Last month, the Whatcom County Health Department unveiled a new, specialized branch dedicated to improving the ways everyday emergencies are handled. Called the Response Systems Division, it hosts an array of brand-new programs alongside the already well-established GRACE and LEAD programs.

GRACE, or Ground Level Response and Coordinated Engagement, has been at work in the local health care community since 2018, serving people who repeatedly cycle through emergency medical services, law enforcement, jails, and the emergency room. “First responders were saying, ‘We’re seeing the same people, who have the same needs, and we’re not able to address the root causes,’” says Response Systems Manager Malora Christensen. “We looked at data to decide how we can intervene in that cycle of crisis.”

Malora Christensen has worked in clinical social services for 10 years, and with GRACE and LEAD for the last three. Photo courtesy of the Whatcom County Health Department

Behind the scenes, GRACE also coordinates communications between several different care groups. “We’ve got behavioral health providers over here, and we’ve got inpatient treatment for substance use over there,” says Christensen. “Then we’ve got the hospital Emergency Department doing what they do, and we’ve got law enforcement responding to 911 calls. We all need to communicate and support each other, and make sure that people aren’t falling through the cracks.”

LEAD, or Law Enforcement Assisted Diversion, was launched in 2020, and does similar work within the legal system. “We’re serving people that are in the legal system because of low-level law violations, charges stemming from poverty, mental health, and substance use disorder. Not criminals, but folks who are caught up in the criminal system,” Christensen says. “We take referrals from law enforcement, the public defender’s office, prosecuting attorneys, and community partners. We work closely with drug and mental health courts, as well as attorneys and the jail.”

Tiny Home Villages, like Gardenview, are an important tool in helping people find stability on their way to success. Photo courtesy of Low Income Housing Institute

Also at work within the Response Systems Division is the Mental Health Court, which seeks to intervene when a community member’s mental health issues have brought them into the criminal justice system. Since spending time in jail does not address the mental health needs that brought them there in the first place, the goal is to move people toward the kind of treatment and rehabilitation that will help them steer clear of court in the future.

Finally, there is the RSD’s Crisis Stabilization Center, which offers a pair of programs aimed at those who have not yet landed in legal trouble. One is a service that reaches people before they’ve been arrested and offers services that help them recover from a mental health crisis and become stable enough that they won’t see a courtroom. The other identifies community members in crisis due to substance use and offers a path to withdrawal and detox services provided by Pioneer Human Service and Compass Health.

Francis House is another partner in progress. “Everybody’s stepping up to the plate to develop infrastructure, and they’re committed to a strategy of responding appropriately and caring and for those who need it,” says Christensen. Photo credit: Steven Arbuckle

There are already plans for more programs in the near future, including two that make use of the ‘co-responder’ model of emergency management. A concept just now being rolled out in a few Washington communities, it provides law enforcement officers — our traditional first responders — with a new set of partners who can answer calls that don’t need to be treated with arrest and jail time.

The Alternative Response Team will coordinate with a triage specialist at WhatComm911, to identify calls that don’t need paramedics or police. Then, a team made up of a behavioral health specialist and public health nurse can respond instead. The ART program will bolster the work being done by the Mobile Crisis Outreach Team, and should be active on the street in the late summer or early fall of 2022. There will also be a corresponding Sheriff’s Co-Responder program, placing mental health specialists with Whatcom County Sheriff’s Office Behavioral Health Deputies.

22 North is one community partner that provides housing. “All of those outreach workers know each other, and when we’re able to build bridges between systems, really beautiful things can happen,” says Christensen. Photo credit: Steven Arbuckle

The Response Systems Division is also partnering with Unity Care Northwest, the Opportunity Council, and PeaceHealth on a street-level project to provide immediate services to community members without housing. The planned Way Station will provide hygiene services like showers and laundry facilities to those who are living with medical and behavioral health concerns, as well as assist them into sustainable housing.

Treatment and housing are key to allowing more community members to enjoy a more stable lifestyle, and Christensen and her team have already had the chance to witness some success stories. “Some of our favorites include seeing someone call a family member for the first time in years, having a medical provider you can trust, getting a job or going back to school, or doing something for fun — remembering how to live outside of just surviving,” she says.

Some of GRACE’s staff — and their first responder partners, of whom just a few are pictured here — see a bright future of better outcomes for those in need. Photo courtesy of the Whatcom County Health Department

These programs have been studied for years and proven in other communities, and now Christensen is able to tell local stories, like the young woman who endured years of homelessness, victimization, and substance use, who left jail for inpatient treatment, then graduated into stable, supportive housing. She also speaks of a mother who was able to work with the courts and CPS to safely keep her two children in her house and solve her legal issues, and a son who was able to connect with his parents for the first time in two years.

Change can be uncomfortable, and even controversial, but Christensen has seen the proof herself. “There’s a narrative that people don’t want help, but people are open to support when it sees them as an individual,” she says. “Even in the messy cycle of crisis, we want to treat people with dignity and respect and figure out what success looks like for them.”

With each of these stories, Christensen sees a better future growing from a network of partnerships. “Our data show that we reduce the use of emergency services. Approaching these challenges in a human-centered way decreases the need for 911 calls, EMS contact, and jail bookings. We have a lot to do — and we have a lot to be proud of.”

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