MonroeCounty.gov; Adam Bello, County Executive

Monroe County Executive Adam Bello Releases Monroe County Mental Health and Substance Use Disorder 90-Day Task Force Report

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  • Short- and long-term goals identified
  • Diverts Low Acuity Mental Health calls from 9-1-1 to 2-1-1
  • Increases access, trust and connection between behavioral health services offered and the communities
  • Strengthens post-crisis supports
  • Dr. April Aycock Appointed Director Monroe County Office of Mental Health

Monroe County Executive Adam Bello today released the Monroe County Mental Health and Substance Use Disorder 90-Day Task Force report and findings. In addition, County Executive Bello announced a sweeping series of recommendations for changes to the way Monroe County delivers vital mental health and substance use disorder services to members of our community as a result of the task force findings.

“For far too long, our systems have failed to help the people who need help the most. It is time to stop the cycle of expending our resources in ways that do not deliver help to people when they need it. The immediate changes I am announcing today are just the beginning of our work: it is impossible for us fix a systemic problem by treating any one single symptom. We must make thoughtful, meaningful and equitable reform,” said County Executive Bello.

At Bello’s request, the Task Force was convened in September to examine how the county can and will do better in addressing systemic barriers by looking at our investment of $40 million in mental health spending and make recommendations for lasting changes, as well as identify both short- and long-term reforms that will improve the county’s delivery of mental health, domestic violence, child protective and other social services through the 911 emergency system.

“We have to find new methods when responding to individuals who are in crisis with mental illness,” said Monroe County Sheriff Todd Baxter. “We are seeing a continuous increase in mental health calls for service, and at times we are putting our police officers in situations that would be best suited for a response from our Mental Health professionals.  We are interested in being a part of the conversation that develops what that looks like. To be frank, we have created an environment where people are accustomed to calling 911 as a solution to a slew of non-law enforcement issues. I look forward to expanding the Forensic Intervention Team (FIT) to address gaps, safely expand the capacity for other non-law enforcement options, and strengthen our community’s capacity to address the full range of individuals’ long-term needs.”

The Task Force report, completed in January, was shaped by input from community members about their experiences and informed by forums held by the Commission on Racial and Structural Equity’s (RASE) Mental Health and Addictions subcommittee. The task force, which had a specific aim of improving the county’s ability to meet the needs of Black, Brown and Indigenous communities, recommended a number of immediate action items, while noting that these changes are just the start of what must be an ongoing process to transform not only the county’s behavioral mental health emergency and crisis response system but to seek to reform all of our systems.

“The 90-Day Task Force serves as a most welcome first step that launches a critically important discussion about how best to assure that persons from Black, Brown, Indigenous and other under-served communities enjoy the fullest access to mental health and substance treatment services.  While Monroe County has many outstanding providers, essential services have been uncoordinated and fraught with barriers to timely and sustained care. This report provides essential guidance; it will be incumbent on local community, regional, and state leaders to vigorously support efforts to assure that these recommendations—these aspirations—lead to meaningful actions. The County and the City must work in synchrony if the next generation of crisis services meets intended needs, and together they must involve our local health systems and diverse providers to develop effective, readily accessible care for all persons and families,” said Eric Caine, MD. Dr. Caine is a member of the 90-Day Task Force and the Commission on Racial and Structural Equity (RASE).

As a result of the Task Force’s work, the county will take these immediate steps to respond to behavioral health crisis calls with the most appropriate option, activating law enforcement only when needed:

  • Link behavioral health crisis calls that do not require an immediate, in-person response to 211/Lifeline for assessment, de-escalation and connection to support services

  • Expand dispatch options for crisis calls that do require a timely in-person response. This is also a longer-term undertaking, but in the immediate term will be advanced by:

    • Leveraging grant funding from the U.S. Department of Justice to expand coverage by the Forensic Intervention Team to create a 24/7 response capability;

    • Collaborating for other in-person (non law-enforcement) response options with mobile behavioral health crisis services available through the University of Rochester Medical Center’s Crisis team and the mobile team with Rochester Regional Health System’s Behavioral Health Access and Crisis Center;

    • Working in partnership with the City of Rochester as it rolls out its new Crisis Response Team, including the development of protocols for back-up support

The task force also determined that there is a significant need to increase access, trust and connection between behavioral health services offered and the communities being served. Ensuring that services are provided in culturally competent ways is necessary. A mid-term goal is to address these issues through educating both behavioral health, healthcare and human services providers and increased outreach to individuals, family members and community members so they can better understand what may be the most helpful services based on the situation and cultural beliefs.

Additionally, the task force identified a clear need for the county to strengthen its post-crisis supports in order to address the full range of individual needs and help prevent future crises. Over the next several months, the Office of Mental Health will focus on developing new community standards for crisis follow-up tailored to meet the needs of diverse individuals, increasing awareness of available follow-up resources, better linking care management services that follow a crisis and expanding the use of peer support for persons in crisis, especially persons from the Black, Brown and Indigenous communities.

Finally, as part of Monroe County’s efforts to improve Mental Health service delivery, County Executive Bello announced the appointment of Dr. April Aycock as Director of the Monroe County Office of Mental Health. In this role, Dr. Aycock will lead the implementation strategies surrounding the recommendations from the 90-day task force and spearheading the County’s efforts to bridge the gap between those in need of services and programs that can provide help.

“Dr. Aycock’s experience working in behavioral health, substance use disorder and health care settings have prepared her to take on the challenges of developing systems that address the multi-faceted challenges confronting our community,” said Bello. “She brings a unique lens of equity and a deep understanding of how these key issues intersect when it comes to delivering mental health services. For far too long, our systems have failed to help the people who need help the most and we must reimagine the way this county delivers critical services and care to individuals in crisis. I am excited to welcome Dr. Aycock as a key addition to the leadership team in Monroe County and look forward to her help in implementing the recommendations made by the Mental Health and Substance Use Disorder 90-Day Task Force.”

Dr. Aycock is a Licensed Mental Health Counselor and Master level Credentialed Alcoholism Substance Abuse Counselor. She is a graduate of the United Way African-American Leadership Development Program and earned her undergraduate and graduate degrees from the State University College at Brockport. She holds a doctorate in executive leadership from St. John Fisher College.

"I am honored to serve the community in the capacity of Monroe County Office of Mental Health Director. I am pleased that County Executive Adam Bello understands that mental health is a crisis affecting our community, especially our underserved communities. We must reimagine how our behavioral health systems provide critical services and care to individuals in crisis and their families,” added Dr. Aycock

During her decade-long career, Dr. Aycock has worked in various mental health and substance use disorder treatment settings, as well as taught and presented on topics related to mental health, substance use and diversity. She previously led the integration of substance use disorder services within the University of Rochester Medical Center Psychiatry Department’s Child and Adolescent Mental Health Outpatient clinic. Most recently, she served as Clinical Coordinator for the URMC Strong Recovery Adolescents and Young Adults clinic, where she provided supervision and consultation for integrated adolescent substance use disorder services within the URMC Department of Psychiatry. 

The full Monroe County Mental Health and Substance Use Disorder 90-Day Task Force report can be found on the Monroe County website at www.monroecounty.gov.

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