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May 16, 2023Austin-Travis County EMS can now offer a different solution to people experiencing a mental health crisis.
Instead of having to transport them to an emergency room or find a bed at a local mental health hospital, the Mental Health Paramedic Responders teams, part of Austin-Travis County EMS’ Community Health Paramedics division, can give an oral anti-psychotic medication to stop or lessen symptoms, including paranoia and hallucinations.
The drug is olanzapine, known by the brand name Zyprexa, but instead of giving it as a 10-milligram injection and transferring the person to a hospital, the Mental Health Paramedic Responders have been giving it as a 5-milligram pill that goes under the tongue and is absorbed.
This treatment allows patients to stay where they are and get follow-up care the next day.
Capt. Kim Griffith, who runs the Mental Health Paramedic Responders program, is collecting data to study its effectiveness. So far, she said, 75% of the people who have been given the oral olanzapine have not needed to be transported anywhere.
Griffith believes after the program’s research is done, Austin Travis-County EMS will be a model for other EMS providers. Only a few EMS systems in states including California and Massachusetts have tried giving the oral olanzapine instead of the injection.
Before this program, “unless a patient was well-insured, the only option was the ER,” Griffith said. “If we move them to the ER, where it’s loud, that’s not comfortable. They would have trouble tolerating the admissions process.”
The mental health EMS teams began using this oral medication option in November, after receiving approval from the Mobile Crisis Outreach Team at Integral Care, the mental health authority for Austin and Travis County.
What happens before a patient gets olanzapine?
The paramedics run through a standard risk assessment for suicide or whether patients are a threat to themselves or others, and whether the psychotic episode is related to alcohol withdrawal, dehydration or other factors.
Who can get olanzapine?
This medication is not for everyone experiencing a mental health crisis:
What happens after they receive olanzapine?
Olanzapine lasts from 21 to 54 hours. Patients who feel OK after taking it can stay where they are. Within 24 hours, they will be connected to their established psychiatric provider or the Mobile Crisis Outreach Team at Integral Care for follow-up care.
If they don’t feel OK, an ambulance can be called to take them to a mental health hospital or an emergency room, if there are no beds available.
“There is no version of it where we give it to them and just leave them,” Griffith said.
How is this program part of a bigger plan?
Capt. Darren Noak, a spokesperson for Austin-Travis County EMS, said that “all these years, EMS had one answer to all problems. Our answer was an ambulance to the hospital.”
This program and others, such as having EMS on site at the airport now, are about changing the paradigm to “the right patient for the right resource at the right time.”
Local mental health resources
Travis County: 512-472-4357 (Integral Care)
Bastrop, Elgin, Georgetown, Giddings, Gonzales, Hutto, La Grange, Luling, Marble Falls, Round Rock, Schulenburg, Seguin, Taylor: 800-841-1255 (Bluebonnet Trail Community Services)
Hays County: 877-466-0660 (Hill Country MHDD Centers)
Crisis phone numbers:
Suicide and crisis lifeline: 988
National Crisis Text Line: Text HOME to 741741
More resources:
NAMI Central Texas also has a downloadable Suicide Risk Assessment Card and a Mental Health Conversation Card. More resources are at NAMI Central Texas, namicentraltx.org.
This article originally appeared on Austin American-Statesman: Austin-Travis County EMS gives pill to help mental health crisis
