Image Courtesy: Jonah Chester/WORT News
Cruising the streets of Madison is an ordinary gray SUV with a small white logo on an extraordinary mission. It belongs to the Community Alternative Response Emergency Services, or CARES, program, which was launched in September of last year with the goal of improving care and response to people experiencing behavioral health emergencies. This nondescript emergency vehicle allows emergency workers to de-escalate non-violent behavioral crises without the stresses of sirens and flashing lights. Yesterday evening, CARES hosted a virtual presentation discussing the results of their efforts so far.
The program started out as an intentionally small pilot program in downtown Madison in September of 2021. It was modeled off of similar programs to provide emergency mental health services such as STAR in Denver, Colorado, and CAHOOTS in Eugene Oregon, though it is still a rarity among emergency services nationwide. Earlier this year, CARES services expanded to cover the South and West sides of Madison. Madison’s current mayor, Satya Rhodes-Conway, says she plans to expand the CARES program again next year.
Over their first year in service, the CARES team has responded to hundreds of calls reporting non-violent behavioral crises such as suicidal thoughts and depression. Teams of community paramedics and crisis workers take the time to deescalate these emergencies and provide patients with care that police or medical services are not trained to deal with. This has allowed police officers and paramedics to shift their focus and resources to emergencies which they are better trained to handle.
“CARES responded to 935 total calls for service with each response averaging about an hour, and we made contact with 724 different individuals among the 935 calls. CARES responded to 57% of the estimated number of mental health calls and 9% of the daily average of check welfare calls that occurred in Madison during the time we were in service,” says Che Stedman, Assistant Chief of the Fire Department of Madison, and one of the key people involved in the CARES project. With the current rate of success of the program, Stedman says that their next goal is to expand the hours that CARES is available.
“The Mayor’s executive budget included for 2023 one more crisis worker and one more community paramedic so that we can open up weekend hours,” Stedman says. Their goal is to have three teams of 24/7 responders by October of 2023.
For those who need more assistance than CARES can offer, Sarah Hendrick from Journey Mental Health describes how CARES transfers patients to other emergency services.
“Also in 3% of cases, patients have been transferred to a law enforcement agency, typically to Madison Police Department. Those cases have primarily involved incidents of individuals who are in an acute behavioral health crisis and need a higher level of care, and are not willing or safely able to access that care via a CARES team transport. So police are called in to place them in protective custody to get them to the care that they need,” Hendrick says.
When this happens, Hendrick says that CARES is often a better first point of contact than other emergency services.
“A well trained and empathetic police officer is still a uniformed, armed, police officer driving a squad car, which may not be the most appropriate, least traumatizing way to get that patient to the care that they need,” Hendrick elaborated.
Hendrick says that, despite the successes of the program, they’re still figuring out the whole workflow.
“The 911 center software or electronic record does not have the capacity to just mark calls as ‘CARES appropriate,’ ‘not CARES appropriate,’ and so we kind of have to extrapolate from the data that we have available to us,” Hendrix said.
CARES does not currently have their own phone number. 9-1-1 will dispatch a CARES team if the situation is deemed appropriate or if the caller requests a CARES team. While other programs such as STAR or CAHOOTS have faced issues with 9-1-1 operator discretion, CARES is seeing their bottleneck in the limit of teams and hours they currently operate with. Patients are not billed for CARES services.
Reporting for WORT news, I’m Erin Ashley.