Sarah Harding has a police radio and a bullet proof vest. She checks in with 911 dispatch as she starts her day.
But she's not a police officer. Harding is a clinical social worker with the Mental Health Association of the Southern Tier.
Meeting People In A Crisis
Harding goes on police calls when a person might be having a mental health crisis. Sometimes, people are a bit wary of speaking with her.
"They see you coming and [they say] 'who's that? what's that for?'" she said. "And then the police will explain, 'this is a social worker. We're trying to, you know, help people and meet people where they're at. And find, you know, the resources in the community to help.'"
Maybe the person needs some kind of support - with housing, bills, or medical care. Or maybe, the person simply needs someone to talk to.
Capt. John Chapman with the Binghamton Police Department said they are seeing an increase in calls related to mental health issues. Harding's help is welcomed.
"She's more expert in that field than we are," he said. "She may see signs that maybe this isn't necessary - to take these steps with somebody that we might have done, just because we were trying to be careful."
In other words, just to be careful, an officer might take someone - willingly or not - to Binghamton General Hospital's Comprehensive Psychiatric Emergency Program (CPEP).
Reducing Visits & Costs
The big picture is the state wants to avoid unnecessary hospital visits and free up Medicaid dollars for other things. Medicaid is the government-funded health insurance plan that covers people with low incomes and disabilities, as well as many elderly people.
From 2009 to to 2014, New York's Office of Mental Health made almost $2 million in Medicaid payments for CPEP visits in Broome County.
That's where Harding's new position comes in. From December through April, Harding's mobile crisis calls diverted 45 people from CPEP - about three-quarters of her visits.
It is like in-the-field triage. Health care professionals say that this kind of care is not only cheaper, it is often better for the patient.
New York is in the middle of a redesign of Medicaid. To enact it, government-funded not-for-profits around the state have started pilot programs like the mobile crisis unit, in part to reduce expensive emergency room visits.
Emily Pape works for Care Compass Network, a not-for-profit working with the state on the Medicaid redesign. Pape said the goal is a 25 percent reduction in emergency room visits overall. Another goal is teaching people about alternatives to the emergency room.
"Mental health and substance abuse services are really complicated in that there are lots of different services," she said. "It's not always obvious how to access them or what would be useful at any given moment."
A Given Moment
Chris Ramey was at work in Binghamton when he got help from mobile crisis. In an interview, he said he was upset with people in his personal life and going through a breakdown. A friend called for help, and Harding showed up.
"I just started to explain to her what was going on," he said, gesturing to his phone. "I showed her exactly what was going on, pictures and messages."
Now Ramey is in regular contact with Harding, along with one of her co-workers. The whole experience has been an eye-opener, he said. "There's more support out there if you're looking for it, if you need it."
Ramey does not have a therapist, though, and Mobile Crisis' ability to follow-up is limited.
Harding hopes the program eventually gets more staff. She often works extra hours, checking in on people she's met. "I actually downloaded the scanner app on my phone, so on my way home I'll listen," she said. "If I'm not too far out, I would go back."
If Harding is not on, CPEP has its own mobile crisis unit it can deploy, and police officers themselves are going through mental health trainings. So far, about 50 officers from around the county have been trained through the crisis intervention program.