Novel Paramedic Programs Respond to Behavioral Health-related Calls.

Area of Science:

• Emergency medicine
• Public health
• Behavioral health

Background:

• Increasing demand on Emergency Departments (EDs) and Emergency Medical Services (EMS) from behavioral health (BH) concerns.
• Patients with BH concerns frequently utilize emergency services, often repeatedly calling 911.
• Existing psychiatric treatment facilities face shortages, creating barriers to timely care.

Purpose of the Study:

• To evaluate the effectiveness of community paramedicine programs in managing behavioral health crises.
• To assess the impact of specialized paramedic training and interdisciplinary team approaches on patient outcomes.
• To determine the cost-effectiveness and efficiency of these alternative care models.

Main Methods:

• Implementation of specialized training for paramedics in handling BH-related 911 calls (e.g., 140 hours in Modesto, CA).
• Pairing paramedics with mental health social workers to form crisis intervention teams (e.g., Upstream Crisis Intervention program in Atlanta).
• Dispatching these specialized units through the 911 system for BH-related calls and proactive patient check-ins.

Main Results:

• Significant reduction in the need for hospital and ED visits for BH patients.
• Expedited linkage of patients with appropriate mental health care and treatment.
• Pilot programs demonstrated substantial cost savings (e.g., over $1 million) and reduced treatment times.
• Most BH patients stabilized within 23 hours, avoiding inpatient psychiatric admission.

Conclusions:

• Community paramedicine programs offer a viable solution to manage BH crises and alleviate pressure on emergency services.
• Specialized training and collaborative care models improve patient outcomes and reduce healthcare costs.
• Addressing the shortage of psychiatric treatment facilities remains crucial for program sustainability and broader impact.