The Salt Lake City Fire Department uses social workers to help manage mental health issues.

This story is part of the Salt Lake Tribune’s ongoing commitment to finding solutions to Utah’s biggest challenges through the work of the Innovation Lab.

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This story is about mental crises and suicide. If you or someone you know is in crisis, call 988 Suicide & Crisis Lifeline.

The man is deeply tanned, in his mid-sixties, and lives in a park near the Jordan. He is wearing no shirt and no shoes. His feet are injured and swollen.

You’re worried about the man. Does he need help? Does he have enough water to stay hydrated? What do you do when you are concerned about a stranger’s well-being?

A Salt Lake City resident concerned about one such man left a message with the city, which was forwarded to the Salt Lake City Fire Department’s Community Health Access Team (CHAT).

Two of the team members, Natasha Thomas and Sarah Bohe, responded to the referral on a July afternoon. The man was easy to find and after telling Bohe and Thomas that his feet were being treated asked for food and water for a day or two. After a quick trip to Smith’s for sandwiches and a few quarts of water, they promised to come back in a week.

(Rick Egan | The Salt Lake Tribune) A man receives food and water from Salt Lake City Fire Department CHAT members Natasha Thomas and Sarah Bohe.

The CHAT team consists of three social workers, Shannon Luckart, Sarah Bohe and Natasha Thomas. They help the city’s vulnerable population access services. They also accompany firefighters in mental crises, substance disorders and medical operations. Rather than sending someone to a hospital emergency room with a mental health issue, social workers can help de-escalate a situation. They help people refill their prescriptions, connect with therapists, or find drug use treatment programs.

“If you need me there to deliver a baby, you’ll be glad I’m there to deliver a baby,” said Kyle Lavender, fire department chief. “But if you’re going through a psychiatric problem or a real crisis, you’ll be really glad there’s a social worker and not just a paramedic.”

Dressed in gray t-shirts, black pants and work boots, the CHAT team is part of a growing body of “alternative responses” to mental health and psychosocial needs in Utah. The Salt Lake City Police Department has its own team of social workers. The mental health hotline — 988 — was launched nationwide just over a year ago. There is a Mobile Crisis Outreach Team (MCOT) and even the downtown Salt Lake City Library employs a social worker.

Often “it’s not about police intervention,” said Ana Valdemoros, a member of the Salt Lake City City Council, whose district includes downtown.

“It’s the mental health crisis that we see and we say it’s serious,” Valdemoros said. “This is something we need to address.”

(Rick Egan | The Salt Lake Tribune) Fire Department Chief Kyle Lavender and CHAT Program Manager Natasha Thomas discuss their Crisis Intervention Program on Friday, July 7, 2023.

(Rick Egan | The Salt Lake Tribune) Thomas is one of three licensed social workers who respond to calls when people are in crisis.

A tested model

Several other communities in the West have created similar programs. In 2021, Seattle is expanding a program that sends social workers along with firefighters, according to a Seattle Times report.

And in Arizona, social workers joined city fire departments more than a decade ago. One study concluded that “Social workers and social work students placed in these agencies benefit both firefighters and the community members served by the fire department through the application of crisis intervention principles and trauma theory.”

“There’s the trauma of the experience,” said Joanne Cacciatore, one of the study’s authors and a professor in Arizona State University’s School of Social Work, “and then there’s the trauma of being abused by the experience.”

Proper training for social workers in crisis intervention can be helpful in many settings, from the scene of a car accident to a hospital setting.

Cacciatore noted that in a study examining good grief counseling, animals proved to be the best support for humans. These non-speaking companions knew how to just show up and say nothing hurtful.

“No human group could touch animals,” she said, “which is sad.”

“If you are treated with compassion, tenderness and love, it will not be a nice experience if your baby dies, if your child drowns, if your husband dies in a car accident,” Cacciatore said. “When tragedy strikes, it’s not going to be pretty, but you can control additional trauma.”

(Rick Egan | The Salt Lake Tribune) Shannon Luckart offers to help those in need during the evacuation of a camp.

Bring resources home

Bob Meyers, a quiet man in his 60s, attempted a short walk in the scorching sun in July and fell, requiring an ambulance call.

He was fine — just dehydrated, but asked for resources that could help him stop drinking. The paramedics who responded called CHAT. Bohe and Luckart arrived, sat in Meyers’ dimly lit living room, and began to listen.

“I’m lonely,” Meyers explained. He’d seen every movie on Netflix. With a disability it was difficult to get outside. He used to love fishing and spending time in the mountains. He wanted to quit drinking, but found it difficult to do it on his own.

Bohe and Luckart looked at his meds, asked about his insurance, and talked about different groups he could join to make friends. Bohe told him about Utah Support Advocates for Recovery Awareness and gave him the organization’s number. When she returned to the office, Bohe also emailed the organization and asked them to call him.

(Rick Egan | The Salt Lake Tribune) Luckart and Bohe visit Bob Meyers at his home on Thursday, July 27, 2023. They offered Meyers resources to address his loneliness and self-reported alcohol abuse disorder.

Sometimes support means a visit to a hospital emergency room. But sometimes there are alternatives. Bohe, Thomas and Luckart help people create a safety plan or refer them to other services that can help them avoid a costly ER visit and a new bill to worry about.

“When people need the emergency room, we’re happy to use it, but it’s often a revolving door, so we want to be able to provide assessment and intervention immediately and on-site,” Thomas explained via text message.

According to data shared by Thomas, the CHAT team avoided emergency room visits on 42% of the calls they responded to from October 1, 2022 to June 30, 2023. And even if the immediate need is medical or requires emergency care, teams can escalate cases to CHAT for further follow-up and support.

“With so many of these calls where we just didn’t know what to do, the social worker is the right tool,” said department head Lavender.

(Rick Egan | The Salt Lake Tribune) Instead of sending someone with a mental health problem to a hospital emergency room, social workers can help people refill their prescriptions, contact therapists, or find substance use treatment programs.

“We’re not replacing firefighters,” he said. “We’re not replacing cops. We’re getting resources to patients’ homes exactly when they need them most.”

A growing team to meet growing needs

Courtney Giles, a homeless advocate and Green Team advocate at Wasatch Community Gardens, quickly concluded after meeting Thomas that she could use the CHAT team’s help with her homeless.

“It’s so important to stay calm and present in a crisis and to be there for that person and meet them where they are,” Giles said.

Giles was impressed with CHAT’s ability to do just that. When a situation spirals out of control or too many mental health crises occur at once, Giles says she feels confident in asking the team for help.

“I just thought, Wow, these women are amazing. Thank god for this team.”

(Rick Egan | The Salt Lake Tribune) CHAT is now working to hire four additional social workers to expand its service area and handle more calls after receiving additional funding from the city budget this year.

CHAT is a small, tight-knit group. Bohe and Luckart each have a unique combination of social work and firefighting experience. They’ve blended in well with the culture at Station 5 in the city’s 9th and 9th wards, where they’re on duty Monday through Friday from 7:30am to 8:30pm. They also spend several days a week in the downtown public safety service establishing, following up, and responding to referrals and calls.

From October 1, 2022 to June 30, 2023, the team answered 439 calls. It’s a small fraction of the 1,932 calls related to drug use or psychiatric treatment that the fire department answered during the same period.

CHAT is now working to hire four additional social workers to expand its service area and handle more calls after receiving additional funding from the city budget this year.

An expanded CHAT team could provide more resources and assistance to needy people in the city, but social workers can also be there when tragedy strikes at home.

At least they will listen and ask what they can do to help.

(Rick Egan | The Salt Lake Tribune)

Justin Scaccy

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