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Shining LIGHT on a new approach to behavioral health calls

A new Las Cruces, New Mexico, program aims to better serve community members experiencing mental health emergencies

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Left to right: Mendy Fowler, LMSW; Korina Jimenez, FF-EMTP; Mychal Torres, FF-EMTP; Allison Stoner, LMSW

A woman calls EMS for help with minor medical issues several times a week but is really just suffering from anxiety.

A man waits until his condition is critical before calling for help because he is fearful of emergency responders.

A manageable mental health episode escalates when law enforcement responds with fire and EMS.

Every firefighter has experienced situations like these, often feeling helpless when they are not able to be more effective in how they respond. But now some emergency agencies are taking a new approach to these challenges.

The LIGHT solution

A new program in Las Cruces, New Mexico, is focused on better managing those in the community with mental and behavioral health crises. Known as Project LIGHT – Lessen the Incidence of Grief, Harm and Trauma – the program will include two teams, each consisting of a licensed mental health worker and a fire department paramedic. These teams will staff specially outfitted response vehicles and initially be available for response during peak hours, six days a week.

Launching in March, Project LIGHT is an expansion of the Mobile Integrated Health (MIH) program in Las Cruces, a community health outreach program that has been in place since 2018 and is coordinated by the Las Cruces Fire Department. That program was designed to better address the needs of those who are high utilizers of emergency services and diminish barriers to accessing health care for all community members.

Project LIGHT is a new program, but a commitment to community outreach is not new in Las Cruces. For over 25 years, the LCFD has run its Vecino (Neighbor) Program, where firefighters make daily phone calls to community members who are homebound or lack sufficient local support systems, just to check in with them. Making calls from the Vecino list “was one of the first things I did as a trainee,” LCFD Chief Jason Smith recalls.

The chief says his department of just under 200 personnel are overall supportive of the new program: “They see the calls we are tasked to go on. They’re hopeful that this will free up ambulances so they can go to the critical calls.”

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LCFD uses three differnet types of resposne units: Ford Explorers, Type II ambulance (shown above) and transit van with wheelchair lift.

Smith noted that the police department is also a “customer of this program” and has been providing referrals to the MIH program for the past six months. “I really want PD to be a resource,” he said. “When they get those difficult calls, they can say, you know, I have someone who can help you.”

Dispatchers are being trained to identify calls that are appropriate for the LIGHT response. Initially, the LIGHT team will likely respond along with fire and/or police, Smith said, “but the hope is, down the road, that this is the one resource they send and we’re not sending a police officer and an ambulance and a fire crew” on incidents that are straightforward welfare checks, as one example.

Funding for the new program has come from several different sources, including two federal grants that provide for capital expenditures and salaries. In addition, money is available through the Telshor Fund, a fund earmarked for community health that resulted from leasing fees from a local hospital. Smith said the program has “strong advocates on city council” as well as with Mayor Ken Miyagishima and City Manager Ifo Pili.

A major goal with Project LIGHT and other LCFD initiatives is to better assign resources to any given 911 call.

“If you have a concern about someone, I do feel in the current climate there may be a hesitation to call 911,” Smith said. He also noted that different response agencies have different approaches to problems, and some approaches may work better for different situations. For example, a person with a mental health crisis might be much more cooperative with someone trained in counseling and intervention vs. someone who is more focused on quickly solving a problem.

“We have to have a different approach and a different face on how we respond to mental health and behavioral crises so that they want to call us, they want to receive that help,” Smith said. He emphasized that this model does not remove police involvement from the equation, but instead allows for more options for treatment and outreach to those in need.

Smith said comprehensive data will be tracked in the new program, including dimensions such as normal response data, disposition of patients from calls, what interventions were provided, what kind of medical care was given and the overall trends in response. Clear data is important for the success and longevity of the program. “I’m the spreadsheet guy,” he said, laughing.

Getting LIGHT off the ground

When asked about lessons learned from this endeavor so far, Smith had a clear list:

1. Look at your own community’s specific needs. “You need to talk to the boots on the ground,” he said, adding that the needs in Las Cruces are quite different from those identified in other areas.

2. Find the right people. “You’ve got to have champions for the program,” he said. “We were lucky to have champions at multiple levels from elected officials all the way down to the firefighter medic who says, This makes a difference. I want to do this.”

3. Be prepared for adversarial relations that might result. “There are other agencies that are trying to do similar things,” Smith said. “But we’re not competing with each other. Unfortunately, there is enough of this need that everyone can provide their model of response” to help with mitigating the current crisis of community mental health.

Looking ahead to the program’s launch, Smith expressed confidence in the project teams. “My hat goes off to them that they are willing to take on this kind of response model,” he said.

Preventing ‘rekindles’

Ultimately, this program is about making sure resources are allocated in the best possible way, both for the community and members of the fire department.

“These calls for us on the fire side feel like rekindles,” Smith said. “We all hate that. Here’s a resource and the right people who can solve the problem, so it doesn’t rekindle. That’s amazing.”

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Take your department in the direction you want. Get expert advice on how to effectively lead your fire department. 20-year veteran Linda Willing writes “Leading the Team,” a FireRescue1 column about fire department leadership.