Integrated Care Team (ICT1)

WPD has been part of ICT1 since its pilot inception in 2019. With increasing calls related to mental health, it was important to develop a team comprised of law enforcement, paramedics, and mental health professionals to assist those in crisis and allow patrol officers to be available for emergency calls. WPD was instrumental in implementing the program and in seeking continual funding for this program beyond the 90 day pilot period. The efforts of this integrated team have positively impacted working with citizens in crisis and providing the best quality services to the community.

Currently, ICT1 is a multidisciplinary, co-responder program aimed at providing resources to those in the community experiencing a mental health crisis. The team is a collaborative effort between Sedgwick County and the City of Wichita and is comprised of a Qualified Mental Health Professional, a Law Enforcement Officer, and a Paramedic. They respond to the emergent mental health crisis in the community, identified through the 9-1-1 system and the COMCARE Crisis system.

Participating agencies in the ICT1 program are WPD, Wichita Fire Department, Sedgwick County Emergency Medical Service (EMS), and COMCARE. The comprehensive team responds to patients who are experiencing suicidality, substance use issues, psychosis, delusions, and many other mental health issues.

Team Composition

The composition of the ICT-1 team was carefully chosen to be a team that encompasses as broad a range of issues surrounding mental health as feasible, with the understanding that mental health crises are complex, multifactorial events with treatment implications reaching into many different disciplines. We also recognize that when another agency is added to the chain of care surrounding patients experiencing a crisis, there is an addition of wait times, transfer of information, and loss of efficiency.

The ICT-1 team is comprised of three team members who respond to mental health emergencies from a dedicated response vehicle. This personnel and the dedicated issues they are targeting are:

1. A Masters level licensed (LMSW, LMFT, or LMLP) Qualified Mental Health Professional (QMHP) provided by COMCARE with specialty expertise in mental health emergencies. The QMHP responsibilities include:
• Assessment of mental health emergencies
  
• Providing interventions including but not limited to:
• Safety planning
• Referral to resources
• Crisis intervention
• Placement of involuntary court holds when a patient is unable to make safe decisions for themselves
2. A Law Enforcement Officer (LEO) provided by Wichita Police Department. The LEO responsibilities on the team include:
• Team safety and safety of the public
• Enforcement of involuntary court holds
• Individuals may not be able to fully comprehend the gravity of their situation due to psychosis or suicidality. In these situations, based on the judgment of the Qualified Mental Health Professional, an involuntary court hold may be placed on the patient to ensure their safety and transition to a safe environment with definitive care. The law enforcement officer enforces the hold and may place the individual in protective custody to ensure their continued safety.
• Coordination and liaison with other police officers in delicate situations
3. A Paramedic provided by Sedgwick County EMS. The responsibilities of the Paramedic include:
• Medical assessment of the patient and identification of medical issues that can lead to behavioral emergencies
• Medical clearance of mental health patients to streamline in-hospital treatment
• Medication administration for mania and psychosis –
• Minimal intervention necessary to achieve safety
• Decision to chemically sedate combative and aggressive patients

Successes

After a one year evaluation of the program, it is showing great success. Here are some of the highlighted successes between July 2019 and July 2020.

1. Disposition type of each call. The end result of each request for assistance that ICT-1 is dispatched to is categorized into predefined categories for tracking purposes. The categories tracked as well as the number of calls that were assigned to each category and percentage of calls are as follows:
   
   
   
2. The number of emergency response units that have been freed up by ICT-1. Individually, how many fire apparatus, ambulances, and police officers were taken off of or not assigned to mental health calls because ICT-1 was responding. ICT-1 freeing up these resources allows for these units to stay available for more acute medical, fire, and law enforcement emergencies and creates increased readiness of the emergency response system.
   
3. The number of transports to COMCARE Crisis Center avoided. By tracking the number of times that a visit to COMCARE Crisis Center was averted, we measure not only increased readiness in COMCARE Crisis but also instances where individuals who were unable to make it COMCARE Crisis were able to be served.
   
4. The number of Emergency Department visits avoided. Many mental health crises are transported or directed to local emergency rooms for treatment, which can overwhelm resources in the Emergency Department as well as have downstream effects with bed placement and inpatient hospital stays.
   
5. Percentage of patients treated in place. One of the primary goals of ICT-1 is to bring appropriate treatments to patients in the community rather than expect the clients to get to the help they need. ICT-1 is tasked with implementing creative and measured interventions with the intent of keeping clients in the community, so they remain connected to their families and support systems. This measure is benchmarked against similar programs in Colorado Springs and Tulsa, with a goal of 50-60% treat in place being considered optimal.