessively but do not seem to be getting their needs met. The director knew exactly who to connect Riley with: Pierce, and the foundation was set for the eventual MCT.

Since their debut, MCT estimates that, on average, they get dispatched to about eight 911 calls daily in Anchorage. Each of those diverted calls saves time for police officers and hospital workers already suffering from a lack of resources. Of those calls, MCT estimates they are able to help 83% of the individuals they are dispatched to see right there in the community without having to be transported by APD or AFD.

In summer 2022, MCT’s celebrated its one-year anniversary and hope to bring on additional personnel and resources as the budget allows.