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Billings Fire Department crisis unit kept busy with mental-health calls

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BILLINGS — Yellowstone County is heightening its focus on the community's behavioral health with a framework plan. Part of that plan is to "prioritize increased access and bolster provider resources," which includes the Billings Fire Department's Crisis Response Unit or CRU that rolled out last October.

The unit is made up of a team of two that use a first response vehicle through the 911 system that can be dispatched to calls specifically related to crisis, trauma, and mental health, depending on the situation.

Not to be confused with the fire department's Mobile Response Teams, the CRU focuses on behavior health calls while the MRT is used similarly to an ambulance.

“We are an EMT by the city paired with the clinician by Rimrock (Foundation, an addiction treatment center) to help bring a medical component but also a mental health assessment,” said crisis response clinician, Ariel Dehart Tuesday.

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Ariel Dehart points to the Crisis Response Unit's resource box.

With a master's degree in social work and a license from the state, Dehart is part of two different teams assigned to respond to mental health calls.

She spends 12 hours a day, four days a week responding to calls with her EMT partner. Those calls can range from welfare checks to suicidal threats or things like supporting individuals experiencing a manic episode.

“Once I can get them closer to a baseline, then we can start thinking about like, what exactly happened here, can we help you see a provider? Can we take you to the women’s shelter? Can we take you to the Crisis Center?” Dehart said.

According to Billings public information officer Victoria Hill, the city has $250,000 budgeted for the CRU this current fiscal year, with part of that coming from marijuana tax dollars. That covers the cost of the EMT, the vehicle, and equipment. The Rimrock Foundation covers the cost of staffing the clinicians.

As of Monday, the CRU has responded to 871 calls.

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Ariel Dehart inside the CRU vehicle.

“Whether it’s just helping them breathe deeply or talking about something that is calming. There’s a lot of different techniques to help people start calming down,” added Dehart.

“Having individuals that are able to respond to scenes that are professionally trained in that type of stuff is definitely beneficial,” said Lt. Matt Lennick of the Billings Police Department.

He said it's a huge time saver for law enforcement agencies like his. Though the department's officers have been through crisis and de-escalation training, behavioral health isn't their main focus.

“Co-responding with the crisis response units to these types of calls, like making sure the scene is safe, everything is good. And if law enforcement isn’t needed and they can handle what’s going on, our guys get to leave,” said Lennick.

But the CRU wouldn't be directly involved in a situation like the one that occurred Sunday in Billings involving a suicidal man making threats. Police had a standoff with the man before he was taken into custody.

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Billings Police Department's LT. Matt Lennick

“For mental health calls that have an additional level of just being unknown, or there is maybe weapon involvement or threats…we’ll kind of just hang out and stage safely,” Dehart added.

Lennick said that because the CRU teams consist of civilians, they're not exposed to situations that could pose a threat to their safety but can treat affected individuals after the situation has de-escalated.

Dehart said it's a common approach used in other cities all over the nation allowing the teams to follow up with the subjects of their calls. The unit can provide resources or transport the person to places like the Community Crisis Center.

The CRU is just one small part of the county's Behavior Health Framework Plan.

“It’s inclusive to the Crisis Now Model and also helping all of the partners respond to behavior health in a new way,” said Zack Terakedis, the crisis coordinator for Substance Abuse Connect in Billings.

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Zack Terakedis of Billings Substance Abuse Connect

The 988 hotline is also a part of the Crisis Now Model. The county encourages those in crisis to call 988 instead of 911 as the line serves as an access point for substance abuse and mental health support services.

“988 is someone to call to help get that mental health service that you need. CRU, the crisis response unit, can then respond if you need the next level of care,” Terakedis said.

The county's framework plan is still evolving, but Dehart is hopeful additional CRU squads will be implemented in the future.

“We just pull all these extra things in, spend more time with them. Where the firefighters, police, it’s not in their realm to be able to sit and spend, and kind of dissect all these issues. They have to see what the issue is and they have to move on,” Dehart added.