People who experience a crisis related to their behavioral health are often met by teams poorly equipped to respond to their disease, including police or emergency room teams. Now, Johns Hopkins Medicine and 14 other hospitals across Maryland have received $45 million in funding to start an initiative aimed at reducing unnecessary emergency department use and police interactions for substance use and mental health crises.

The Greater Baltimore Regional Integrated Crisis System, a five-year initiative, will launch in January and will serve Baltimore City and Baltimore, Howard and Carroll counties in Maryland.

“It’s our responsibility as health care leaders to use evidence-based best practices to design systems that address needs beyond those that are immediate, says Kevin W. Sowers, M.S.N., R.N., F.A.A.N., president of the Johns Hopkins Health System and executive vice president of Johns Hopkins Medicine. “This is about changing and improving how our society engages with people and families experiencing a behavioral health crisis. These individuals deserve compassionate care provided by experts who understand their needs. This new effort will allow us to manage the crisis situation while getting people the help they need to address what got them to that point in the first place. This is how you protect the health and dignity of the patient while supporting families and keeping our communities safe.”

The initiative will provide a regional hotline with trained professionals who can perform assessment and de-escalation, and help schedule same-day appointments using technology that shows treatment bed availability and open appointments across hospitals and community-based providers. The hotline will deploy mobile crisis teams, available around the clock, to respond to people experiencing crisis and help them safely stabilize and connect with health care services.

“Many crisis situations can be managed within existing outpatient clinical settings, if people are able to immediately access such care,” says Mustapha Saheed, M.D., medical director of the Department of Emergency Medicine at The Johns Hopkins Hospital and assistant professor of emergency medicine at the Johns Hopkins University School of Medicine. “This initiative will support outpatient behavioral health providers to offer walk-in or virtual appointments for people who need immediate assessment, de-escalation or treatment services. This is an important component of effective crisis intervention and response.”

Annually, more than 58,000 emergency department visits in the new initiative’s three counties and Baltimore City are related to behavioral health crisis. The Greater Baltimore Regional Integrated Crisis System builds on the current behavioral health crisis system and aligns with the Crisis Now model, a nationally recognized framework for comprehensive care.

Behavioral Health System Baltimore, the nonprofit Local Behavioral Health Authority for Baltimore City, will oversee this initiative. The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center and Howard County General Hospital will help lead the initiative for Johns Hopkins Medicine, including providing the care models needed to sustain and grow the program, identifying and building the work groups responsible for designing and improving infrastructure, helping to achieve success and sustainability, and ensuring that patients and communities have access to appropriate crisis services.

“No state, no county, no community is immune to the behavioral health crisis. That includes Howard County, where we have seen increases in the numbers of adults and children who come through our doors with behavioral health needs, oftentimes after struggling to access services in the community,” says Elizabeth Edsall Kromm, Ph.D., M.Sc., vice president of population health and advancement at Howard County General Hospital. “We are excited to be partnering to create a response system across the four regions in Maryland. This program will allow us to better meet the needs of anyone experiencing a behavioral health crisis.”

“The need for real time open access to behavioral health care has never been greater than it is today,” says Kai Shea, M.S.W., L.C.S.W.-C., senior director of care management at Johns Hopkins Bayview Medical Center. “People living in our communities often end up with many of their needs misunderstood and unmet. This collaboration will enable us to improve access to care across the continuum by creating a system of response that provides the right care, at the right time, in the right place by the right professionals,”

The Greater Baltimore Regional Integrated Crisis System is funded by Maryland’s Health Services Cost Review Commission Regional Partnership Catalyst Grant Program. To sustain the initiative beyond the initial five-year funding, the creators of the program hope to secure local government funding, expand existing support from the commission and establish an insurance reimbursement model to cover care interventions that the initiative provides. If the initiative is effective, the group hopes it will become a model for the rest of the state and even the nation.

Greater Baltimore Regional Integrated Crisis System Participating Hospitals

1.      Ascension Saint Agnes Hospital (Ascension health system)
2.      Carroll Hospital (LifeBridge Health)
3.      Grace Medical Center (LifeBridge Health)
4.      Greater Baltimore Medical Center
5.      Howard County General Hospital (Johns Hopkins Medicine)
6.      Johns Hopkins Bayview Medical Center (Johns Hopkins Medicine)
7.      The Johns Hopkins Hospital (Johns Hopkins Medicine)
8.      MedStar Franklin Square Medical Center (Medstar Health)
9.      MedStar Good Samaritan Hospital (Medstar Health)
10.      MedStar Harbor Hospital (Medstar Health)
11.      MedStar Union Memorial Hospital (Medstar Health)
12.      Mercy Medical Center
13.      Northwest Hospital (LifeBridge Health)
14.      Sinai Hospital (LifeBridge Health)
15.      University of Maryland Medical Center (University of Maryland Medical System)
16.      University of Maryland Medical Center Midtown Campus (University of Maryland Medical System)
17.      University of Maryland St. Joseph Medical Center (University of Maryland Medical System)