Graduation Year

2021

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Psychological and Social Foundations

Major Professor

Norín Dollard, Ph.D.

Co-Major Professor

Svetlana Yampolskaya, Ph.D.

Committee Member

Jennifer Marshall, Ph.D.

Committee Member

Kathleen Moore, Ph.D.

Keywords

Mental health, Mobile crisis, Youth issues, substance use

Abstract

Introduction: This dissertation includes three separate manuscripts that coalesce under the shared topic of mobile crisis response and the emergency behavioral health system. Method: The first manuscript includes a synthesis of the research on mobile crisis response from the 1960s to present day to assess whether mobile crisis services can improve mental health care access in the U.S. for youth and adults. The second manuscript includes bivariate and multivariate analyses of MRT participant data to characterize participants who receive an involuntary psychiatric evaluation versus those who do not, and to assess factors associated with involuntary psychiatric evaluation or referral to outpatient treatment in Sarasota County. The third manuscript includes a qualitative analysis of 16 participant interviews to identify the EBH agencies in Sarasota County, assess strengths and challenges of the partnerships between these agencies, and to examine whether the MRT could reduce unnecessary Baker Act initiations. Results: Minimal outcomes-based research exists on U.S. based mobile crisis response. The Sarasota County MRT had 21 Baker Act initiations during the study period, with older age youth, emergent call type, suicidal ideation, and being referred to the MRT by school personnel all significantly associated with higher odds of receiving an initiation. Interview participants who had experience with Sarasota County’s MRT thought to reduce unnecessary Baker Act initiations, mental health services must shift toward preventative care rather than relying on acute care measures including the MRT. Conclusions: Mobile crisis response is a cost-effective way to reduce hospitalization among people experiencing crises compared to police response or receiving behavioral health treatment in the emergency room. However, by the time an MRT is needed, a crisis has already occurred. and more focus needs to be on funding preventative mental health services to mitigate crises from happening to begin with.

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