From left, CEO Scott Osiecki, Kate Kern-Pilch, second vice chair, and Maggie Tolbert, assistant chief clinical officer, with the ADAMHS Board, talk about care response at a Planning and Oversight Committee meeting on Wednesday, Sept. 13, 2023. Osiecki talked about what the board is focusing on as it plans for a non-police crisis response team in Cleveland.
From left, CEO Scott Osiecki, Kate Kern-Pilch, second vice chair, and Maggie Tolbert, assistant chief clinical officer, with the ADAMHS Board, talk about care response at a Planning and Oversight Committee meeting on Wednesday, Sept. 13, 2023. The ADAMHS board is moving forward with planning for a non-police crisis response pilot program. Credit: Stephanie Casanova / Signal Cleveland

The Cuyahoga County Alcohol, Drug Addiction, and Mental Health Services (ADAMHS) Board is working on a non-police crisis response program, but mental health advocates feel left out of the process.  

The ADAMHS Board is working with FrontLine, a community behavioral health center serving the county, to create a non-police crisis response — also called care response. 

Board members provided an update on care response during their Planning and Oversight Committee meeting on Wednesday. Scott Osiecki, CEO of the ADAMHS Board, said they are budgeting about $1 million for a pilot program. 

The pilot program would include five response teams, all serving Cleveland.

What is care response? Care response is a program where a mental health expert and often a paramedic respond to emergency mental health crisis calls. This program does not involve police at all.

FrontLine manages the County’s 988 suicide and crisis lifeline and already has an adult mobile crisis team and a child response team. 

‘You’re not involving the community’

Some mental health advocates raised concerns about the lack of community input in developing the program. 

During public comment at the meeting, Elaine Schleiffer said community members want a planning process that includes focus groups and input from residents who are most likely to use the program. 

Schleiffer is a co-founder of REACH (Responding with Equity, Access, and Community Healing), a coalition advocating for the expansion of crisis services in Cuyahoga County. 

“I feel concerned that the care response pilot program being envisioned in this building may look drastically different than the care response program ideas that exist in the community,” Schleiffer said. 

Rosie Palfy, a former member of the Mental Health Response Advisory Committee (MHRAC), echoed Schleiffer’s comment.

“The problem I have is, you guys are doing great work but you’re not involving the community,” Palfy said. “You’re not involving people in crisis, people who have loved ones who have been in crisis, in these discussions. There are many different care response models, and it appears that this is being done behind closed doors.”

Planning includes training dispatchers

In care response, behavioral health providers, often social workers, are the first to respond to behavioral health crises.  

In most existing programs, a team is made up of a licensed behavioral health professional and a peer support specialist or someone with lived experience with mental health or substance use disorder who has been through training and certification. Teams also often include an emergency medical services professional.

Osiecki said the board doesn’t know when the program will start. Planning will include figuring out how much the program will cost and training 911 dispatchers to identify what would constitute sending a care response team instead of police, EMS or fire response.  

Osiecki said there was community input in the recommendations that Dr. Mark Hurst, a psychiatrist and healthcare consultant, gave the board in May

Schleiffer, who was involved in some of those meetings, said the process for that report was a handful of meetings with leaders of behavioral health agencies and some advocates. 

She said the meetings did not include direct community outreach.

“I think there are still big gaps in what we need to know about how to best serve the people who need care response the most,” Schleiffer said. 

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Criminal Justice Reporter (she/her)
I write about the criminal legal system, explaining the complexities and shedding light on injustices/inequities in the system and centering the experiences of justice-involved individuals, both victims and people who go through the criminal legal system and their families. I highlight ways in which Cleveland residents are working on the ground to reduce crime to make their communities safer.