Dutchess County, N.Y. opens 24/7 walk-in mental, substance abuse health center

Dutchess County's walk-in mental health stabilization center saw 175 clients in its first six weeks 

The Dutchess County Stabilization Center, designed to keep people with mental health or drug problems out of jails or emergency rooms, opened earlier this year in Poughkeepsie, N.Y. In its first six weeks, the center saw 175 clients. Most of the people treated there are in significant emotional distress but not an imminent danger of harm to themselves or others, the county said.

The center serves as an initial entry into detox and other substance abuse services, as well as other behavioral health services.

The $5.6 million center is part of the county’s behavioral and community health department’s mental health division. The county partnered on the center with MidHudson Regional Hospital, Mid-Hudson Addiction Recovery Centers, Astor Services for Children & Families and People Inc., the county’s non-profit human services agency. State funding also was used to get the center launched.

“This Stabilization Center is the result of a unique public-private collaboration, and we thank our community partners for their cooperation in bringing this life-saving facility to fruition,” said Dutchess County Executive Marcus J. Molinaro.

“This facility is a model for New York and the nation, one that can be replicated throughout America as we improve the lives of our neighbors living with mental health and substance abuse issues,” Molinaro said.

The center was dedicated to former longtime County Commissioner of Mental Hygiene, Dr. Kenneth M. Glatt, who was the driving force behind the creation of a Mobile Crisis Intervention Team. He retired in 2015 after 35 years in the job.

 

How It Works

A resident in distress can get to the center several ways. If they call or text the county’s 24/7 crisis helpline, a crisis intervention team can be dispatched, responding immediately to individuals in crisis to help avoid an ER visit or an arrest. The center is also accessible by Dutchess County Public Transit bus service and people often come in either alone or with family members or friends. Law enforcement officers have also been trained to bring people there to avoid a trip to the ER or jail especially when responding to calls of intoxication, domestic conflicts or altered mental status.

Some of the services made available at the center include:

• Crisis counseling.
• Mental health assessments.
• Supervised outpatient withdrawal services.
• Addictions and substance abuse counseling.
• Peer advocacy and support.
• Help contacting community-based resources.

The crisis intervention team also helps people over the phone, assisting with prescriptions, counseling and even attending court arraignments to help divert an individual into mental health treatment services rather than being incarcerated.

Tracking How the Center Is Used

Dutchess County tracks the use of the center using an electronic medical record system, which was set up by the county’s Office of Central and Information Services. The county tracks several data points including age, gender, arrival time, length of stay, disposition, number of individuals being brought to the center by police as well as other referral sources. The county is monitoring the number of individuals who are substance abusers vs. those with mental health needs. The county also tracks the number of referrals it makes for ongoing services once the person leaves the center as well as repeat visits.

Financial Considerations

Services at the center are Medicaid billable; however, no one is turned away based on an inability to pay. “Because this is a new service, we are working with insurance companies to include the services at the center in their benefit packages,” the county noted.

Dutchess County Department of Behavioral and Community Health has county staffing and operational costs associated with the center included in its budget. The county also has several community partners who also provide staffing at the center, including MidHudson Regional Hospital, part of the Westchester Medical Center network, which provides four full-time nursing staff at the Center at their cost. The goal of the center is to be self-sustaining through billable services as well as continued community partnership agreements for staffing and services.

Follow-up Care

People who visit the center can stay for up to 23 hours and will receive follow-up care from staff after they leave. “We create follow-up plans that meet the guest’s stated needs,” the county said.

“If a referral to the adult partial hospitalization program is indicated, we can make a next-day connection; the same is true for the adolescent partial hospitalization program.”

Referrals and connections are made to a variety of services such as intensive or outpatient substance abuse services, rehab programs, children’s services, public and private providers in the community and care management. “We do follow-up calls to ensure that after-care appointments are kept and assist with rescheduling them when indicated,” the county said.

Bringing It All Together Like No One Else

The establishment of the Stabilization Center is part of the county’s ongoing efforts to drive down the rate of recidivism and to intervene and divert individuals in crisis from hospital emergency rooms and jails.

There has been a great deal of interest in the county’s Stabilization Center since it opened, from other communities, and the county has already had visits from representatives of the New York City Division of Mental Hygiene and the Bureau of Mental Health.

After visiting several other communities, they noted that Dutchess County “has created the foundation to bring it all together like no one else has.”