Q: What is the JHU Behavioral Health Crisis Support Team (BHCST)?
A: The JHU BHCST is a co-responder program, pairing behavioral health clinicians with specially trained security personnel on every shift, seven days a week. The BHCST will provide immediate assistance to those who need it and, just as importantly, link individuals in crisis to ongoing university support services in the days and weeks that follow. For community members in crisis who are not directly affiliated with JHU, careful follow up and support will be facilitated by the BHCST but provided through Baltimore Crisis Response, Inc. (BCRI), a well-established and highly respected community organization with significant experience helping individuals in crisis throughout our region.
Q: Why is JHU developing the BHCST?
A: JHU is developing the BHCST in response to a growing need, as supported by data and a desire from our community, for a more comprehensive, public health response to individuals who may be experiencing a behavioral or mental health crisis on or around our Baltimore campuses.
Over the past year, we undertook an in-depth analysis of contemporary best practices and assessed our more traditional, security-based responses and interventions. We considered carefully the recommendations outlined in the 2018 report of the JHU Task Force on Student Health and Well-Being and were also guided, in developing this program, by Dr. Ronald Means, a locally and nationally recognized child/adolescent, adult and forensic psychiatrist and expert consultant in the field of behavioral health crisis services, and an Advisory Committee comprised of faculty, staff, students and neighborhood leaders. Through these multiple efforts, it became clear that many of the calls being addressed by Campus Safety and Security could be more effectively and appropriately handled by behavioral health clinicians.
Q: Currently, what happens if someone has a behavioral crisis at JHU?
A: While calls can come in from any number of sources, Johns Hopkins Campus Safety and Security officers are often the first and sole in-person responders to behavioral health emergencies within our university community. After Campus Safety and Security receives a call through dispatch, they determine if the call for assistance has a behavioral health component. In the case of a student, they contact the appropriate campus mental health center for consultation (e.g. undergraduates are referred to the Counseling Center). JHU students comprise nearly three quarters of the behavioral health calls received through dispatch. Immediate and follow-on care is then transitioned to one of these mental health centers if the incident occurs between 9am-5pm, Monday-Friday.
For behavioral crisis calls that occur on weekends or after business hours, Johns Hopkins works with ProtoCall, a 24-hour crisis hotline that offers immediate teletherapy and reports back to JHU student mental health services on the nature and status of each call. Clinicians typically do not respond on-site, providing clinical support remotely via phone or iPad. This process is facilitated by the Campus Safety and Security officer who has responded to the call and is present with the distressed individual.
For all other behavioral health calls, Campus Safety and Security often responds alongside the Baltimore City Police Department, as these calls are usually routed through 911 dispatch.
Q: What will this team look like in practice?
A: The BHCST will be comprised of licensed mental health clinicians with expertise in crisis care who will respond to behavioral health-related calls alongside crisis intervention-trained Campus Safety and Security personnel. In addition to initial triage and stabilization, BHCST will provide short-term counseling and case management to connect individuals with additional services if appropriate. If initial stabilization is not possible, the team will assist in seeking more intensive services such as hospitalization.
For community members in crisis who are not directly affiliated with JHU, careful follow up and support will be facilitated by the BHCST but provided through Baltimore Crisis Response, Inc. (BCRI), a well-established and highly respected community organization with significant experience helping individuals in crisis throughout our region.
Q: What types of calls will go to BHCST?
A: The JHU Behavioral Health Crisis Support Team will be dispatched as the initial response resource if a call for assistance is believed to have a behavioral health component, such as a request to check on someone’s well-being or a report of someone with suicidal ideations.
Q: Who will be served by this team?
A: This program will be available for anyone experiencing a behavioral health crisis on and around our Baltimore campuses, where the vast majority of our undergraduate and graduate students reside (only a fraction actually reside on campus). This includes Johns Hopkins students, faculty, staff, and our unaffiliated, Baltimore neighbors — in a moment of crisis, we will not adjudicate assistance based on affiliation status.
