Jennifer Pierce was riding shotgun with a paramedic at the wheel when her cell phone rang.
“How are you doing today?” Pierce asked. “What's going on?”
A woman on the other end said her heart was racing.
“Can we try to take some slow deep breaths together on the phone?” Pierce suggested.
Pierce is a psychologist with the Anchorage Fire Department. She heads a team that responds to people having mental health or substance use crises.
“We'll be there soon,” she told the caller.
Pierce used to be a beat cop. The crisis response team is a big shift from her job a few years ago, she said, before she went back to school for psychology.
“I felt like I was really ill-equipped to talk to someone who was suicidal, other than ‘I can take you to the hospital,’” she said. “But is that really what someone needed in the moment?”
Pierce is in charge of the Anchorage Fire Department’s Mobile Crisis Team. It’s part of a multi-agency approach to get people the care they need, while taking pressure off emergency response resources. Officials say the Mobile Crisis Team has been a huge success. In the five years since the program has been up and running, they’ve steadily served more people each year.
In the past, when the police or fire departments responded to emergency calls, they only had a few choices: the emergency room, jail or the city’s Safety Center, where they take people to sleep off intoxication. There really wasn't a great option for people having a tough time with substance use disorders or their mental health. But now, crisis response teams are getting those people help. They’re serving between 300 to 500 unique individuals a month, according to city data.
Assistant Chief Ben Lewis heads the fire department’s crisis response. Call volume for the Anchorage Fire Department has increased over 50% in the past decade, he said. A lot of those are mental health and substance use calls.
“Our Mobile Crisis Team has responded to 3,000 calls for service, year to date,” he said. “Our busiest ambulance in the city, just as a comparison, runs about 4,500 in a year, so the demand for services is very, very high for the Mobile Crisis Team.”
Crisis response is supposed to be similar to what someone could expect if they broke their arm, said Thea Agnew Bemben, a special assistant to Anchorage Mayor Suzanne LaFrance.
“What if there wasn't a way to get your broken arm dealt with very easily? We'd all be walking around with our arms at weird angles and then we'd all be wondering, ‘What's wrong with everyone's arms?’” she said.
The two teams are similar but target different situations. The fire department mostly deals with the overlap between physical and mental health and pairs a therapist, psychologist or social worker with an EMT.
At the police department, those social workers and therapists work with a police officer. That team, which started in 2023 and is called the Mobile Intervention Team, deals with the overlap between mental health and more criminal, violent activity.
There’s a two-person crew on at all times at the fire department. The police department’s team is on call during the daytime.
The teams are reconnecting people with support systems, helping them maintain or regain stability, and de-escalating situations, Agnew Bemben said. That makes it possible for patrol officers and EMS crews to respond to emergencies that are more in their wheelhouse. And it frees up emergency rooms and hospital beds, too, since the crisis response teams are usually helping people where they are.
Data show that about 80% of the time the situation is resolved just by talking on the phone or with a quick visit from the team, Agnew Bemben said. It might seem small, she said, but without that, unchecked mental health and addiction problems can escalate.
“If we don't provide positive help,” she said, “we are going to be encountering them through police and fire.”
Substance use and mental health challenges overlap with all sorts of other issues, Agnew Bemben said, like health problems and chronic homelessness.
At a recent press conference, Anchorage Police Chief Sean Case said studies by the department show mental health and substance use play a huge role in police shootings.
“Behavioral health is impacting some of these incidents, and when I say the majority of them, I’m talking like 90% of them,” he said. “It's a very high percentage.”
He’s excited, he said, that the crisis response programs make it possible to get people help before situations require a traditional police response.
Addiction and mental health challenges are also significant contributors to chronic homelessness, Agnew Bemben said.
“If it's just simply that someone is unhoused, it's not that hard for us to solve that problem,” she said. “But if they are unhoused and also dealing with a serious addiction or a serious mental health issue or the longtime effects of trauma, that is a much more complex picture to solve.”
More homeless people are already going into treatment as a result of crisis response and outreach teams, she said.
But most of the people the crisis team visits — about 70% — are housed, Agnew Bemben said. A lot of times it’s those visits that help keep people stable and in their homes, she said.
While most people just need a call or a quick visit, Agnew Bemben said, sometimes they need more. And while the city has behavioral health treatment programs, there are very few places available 24/7 to help stabilize someone in crisis. That will change this fall, when two crisis stabilization centers open.
Once those centers are operating, response teams will have a place to take people that can meet their needs, Agnew Bemben said. She said she hopes that will make it possible for people who haven’t gotten care to get back to a life that’s safer and healthier.
“Where they're more connected to their family, where they can maintain their housing and not be in crisis all the time,” she said.
On that front, Southcentral Foundation's Yeshjesh T’uh is expected to open this fall and Providence’s stabilization center should open by the end of the year.
