Success on the Front Line: Learning from the Virtual Crisis Care Pilot  

Scott Johnson

Program Officer

Elizabeth Ruen

Program Officer

In 2014, Helmsley’s Rural Healthcare Program funded a study to assess the unmet mental health needs across South Dakota. We knew there were many. Our program relies on data to help guide our strategy, and we sought a clearer picture of the ways we could start to make a difference. This work was followed by funding a task force that looked at the cross-section of the criminal justice system and mental illness early intervention.

As in many rural states, South Dakota’s mental health workforce is limited, and accessing services in a timely manner can be challenging. In-person mental health crisis response teams — which have proven effective in urban America by substantially reducing the need to transport individuals in crisis to jail or the hospital — are difficult to deploy in rural areas. As proponents of and early investors in telehealth, we saw an opportunity to overcome both the workforce and distance challenges with technology, and to support rural law enforcement officers who regularly respond to calls involving someone experiencing a mental health crisis.

In 2020, Helmsley helped launch a pilot project in South Dakota to test whether Virtual Crisis Care might be part of the answer. Virtual Crisis Care equips law enforcement with tablets providing access to psychiatric telehealth care. With the touch of a screen, an officer can link someone in crisis to a trained professional who can talk with them and assess how best to help. We believed this could be an invaluable tool to both support people and give officers much-needed options. As our Trustee, Walter Panzirer, has observed, without Virtual Crisis Care, “a mental health crisis [was] the only medical condition that could end a person up in jail.”

Based on the success of that pilot, the program expanded in 2021. Virtual Crisis Care now equips 23 South Dakota county sheriff’s offices, police departments in 10 cities, and probation officers in the First Judicial Circuit and Fourth Judicial Circuits with tablets, allowing even more officers to provide 24/7 access to behavioral health professionals via telehealth.

A Crime and Justice Institute (CJI) study found that eight of every 10 people who used South Dakota’s Virtual Crisis Care were successfully diverted from involuntary hospitalization or jail.

“Most often, people were able to remain at home and continue with their daily activities, avoiding the costs associated with hospitalization and the stigma of being transported by law enforcement in handcuffs,” the report said. CJI prepared “South Dakota’s Virtual Crisis Care Pilot Program: A model for rural states” on behalf of the South Dakota Unified Judicial System, and you can read the full report here.

Data in the report counter initial concerns that people might not be willing to engage with a mental health professional through video. Only five percent of the participants refused to engage or prevented the mental health professional from completing an assessment.

Of the 185 people who used Virtual Crisis Care from January 2020 through June 2021, 43 percent were dealing with suicidal ideation, 18 percent were suffering from depression, 15 percent were showing aggressive or disruptive behavior and 11 percent were threatening self-harm.

Program leaders say that the 80-percent diversion rate from involuntary hospitalizations can save counties money, but the vast number of agencies involved in mental health care make it difficult to quantify program-wide financial savings. One western South Dakota county was able to track a 15-percent savings on mental health costs and a 31-percent savings on Mental Health Board costs, according to the report.

Last month, Helmsley launched Virtual Crisis Care in Nevada, where the governor and state legislature have lent their support. Virtual Crisis Care is a way to better care for people in need of help while giving officers necessary tools and support and easing strain on hospitals. This is particularly true in rural areas (97 percent of our nation’s land), where mental health care is limited and law enforcement’s list of responsibilities is increasingly long. Perhaps most importantly, Virtual Crisis Care is keeping people out of jail. We encourage anyone who is interested in learning how to establish Virtual Crisis Care in your community or state to please be in touch with us.