County hails ACCORD program as success, seeks expansion

The Enterprise — Noah Zweifel

University at Albany Professor Tomoko Udo discusses the promising first-year findings of the county’s ACCORD program outside Draper Hall in Albany. Behind her, from left, are Andrew Joyce, chairman of the Albany County Legislature; legislator Matthew Peter; and Stephen Giordano, the county’s mental-health commissioner.

ALBANY COUNTY — Albany County officials have declared ACCORD, the county’s experimental mental-health-crisis response program, a success, and suggested that it’s likely to expand throughout the county, if not the state. 

ACCORD, which stands for Albany County Crisis Officials Responding and Diverting, was implemented as a pilot program in the rural Hilltowns last June following nationwide scrutiny of policing tactics, and aimed to address local mental-health crises that would normally be responded to by law enforcement with, instead, mental health experts.

Simultaneously, the county tapped the University at Albany to study the program. The study’s findings were released on Friday following a press conference outside of the university’s Draper Hall. 



In sum, the study found that “the ACCORD team was able to resolve the problem on the scene in many cases and provided follow-up phone call services when needed. This suggests the great benefits of ACCORD as a program that can connect previously underserved communities with social services. In the long run, this may help reduce utilization of emergency rooms and medical services by individuals in or at risk for experiencing nonviolent behavioral health crises.” 

Over the course of a year, the study says, the ACCORD team received 240 dispatch calls (though only 218 were responded to, because the remainder were withdrawn) resulting in 548 encounters with 210 individuals. Sixteen calls did not result in services offered because of “the patient not being found or refusing assistance.”

The majority of calls — 91.3 percent — fell under the two lowest-priority rankings by which calls are categorized, and most commonly involved “EMS, general medical assistance, and services for those who reported suicide attempts, all without transportation services,” the report says. 

The average age of patients was 44 years old, with 56.6 percent being female and 92.9 percent presenting as white. The majority of patients — around 83 percent — had never before used services offered by the Albany County Department of Mental Health. 

The report states that only 62 encounters were with individuals with a mental health diagnosis listed in a database, with the majority diagnosis being bipolar disorder at 25.8 percent, followed by anxiety disorders at 17.7 percent, borderline personality disorder at 14.5 percent, and attention deficit hyperactivity disorder at 11.3 percent.

In 42.5 percent of encounters, the report says, a law-enforcement officer was present at the scene, though it’s not known “when in the encounter, or in what capacity, they were present.”

The average response time for the ACCORD team was just under 21 minutes, owing to “non-emergency travel (no lights or sirens) from the ACCORD ‘home’ base in Clarksville to the site of disturbance in the Hilltowns area,” the report says, noting that it’s nevertheless a “significant reduction in response time, compared with, for example, dispatching of county [mobile crisis team] from the City of Albany.”

The report also pointed out that the types of calls ACCORD responded to grew over the course of the pilot year, with one anonymous interviewee involved in the program describing “assisting patients in the field with anything from referrals to New York Connects to providing grief and bereavement to family members at the scene of a death.”


What’s next?

At the press conference, Albany County Legislator Matthew Peter, who championed the program, said that the ACCORD team freed up law-enforcement officers to deal with other matters more relevant to their skillset by reducing the amount of time those officers would have to devote to a call.

“Based on the initial results,” he said, “... every locality in the county of Albany has agreed to let us review their 911 data and allow for us to basically recommend what expansion would look like.”

He hopes the program will expand throughout the county by the third or fourth quarter of 2003 “as long as we can get staffing and hiring up to date,” Peter said. 

Last December, the state legislature granted the county $350,000 to help with the expansion. How much will ultimately be necessary is yet unknown, Assemblyman John McDonald, who was credited with securing the money, said at the press conference. 

“We’d have to work with the sheriff and the legislature and executive to look at that,” he said. “I could see us moving [the funding] up by a couple hundred thousand as a starting point, but the other challenge is each community has a different way of responding, and therefore there may need to be a more balanced approach, either through the county or working with governments to provide support to the county to expand what they need.”


Five keys

The UAlbany report gave five “key recommendations” for program expansion:

—  Further time investment before implementation.

Planning and training were crucial to the success of the program, but time was difficult to come by once the team started responding to calls, the report says. In communities where there’s not as much pre-existing collaboration between public mental-health workers and law enforcement, more time may be required; 

Law-enforcement training.

Officers were initially reluctant to provide much distance to the ACCORD team for fear of the team members’ safety, but that this changed “as law enforcement became more familiar with the ACCORD team and their work,” the report said; 

Expanded onboarding training.

The ACCORD staff must practice de-escalation, the report states, and refining what de-escalation means and “how staff are meant to use the principles” might streamline that training;

Community inclusion and education.

Improving community awareness and incorporating residents’ voices has the potential to increase collaboration and “program fidelity,” the report says; and 

Improvement in data collection

Even in the program’s relatively small form, processing data was “time-intensive,” the report acknowledges, and says that expansion would naturally lead to more data, and proposes “a more efficient data collection and processing system. 

“This data should include time stamps and indicators of involvement of law enforcement to track the amount of time law enforcement spends on the ACCORD cases, which will be helpful for cost calculation in the future,” it says. “Finally, the evaluation will move into the summative evaluation phase along with the county-wide program expansion. 

“Clear definitions of outcomes, particularly around long-term service utilization and management of behavioral health issues among ACCORD patients, will be critical to further demonstrate the effectiveness of the ACCORD.”

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