County is answering the call for mental-health crises in a new way

The Enterprise — Michael Koff

“We’re in the midst of a mental-health crisis across the country, across the state, and certainly locally,” said Stephen Giordano, the director of Albany County’s Mental Health Department. “Our hospitals are overwhelmed. Our crisis units are busy and often overwhelmed.

ALBANY COUNTY — On Friday, the first team of trained mental-health experts was poised to answer calls in the rural Hilltowns just as the ACCORD program was being detailed for the press.
The Albany County Crisis Officials Responding and Diverting program was announced in December when $170,000 was allocated in the budget to create two new Department of Mental Health social-worker positions. The county legislature on Monday unanimously another $30,000 to pay for data analysis of the pilot program to be conducted by the University at Albany.

“Starting this afternoon, the first of two response teams consisting of social workers and paramedics will be rolling out on their first shift,” Andrew Joyce, chairman of the county legislature, said at the noon press conference, held at the Emergency Medical Services station in Voorheesville.

In the reckoning that followed George Floyd’s murder in Minneapolis last May, as communities across the country re-evaluated the role of police, New York’s governor required each police department to come up with a reform plan.

“The question we were always talking about was: What else can we be doing to make sure those suffering from mental-health crises are met with the appropriate personnel?” said Matthew Peter, the Albany legislator who broached the idea.

Albany County looked to a program launched across the country in Eugene, Oregon in 1989 called CAHOOTS, for Crisis Assistance Helping Out On The Streets. The community-based public safety system provides mental-health first response for crises involving mental illness, homelessness, and addiction.

With the “unrest of society right now,” Joyce said on Friday, the legislature asked the sheriff, “What can we do?”

Joyce stressed, “We are not going to be defunding the police in Albany County … What we are going to do is innovative. We’re going to look at our budget. We’re going to look at where we apply money, where we apply resources, where we apply our energies and we’re just going to be smarter about it.”

The initial pilot program will have two crews, each with its own car, made up of a social worker and trained county EMS staff. The first crew, which started Friday, will respond to calls from Monday through Friday. The second team, which starts toward the end of June, will be responding to calls Sunday through Thursday.

Stephen Giordano, the county’s mental-health director, stressed that the new program is an enhancement. “We have a 24/7 mobile crisis team for the county,” he said.

“We have been in the business of mobile crisis for 35 years,” he said. “We were the first in New York State and we are already responding across the county to many, many, many calls, upwards of 1,500 a year.”

“We’re in the midst of a mental-health crisis across the country, across the state, and certainly locally,” Giordano said. “Our hospitals are overwhelmed. Our crisis units are busy and often overwhelmed. We are always looking for new and innovative ways to address what is a growing problem in our society and made worse this past year through the pandemic.”

Giordano outlined three goals of the pilot program. First, he said, “Mental-health crises deserve mental-health responses … That is the best way to serve people.”

Second, he said, the program will free up law enforcement to do public safety work since oftentimes, mental-health response is not integral to their work.

The third goal, Giordano said, is “to keep all parties safe, divert folks from hospitals which … are overwhelmed and from our jails … Our jails have become the defacto psych hospitals in this county, in this state, and in this nation.”

In six months to a year, Giordano said, researchers at the University at Albany will “tell you what worked, what didn’t work, and how this can be replicated elsewhere.”

Albany County Sheriff Craig Apple said that some people are “leery” of the program, “because they’re thinking, ‘My gosh, we’re sending these folks into domestic situations or whatever.’ And that’s not really the case. We’re sending them to those very low-priority calls that would normally tie an officer up who is not really trained to do that. 

“Officers today are wearing seven or eight different hats, and mental health is not their specialty,” said Apple, noting that training in that field amounts to 16 to 24 hours in the police academy.

The EMS crews working from the ACCORD car, he said, have received training in both crisis intervention and self-defense so they can “keep people safe but also keep themselves safe.”

“Our hopes are to increase our service … and hopefully prevent something that may go the other way when an officer arrives,” said Apple. Sometimes, just the presence of an officer, he said, “can escalate  matters.”

“We will still be sending cars to the area in case things do start to go awry,” the sheriff said, adding that Voorheesville will be the center of operations and the program will expand from there.

County legislator Wanda Willingham, who represents Arbor Hill, credited Joyce with making sure “our dollars … are evenly distributed throughout Albany County.”

She said that various ZIP codes across the county were looked at and it became clear that, while the city was receiving the services it needs, “we were missing something of this area of Albany County.”

“A lot of these folks out here go without services and that’s been one of our biggest drives out here ...,” said Sheriff Apple. “A lot of these folks out this way do not want to go down into the city to get services so here we’re bringing services to them and I think this is just going to grow and grow.”

He said that one day agencies in nearby towns like Guilderland or Bethlehem may be able to access the ACCORD program. “I think they’ll be grossly understaffed in a short period of time,” said Apple.

Carmen Morano, associate dean for research at the University at Albany, said, “Data collection is a critical part of any policy-making enterprise.”

He commended the way UAlbany was involved in planning for the pilot program so that collection of needed data is built into the process.

The university team, he said, will look at a variety of outcomes such as what calls get diverted.

“The ACCORD team will work with a form of case management,” he said, explaining that, after the 9-1-1 call is answered, the person who called “will receive support to make sure they get engaged with the appropriate mental-health services.”

Giordano concluded that the ACCORD program is “at the front edge of what a lot of people are thinking about but not very many are doing.”

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