SWIA MHDS Region officially rolled out its Crisis Access Network (CAN) on July 1, 2022, after a soft roll out the prior year. The region did not officially designate the CAN as an Access Center, however, during FY23 the process for designation is intended to be completed. The CAN meets all the Access Center requirements, but is done in a virtual manner, taking the assessment to where individuals present and then coordinating additional services based on that assessment. The Crisis Access Network is made functional through extensive communication amongst all its providers. 

The region continues to enhance the array of crisis services that comprise the Crisis Access Network (CAN). Twenty-Four Hour Crisis Response is provided by mental health centers and clinics located throughout the region. Screening services are available by means of telephone, electronic, or face-to-face communication 24 hours per day, 365 per year.  

Mobile Crisis Response, known as the Mental Health Crisis Response Team (MHCRT), is contracted through Heartland Family Service. MHCRT serves both adults and children providing effective and timely connection to community-based services or to a higher level of crisis care when appropriate. Data for FY23 indicate that MHCRT provides contact within 60 minutes of dispatch to all clients served in the SWIA MHDS Region with an average response time of 12 minutes. Heartland Family Service’s MHCRT is dispatched only by Law Enforcement (911), rural critical access hospital emergency departments, or the court system. 

Crisis Stabilization Residential Service (CSRS) is offered by two providers within the region. Harbor Point (located in Clarinda) is contracted through Zion Integrated Behavioral Health Services. Bridges Crisis Care (located in Council Bluffs) is contracted through Heartland Family Services. Both offer a 24-hour safe place providing psychiatric stabilization and case management for individuals 18 years and older experiencing a mental health crisis who don’t meet criteria for hospitalization. The programs strive to stabilize clients and assist them in returning to the community where they live. When staff are available, Harbor Point can provide transportation to clients referred/accepted into their program. The length of stay is expected to be three to five days and is completely voluntary.

Heartland Family Service Crisis Stabilization Community-Based Services (CSCBS) began operations in January 2023. CSCBS provides crisis stabilization services to adults 18 years and older experiencing crisis in order to help them stabilize and remain within the community they live. This service is provided in the client’s home or community rather than a residential setting. Heartland Family Service CSCBS team provides access to psychiatric care, medication, therapy, outside resources and peer support to help in the client’s journey. The duration of this service is three to five days and is completely voluntary.

Children’s CSRS and Children’s CSCBS: SWIA MHDS continues implementation of Children’s Behavioral Health Services including Children’s Crisis Stabilization Residential Service (CSRS) which is set to open sometime in 2023. Children’s Square USA will be the provider of this service and will begin with two beds and grow from there. Once the CSRS begins service, Children’s Square USA will plan for implementation of Children’s Crisis Stabilization Community-Based Services (CSCBS). Both services will operate similarly to those mentioned previously that serve adults.

Crisis Service Coordination: The Region started a soft roll out of the Crisis Access Network’s Service Coordination on January 25, 2021. This soft roll out was designed to begin working on the warm hand off between the CAN Crisis Services previously mentioned and the Region’s Crisis Service Coordination. Crisis Service Coordination is a voluntary service available to all adults and children who were served by CAN Crisis Services. Crisis Service Coordinators follow up within 24 hours of the referral from the CAN Crisis Service provider and continue to follow the individual for at least 30 days, ensuring that the appropriate Mental Health and Substance Use services are set up for the individual. After 30 days, the Crisis Service Coordinator completes a Follow-Up Questionnaire with the individual to ensure the appropriate services are in place and then discharges the individual from crisis service coordination if they no longer require assistance. 

Utilization of the Crisis Access Network Through March FY23

An example of the hard work and dedication of the CAN process is the following success story.

The first Crisis Stabilization Community Based Service (CSCBS) client was a 78-year-old Council Bluffs woman who was referred by a local medical clinic. She had recently suffered the loss of her husband and she exhibited signs of needing additional support in multiple spectrums ranging from emotional to financial. Heartland Family Service (HFS) is the agency that has stepped into the role of providing staff which aids community-based crisis clients in their first few days. A referral was then made to the Southwest Iowa Mental Health and Disability Services Region which is a Crisis Access Network (CAN). A Regional Crisis Service Coordinator was assigned to help this client and supported her for 30 days. A warm hand-off meeting occurred between HFS staff and regional staff so that this client knew the plan and who she could reach out to directly if she had any questions.

This client was also assigned to a Case Coordinator with the Heartland Family Service Certified Community Behavioral Health Clinic (CCBHC) which is not a Crisis Service but still an important part of the coordination process. 

During the 30 days this client was connected to services through the help of the CAN including being linked to a financial service that could assist with her heating/cooling bills, food pantries, (even a pet food pantry for her dog) as well as non-food pantries to help make her limited income stretch father. This client was also provided a resource for a local grief group that HFS holds weekly. Numerous collaboration efforts were made to agencies such as the Council Bluffs Social Security office, Pottawattamie County Veterans Affairs offices as well as West Central Community Action. Updates were also provided with her doctors and providers through the local Medical Clinic to make sure they were updated on her progress. Once her 30 days with the CAN came to an end a final collaboration meeting occurred with CSCBS, the Region Crisis Service Coordinator and HFS CCBHC staff.

During her closing meeting she reported she strongly agreed she is overall better able to deal with crisis since her contact with the CAN team and she benefitted from the services she received. She did state she disagrees she can deal with her daily problems effectively as she feels she needs to continue working on this and getting the support she needs. She reported she is still very heartbroken over the loss of her husband and feels she continues to get overwhelmed and is not able to deal with her daily problems on her own. She told staff she does feel the assistance provided from the CAN team has helped and she has gotten connected to the supports she needs. She is collaborating with her HFS CCBHC Care Coordinator who will be able to follow her long term and assist with her needs moving forward. This client was very appreciative for everyone’s help and expressed she felt like there was an outpouring of support in her time of need when she did not know where to start or whom to turn to. She conveyed to staff she felt like all she kept doing was telling people “thank you” over and over but then she decided one day she was going to start using the word grateful as that is what she was, “oh so very grateful” for all the help, support, and guidance she received. *Client gave permission to use her success story.