One of the most significant challenges in our health care system is the relationship between service providers and people who are experiencing behavioral health issues. Gaps in the health system effect many people struggling with mental health, mental illness, and substance use disorder issues, causing them to rely on 911, first responders, and emergency rooms to address their needs and get assistance. These inequitable gaps not only strain the emergency medical services (EMS) system, but they create barriers for people, no matter their age, race, gender, or sexual orientation, to access the help they deserve in order be a healthy person who contributes to a thriving community.
In Poulsbo, this is where an innovative, multidisciplinary, and person-centered partnership between the Poulsbo Fire Department and the City of Poulsbo comes in: the Poulsbo Fire Community Assistance, Referral, and Education Service (CARES) team.
When a person in distress calls 911 and is experiencing a behavioral health crisis, first responders in the field can make referrals to the CARES team – a crisis intervention-trained firefighter, a social worker, and a substance use disorder professional – to respond in the moment or through follow up. The team will help connect the individual to the wraparound services they need – medical, behavioral health, substance use disorder, and/or social services. The program doesn’t only serve Poulsbo, but has expanded its referral reach across much of North Kitsap – Poulsbo, Kingston, Suquamish, and even Bainbridge Island.
As Poulsbo Fire Captain Jake Gillanders put it, a purely medical EMS response “might be resolving the crisis at that moment, but there is no long-term benefit to the patient…” Instead, CARES can proactively help stabilize a person in crisis with supportive resources for the long term. This in turn helps more people stay out of crisis permanently, or to have fewer crisis events.
CARES helps people form new relationships with community partners like Fishline (a local food bank and comprehensive services organization), the Suquamish Wellness Center, the Port Gamble S’Klallam Tribe Health Center, and Believe in Recovery (a SUD treatment organization), and more.
CARES works alongside other health care and emergency providers across North Kitsap, including Kitsap Mental Health Services, Peninsula Community Health Services, Aging and Long Term Care, other fire departments, and police departments – and they want to continue to grow. One of the benefits of a multidisciplinary, multi-partner approach is that CARES can help identify gaps, try new solutions, and fill in gaps of the health system where the most vulnerable people are falling through the cracks.
In North Kitsap, CARES has found that people over the age of 65 who have co-occurring behavioral health and physical health conditions are particularly vulnerable and tend to have less access to the financial and relational support they need. In turn, their various needs tend to go unnoticed. Sometimes, EMS is the only entity that will “answer calls that other people can’t or won’t,” the team said. EMS, and in this case, CARES, is the only service that consistently responds to people in crisis.
Equity is built into the CARES team’s DNA.
The members of the CARES team truly value the individuals they serve and are thrilled to have the partnership of other community entities. Julie Rogers, the community support specialist, loves partnering effectively with other institutions. Gabbie Caudill, the team’s substance use disorder professional who also owns Believe in Recovery, values these partnerships as well because “being able to get things done is huge,” and allows the team to have a personal touch and connection with these individuals. After years of seeing people cycle through the EMS system time and time again, Capt. Gillanders loves seeing people finally be able to get the help they deserve, breaking that spiral. Similarly, Kimberly Hendrickson, the program’s manager, finds it fulfilling to tell people, “Yes,” when they need help – and not have it just be a temporary solution.
Poulsbo’s Fire CARES team is one of the Olympic region’s many innovative, effective, and equitable health care programs, responding creatively to unique challenges and working upstream to prevent behavioral health crises. Through their dedication, expertise, and partnerships with others, they are helping change North Kitsap into a more equitable place for everyone, promoting healthy people and thriving communities in the region.
Thanks you, Poulsbo Fire CARES!