This story is part of The Salt Lake Tribune’s ongoing commitment to identify solutions to Utah’s biggest challenges through the work of the Innovation Lab.
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This story discusses mental health 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 River. He doesn’t wear a shirt or shoes. His feet are injured and swollen.
You are concerned about the man. Does he need help? Does he have enough water to stay hydrated? What do you do when you’re concerned about a stranger’s wellbeing?
One Salt Lake City resident worried about just such a man left a message with the city that was passed on to the Salt Lake City Fire Department’s Community Health Access Team (CHAT).
Two of the teams’ 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 he was receiving treatment for his feet, he asked for a day or two’s worth of food and water. After a quick trip to Smith’s to pick up sandwiches and a couple of gallons of water, they promised to return in a week.
The CHAT team is made up of the three social workers — Shannon Luckart, Sarah Bohe and Natasha Thomas. They help the city’s unsheltered population connect to services. They also accompany firefighters on mental health crisis, substance use disorder, and medical calls. Rather than sending someone with a mental health issue to a hospital emergency room, the social workers can help de-escalate a situation. They help people get their prescriptions refilled, connect to therapists or find substance use treatment programs.
“When you need me there to deliver a baby, you’re going to be glad I’m there to deliver a baby,” said Kyle Lavender, fire department division chief. “But when you’re having a psychiatric problem or a true crisis at that moment, you’re going to be really glad there’s a social worker, not just a paramedic.”
Dressed in gray t-shirts, black pants and work boots, the CHAT team is one part of a growing number of “alternative responses” to mental health and psycho-social needs in Utah. The Salt Lake City Police Department has its own team of social workers. The mental health hotline–988–launched across the nation a little more than a year ago. There’s a Mobile Crisis Outreach Team (MCOT), and even the downtown Salt Lake City Library employs a social worker.
A lot of times, “it is not a matter of police intervention,” said Ana Valdemoros, a Salt Lake City Council member whose district includes downtown.
“It’s the mental health crisis that we’re seeing and we’re saying it’s serious,” Valdemoros said. “It’s something that we need to address.”
A tested model
Several other communities across the West have created similar programs. In 2021, Seattle expanded a program that sends social workers out with firefighters, according to reporting from The Seattle Times.
And in Arizona, social workers joined municipal fire departments more than a decade ago. One study concluded that “using principles of crisis intervention and trauma theory, social workers and social work students placed in these agencies are benefiting both firefighters and community members served by the fire department.”
“There’s the trauma of the experience,” said Joanne Cacciatore, one of the study’s authors, and a professor in the School of Social Work at Arizona State University, “and then there’s the trauma of being mistreated through the experience.”
Having social workers properly trained in crisis intervention can help in many settings, from the scene of a car crash to a hospital.
Cacciatore noted that in one study examining good grief support, animals proved to be the best support for humans. Those non-speaking companions knew how to simply show up and not say something hurtful.
“No human group could touch animals,” she said, “which is sad.”
“If you’re treated with compassion and tenderness and love, it’s not going to make it a beautiful experience when your baby dies, when your child drowns, when your husband dies in a car accident,” Cacciatore said. “When tragedy hits it’s not going to make it beautiful, but you can control additional trauma.”
Bringing resources home
Bob Meyers, a soft-spoken man in his sixties, tried going for a short walk in the baking sun in July and fell down, prompting a visit from an ambulance.
He was OK — just dehydrated, but he asked for resources to help him quit drinking. The paramedics who had responded called for CHAT. Bohe and Luckart arrived and sat down in Meyers’ dimly lit living room and started listening.
“I’m lonely,” Meyers explained. He’d watched every movie on Netflix. Getting outside was tricky with a disability. He used to love fishing and spending time in the mountains. He wanted to stop drinking, but he struggled to do it on his own.
Bohe and Luckart looked at his medications, asked about his insurance and talked about different groups he might join to make friends. Bohe told him about Utah Support Advocates for Recovery Awareness and gave him the number for the organization. Bohe also sent an email to the organization when she returned to the office, and asked them to call him.
Sometimes support means a trip to a hospital emergency department. But other times there are alternatives. Bohe, Thomas and Luckart help people create a safety plan or channel them to other services that may help them avoid a costly ER visit and a new bill to worry about.
“If people need the ED we’ll gladly take them but it’s often a revolving door so we want to be able to provide the assessment and intervention in the moment and in the field,” Thomas explained over text.
According to data shared by Thomas, the CHAT team avoided ER trips in 42% of the calls they responded to from October 1, 2022 through June 30, 2023. And even if the immediate need is medical or requires emergency care, crews can refer cases to CHAT for further follow-up and support.
“The social worker is the right tool on so many of these calls where we just didn’t know what to do,” said division chief Lavender.
“We’re not replacing firefighters,” he said, “we’re not replacing police officers. We are bringing resources to the patient’s home, when they need it the most.”
A growing team to meet growing need
Courtney Giles, an advocate for the unsheltered and a Green Team Advocate at Wasatch Community Gardens, quickly determined she could use the CHAT team’s help with her unsheltered clients after meeting Thomas.
“It is so important that when there’s a crisis going on, that you stay calm and that you are present and that you are available for that person and meeting them where they’re at,” Giles said.
Giles was impressed by CHAT’s ability to do just that. When a situation spirals out of control or there are too many mental health crises going on at once, Giles said she feels confident asking for the team’s help.
“I was just like, wow, these women are amazing. Thank God for this team.”
CHAT is a small, tight-knit group. Bohe and Luckart each have a unique combination of social work and fire department experience. They’ve fit in well with the culture at Station 5 in the city’s 9th and 9th neighborhood, where they are dispatched from Monday through Friday from 7:30 a.m. to 8:30 p.m. They also spend several days a week at the downtown Public Safety Building, doing follow-up and responding to referrals and calls.
From October 1, 2022 to June 30, 2023 the team responded to 439 calls. It’s a small portion of the 1,932 substance use or psychiatric-related calls the fire department answered during that same period.
CHAT is now working to hire four additional social workers to extend its service area and attend more calls after receiving additional funding in the city budget this year.
An expanded CHAT team could provide more resources and outreach to unsheltered people in the city, but the social workers can also be there when tragedy strikes at home.
At the very least, they will listen and ask what they can do to help.