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LA County Partners With Nonprofit To Ramp Up Unarmed Mental Health Crisis Response

The mental health crisis response workers stand in front of a black SUV. The wear reflective safety vests and are looking towards the camera.
Clinician Alison Tsai (L) and Peer Support Specialist Elizabeth Roman (R) are staffer with Sycamores' Mobile Crisis Outreach Team (MCOT) effort
(Mary Kay Wilson)
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L.A. County is partnering with a nonprofit behavioral health agency to build out its mobile mental health crisis response system, a service which county leaders want to eventually have running 24 hours a day, 365 days a year.

The county is contracting with the group Sycamores to supplement its Psychiatric Mobile Response Teams (PMRT), which are made up of two unarmed clinicians from the L.A. County Department of Mental Health.

Assistance For Mental Health Crises Or Support

County leaders, families living with mental illness and mental health advocates have long called for ramping up the county’s unarmed response system, while callers still say they sometimes have to wait hours or even an entire day to get help during a psychiatric emergency.

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Law enforcement interactions with people in crisis continue to have violent or deadly outcomes. According to the LAPD, of the 31 people officers shot at last year, nine had a perceived or confirmed mental illness.

Sycamores' Mobile Crisis Outreach Teams (MCOT) began responding to mental health crisis calls alongside the county’s teams last fall with the goal of getting the person psychiatric help without involving law enforcement. They’ve slowly increased the number of teams available and are officially launching the service this weekend, according to a press release.

“I do think of mobile crisis as the ER equivalent to our mental health system. The individuals that we’re providing services to are in higher need and they’re in immediate need,” Jana Lord, chief program officer at Sycamores, told LAist.

Sycamores' two-person MCOT teams are made up of a licensed clinician (licensed clinical social worker or licensed psychiatric technician) and a peer support specialist (someone who has live experience providing help during mental health crisis).

The teams have the capability to place someone on what’s known as a 5150 involuntary hold as well as transport them to a hospital, if needed.

The Sycamores teams will service a wide geographic area, spanning from metro and south L.A., to the San Gabriel, San Fernando and Antelope Valleys.

Lord said she has worked since last October to hire enough people to staff four teams. She hopes to eventually have a total of fully staffed 43 MCOT teams in addition to the 33 teams the Department of Mental Health currently operates directly.

According to a county-ordered report from the group RI International, the county would need 138 mobile crisis teams in order to reach its 24/7/365 service goal.

Why Sycamores?

Lord said Sycamores already provides mobile crisis outreach to clients under their care, so it made sense to partner with the county. The more than century-old nonprofit offers a range of behavioral health services, including individual therapy, crisis stabilization and drug counseling, according to its website.

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According to Sycamores' data dashboard, their crisis teams responded to 323 people in crisis since October 2022 with 76% of people stabilized without requiring hospitalization. Sycamores did not immediately have data available showing how many times calls escalated and required law enforcement involvement.

The contract for the Sycamores mobile crisis response services totals more than $27 million for fiscal year 2022-23.

This Saturday, L.A. Mayor Karen Bass, L.A. County Supervisor Lindsey Horvath and others are slated to attend a Sycamores event marking the official launch of the MCOT program and to raise awareness for 988, the national mental health crisis line.

‘People don’t apply for the job’

As L.A. County struggles to beef up its unarmed mental health crisis response system, some families say they’re left feeling helpless when they call for help.

“When a family’s in crisis, and you don’t want to call 911... but you gotta wait five hours, that’s a long five hours,” said Mark Gale, criminal justice chair for National Alliance on Mental Illness (NAMI) in greater L.A. County.

A recent LA Times analysis of mobile crisis response data found that in 2022, 34% of dispatched PMRT units took more than eight hours to respond.

Gale said he applauds the county and Sycamores for making the effort to increase the number of teams available, but he said hiring enough of the right people for the job will continue to be a challenge.

“There’s a political discourse, a presumption that we can build what we say we want to build, and then we go to build it and people don’t apply for the job. And that’s a huge problem,” Gale said.

The county and the Department of Mental Health have tried to address the staffing issues with incentives and trainee programs, but the mental health worker shortage continues to be a problem across the state.

Update: An earlier version of this story stated they are 33 and not 36 PMRT units the Dept. of Mental Health currently has staffed.

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One of my goals on the mental health beat is to make the seemingly intractable mental health care system more navigable.

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