The benefit of integrating this team within our existing health and well-being framework is that we will be able to connect JHU students, faculty and staff who are interested in accessing longer term behavioral health services with additional resources and counseling beyond the initial mobile crisis response.
For community members in crisis who are not directly affiliated with JHU, careful follow up and support will be facilitated by the BHCST and provided through Baltimore Crisis Response, Inc. (BCRI), a well-established and highly respected community organization with significant experience helping individuals in crisis throughout our region.
Q: Is there a geographic focus for this program?
A: JHU developed the BHCST in response to a growing need for more substantive crisis services, as supported by data and a desire from our community, for a more comprehensive, public health-based response to individuals who may be experiencing a behavioral or mental health crisis on or around our Baltimore campuses. The BHCST responds to calls within the Johns Hopkins University Public Safety service area without regard to university affiliation; Public Safety provides services and responds to calls within a specified community boundary, including areas heavily populated by undergraduate and graduate students. Currently, the team serves the Homewood campus and surrounding area. We plan to expand coverage to the Peabody campus and Mt. Vernon area in fall of 2022 and then to the East Baltimore campus area over the next year. This scope reflects and honors the university’s commitment to respond to the safety needs of our student population.
Q: Why does Campus Safety and Security respond to calls involving community members?
A: In the fall of 2021, Johns Hopkins University launched the Johns Hopkins University Behavioral Health Crisis Support Team (BHCST) on and around the Homewood campus. This is a co-responder program, pairing behavioral health clinicians with specially trained public safety officers who will provide immediate assistance to individuals experiencing behavioral health crises and, just as importantly, link those individuals to ongoing support services in the days and weeks that follow. We plan to expand coverage to the Peabody campus and Mt. Vernon area in fall of 2022 and then to the East Baltimore campus area over the next year.
Q: When will this team be ready to support the JHU community?
A: Over the summer, we will begin hiring and training BHCST professionals and building their partnership with Campus Safety and Security and Baltimore Crisis Response, Inc. We plan to fully launch the new program on a pilot basis in the fall of 2021, first on and around Homewood and then expanding to our other campuses in Baltimore.
Q: Have there been additional measures taken to implement the recommendations presented by the Task Force on Student Health and Well-Being?
The Task Force recommended 3 broad recommendations on student health and well-being:
Promoting a climate of awareness and support for student mental health, wellness, and stress reduction
Improving student care and access at JHU mental health services
Expanding training on mental health awareness and resources for faculty, staff, and students
The university has made significant progress putting these recommendations into action. These include, but are not limited to:
Student Health and Well-Being has been restructured to leverage expertise and centralize efforts
Consolidation of mental health services under one SHWB portfolio allows for sharing of resources, producing university-wide programming thus creating greater consistency in student access and experience
Investment in staffing in all three university mental health offices and disability services
Enhanced training, outreach and programming to support under-represented populations
Online platforms and telemental health (e.g. TimelyMD) were implemented during the COVID-19 pandemic to remove provider licensure barriers across state lines
SilverCloud is now offered as an additional resource which provides a suite of evidenced-based programs on a confidential online portal that teaches users about mental wellness, and provides tips and tools for dealing with anxiety, depression, and stress
Enhanced faculty training and resources
Q: What have been the initial results of the pilot program?
A: In the fall of 2021, Johns Hopkins University launched the BHCST on and around the Homewood campus. Initially, clinicians served in designated shifts, but once fully staffed in March 2022, clinicians began covering all shifts on and around the Homewood campus 24 hours a day, 7 days a week.
Since the program launch – from October 27, 2021 through May 12, 2022 – the BHCST has responded to 44 calls on and surrounding the Homewood Campus, 41 of these calls were to assist students and 3 calls were to assist members of the community. During these calls, the BHCST clinicians have conducted safety assessments, provided compassionate listening, validation, and de-escalation, and helped the person in distress plan next steps. The BHCST clinicians have also had the opportunity to engage with students and staff through televideo evaluations when needed.