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Mental-Health Crisis Intervention Program Available in Only 11 Counties

Assembly members, healthcare providers call for quickly expanding program statewide

Joseph Miller (on left)
Joseph Miller, left, is director of neurosciences and behavioral health for the five-hospital Meridian Health system.

Advocates want to quickly expand a program that offers an alternative to the longstanding practice of bringing people to hospital emergency rooms when they are experiencing a mental-health crisis.

Early Intervention Support Services (EISS) provides treatment for up to 30 days through community providers, frequently allowing patients to become stabilized after crises without visiting hospitals.

The state has been building the program, which is under the auspices of the Department of Human Services, for several years. It’s currently available in 11 counties. Support for speeding up expansion of the program was voiced during an Assembly Human Services Committee hearing on mental-health crisis response held yesterday.

While every county has a 24-7 screening center that answers mental-health-related calls and aims to prevent crises, not all of them have enough funding to do the outreach necessary to prevent frequent emergency-room visits, according to policy experts.

That’s where the separate, more intensive EISS services come in, providing services in settings better-suited to help mental-health patients, rather than bringing them to the stressful environment of a hospital ER.

The 11 EISS centers serve Atlantic, Bergen, Camden, Cumberland, Essex, Hudson, Middlesex, Mercer, Monmouth, Morris and Ocean counties.

Joseph Miller, director of neurosciences and behavioral health for the five-hospital Meridian Health system, said “emergency departments are simply not built to take care of the needs of psychiatric patients.” He cited as an example the need for suicidal patients to be a safe setting, while noting that emergency departments are filled with needles, scalpels and other potentially deadly objects.

But he noted that patients and their doctors have a sense that they should go to the hospital in an emergency.

“One of the things that’s very challenging for us is, we’re hearing about all these terrific programs out in the community (like EISS) – I don’t know how many people know about them,” Miller said. “And we have a culture that says, go to the police station, go to the emergency room and figure it out there.”

Local doctors can be a crucial link in connecting people with these centers, since they often are in a position to recognize troubled patients before a crisis occurs.

James Romer, director of psychiatric emergency services for Monmouth Medical Center, said members of the Assembly committee knew more about the available services available after a 10-minute discussion than most pediatricians in the state.

“It’s a marathon – you have to be out there, every day, knocking on doors, talking with whoever will meet you,” Romer said, suggesting that mental-health providers need to reach out to inform primary-care providers about the EISS program.

Assemblywoman Valerie Vainieri Huttle (D-Bergen), the committee’s chair, said she had already been planning to hold a hearing on emergency mental-health services, but the sense of urgency increased after a recent experience with a constituent.

The person visited Huttle’s district office in an agitated state and was clearly experiencing a crisis, she said. However, it took five hours of calling different mental- health providers before Huttle and her staff were able to find help for the woman.

“We really found out that there were significant gaps in services – first of all, where to assess her and to send her,” Huttle said.

Huttle said she would like to expand the EISS program to all 21 counties and would support funding the program through the state budget. But she noted that the program isn’t perfect – while Bergen County’s EISS provider helped her constituent, it took a lot of time to connect her with the proper mental-health provider.

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