In an effort to reduce a strain on San Diego’s 911 response system, the city’s mayor announced the resurrection of a decade-old program to help its top abusers -- some who call hundreds of times a year.
“Every day, San Diego’s emergency 911 response system receives thousands of calls day and night for help from residents and visitors alike. Unfortunately, there is a very small group of individuals who call over and over and over again,” Mayor Kevin Faulconer said during a press conference Monday.
Faulconer announced the City of San Diego will partner with the county to revamp the Resource Access Program (RAP), which is a mental health initiative that tracks frequent 911 callers and provides assistance for long-term care.
RAP clients represent less than 1 percent of the San Diego population yet generates 20 percent of the emergency calls, according to Faulconer.
“They call because they don’t know how to get help, and while they may not need emergency assistance every time, they do need help,” he said. “They suffer from chronic homelessness, mental illness, substance abuse, disorders, complex medical conditions, or a combination of all of the above.”
The mayor said these frequent 911 callers are “among the city’s most vulnerable individuals.”
RAP measures the “vulnerability” of its clients by how many times they call 911, which paramedic Shawn Percival said is “a cry for help.”
These clients are then continually monitored by a data-driven system.
“All the ambulance and fire engines in the city have an iPad. And then they put every patient they encounter in the iPad. And then all that stuff gets aggregated into our system, where we surveil it and keep lists of the top users,” Percival said.
When first responders are then dispatched to a person who has a history of calling 911, RAP will intervene or assist crews once they arrive at a hospital to look ahead for long-term care.
“(The goal) from a system standpoint, to reduce their call volume, but from the patient standpoint, we want to give them the help they actually need,” Percival said. “Their needs are usually social, so we’ll interact with a lot of the social programs or addiction programs throughout the county and try to move the patient there where they can get the help they deserve.”
The director of the Psychiatric Emergency Response Team, Dr. Mark Marvin, called the majority of these calls “reactive” during “the very toughest times of their lives, psychiatrically.”
Faulconer cited that 40 percent of San Diego’s homeless suffer from mental illness and 90 percent of RAP clients experience homelessness.
Percival spoke at Monday’s press conference about one woman who benefited from RAP.
Julie was one of the top 10 users calling San Diego’s 911 response system, he said. She would call 60 to 70 times a year.
One day, Percival and his partner found Julie intoxicated on the beach with her boyfriend. Percival introduced himself and explained RAP to them.
“Surprisingly, Julie jumped up, woke up her boyfriend, and said, ‘Get up, today’s the day we change our lives.’ This is not normally how it goes for us,” he said.
Shortly after, Julie was taken to a detox center, and later, she was placed in long-term treatment.
“Our RAP team continues to support Julie with a variety of things. This includes getting a valid ID, her birth certificate, or anything else she needs to become more successful and self-sufficient,” Percival said.
Now, Julie lives in an apartment and attends regular therapy. She is aspiring for a career in a peer support role to help others who are going through what she went through. Percival said she is “serving as a role model.”
“I’m very happy RAP is back in action, expanding and helping people getting their lives back,” he said.
RAP began as a pilot program in 2008, and since its inception the city said it “reduce(d) their 911 calls and achieve(d) a higher level of stability.”
“In 2017, due to funding limitation, the program was reduced to one position. And not surprisingly, the number of callers jumped back up,” Faulconer said. “This puts a strain on our emergency system and takes first responders away from responding to critical public safety emergencies across the city.”
Two years later, in May 2019, the program was reinstated with paramedics and behavioral health staff, and now the reinvigorated program could be boosted by the county’s budget proposal which will be considered Tuesday.
“The budget that the county will consider tomorrow represents one of the single largest increases in behavioral health services in the history of San Diego County,” said County Board Supervisor Nathan Fletcher during Monday’s press conference.
If approved, Fletcher said RAP could become “an example not only for our region but for the rest of California.”
City leaders spoke about the mental health program outside Fire Station No. 1 downtown.