Providing Alternative Transportation Services for Individuals Experiencing a Mental Health Crisis

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“In Minnesota, as in many other states, a patient who suffers a mental-health crisis often faces the added indignity of being taken to the emergency room in an ambulance or the back of a police car — even when there is no public safety risk. The experience can aggravate the patient’s trauma by alerting neighbors and friends to a mental illness they would rather keep private.” – Chris Serres, Star Tribune, Minneapolis, MN

Most individuals who are being transported to inpatient treatment under a temporary detention order (TDO) are placed in a law enforcement vehicle and may be handcuffed even though the vast majority of individuals committed no crime.

Now, a number of hospitals and local officials across the country are experimenting with ways to transport mental health patients in a more dignified manner, such as unmarked vehicles with plainclothes paramedics. For people experiencing a mental health crisis and have been clinically assessed to be appropriate for such transportation. “Alternative transportation” can fundamentally change how children and adults are transported from the evaluation site to inpatient psychiatric treatment.

The goal is to reduce the stigma associated with a psychiatric crisis while also reducing the enormous cost of sending ambulances long distances. In addition, these alternatives could ease the pressure on local EMT departments and police, who spend thousands of hours each year transferring psychiatric patients who pose little or no safety risk.

For the past year, the Virginia Department of Behavioral Health & Developmental Services has been contracting with a private transportation services company to transport psychiatric patients from the hospital emergency room to mental-health facilities across the region. The company provides unarmed, specially trained drivers to transport patients in safe , secure unmarked vehicles.

“When a person is experiencing a mental health crisis, we should do all we can to reduce additional trauma and stigmatization,” said Governor Ralph Northam. “Alternative transportation has been shown to do just that for individuals in need, while also alleviating local law enforcement who currently undertake this important task.”

“An individual experiencing a mental health crisis, especially one under a TDO, is already in an intensely stressful situation,” said Secretary of Health and Human Resources Daniel Carey, MD. “This trauma-informed approach will help reduce the impact of that and promote potential paths for recovery.”

“The current practice in Virginia of transporting people in need of involuntary hospitalization can intensify trauma and make them less likely to engage in treatment in the future,” said DBHDS Commissioner S. Hughes Melton, MD. “This new alternative transportation program is an exciting and significant step forward in how we treat people in crisis who need involuntary hospitalization.”

Alternative transportation also has the benefit of reducing the burden on paramedics and local police who are effectively out of service for hours at a time and unable to respond to more urgent emergencies. As a result, State mental health departments and hospital systems are increasingly exploring the possibility of hiring private security guards in unmarked vehicles to move people suffering from psychiatric crises.

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