Whether a broken down car, a burning home or broken arm, everyone wants help fast when a friend or family member is in crisis. The length of time between the crisis beginning and help arriving is critical and can feel eternally long.
Meridian Behavioral Healthcare is spearheading a new project to cut down that time for people in mental health crisis with something called a central receiving facility. The project started as a dream 13 years ago, but with city, county and state funds, Meridian hopes to open the doors on the new project next summer.
Don Savoie, president of Meridian, said the team can finally realize the vision to help residents from across North Central Florida.
“It's going to reduce trauma, it's going to coordinate better and, over time with the high need/high utilizers folks with severe and persistent mental illness, we're going to be able to, from a recidivism standpoint, get them where they need to be nearly immediately,” he said.
Just as Gainesville and Alachua County serve as a shopping and employment hub for many surrounding communities, Savoie said the same dynamic applies to mental health. Four facilities in Gainesville—Meridian, UF Health Vista, HCA Florida North Florida Hosptial, and the VA Center—also work with patients from Gilchrist, Levy, Dixie, Union and Bradford counties.
Many patients come voluntarily seeking help, while others come through mandatory submissions by law enforcement. The central receiving facility will care for both and better coordinate the confusion of the current system.
Currently, law enforcement might bring patients to any one of the four licensed centers, regardless of past treatment. And if one facility is full, that could mean another trip to another facility, increasing transportation costs, the time an officer is off patrol, and trauma for the patient.
“It's very disjointed and disconnected the way we operate today,” Savoie said. “And some of it’s federal law and just how it's put together.”
He refers to it as Groundhog Day.
Because of federal HIPPA (Health Insurance Portability and Accountability Act) regulations, a Meridian clinician can’t call UF Health and ask about a patient's history—former visits, current medication or doctor. A coherent patient or family member can provide those details, but that information can get lost during a crisis.
With the central receiving facility, all law enforcement will bring patients to Meridian’s center, located at its main campus on the southwest corner of SW 13th Street and Williston Road. Unless a person specifically requests a certain provider, Meridian will be ready to assess and assign treatment at one of the four mental health systems.
It’s a coordinated entry system in the mental health network, and Savoie says it’ll be a win for patients as well as law enforcement.
Alachua County Deputy Dan Maynard said he’d rather law enforcement not be involved with mental health decisions, like whether to mandate treatment through the Baker Act.
“If it were to ever go to vote: ‘Should cops have Baker Act powers?’ I’d be the first one to mark ‘no.’ I know how much authority is bestowed upon me by the statute, and I don't take it lightly,” he said.
Maynard serves as part of the co-responder teams for the Alachua County Sheriff’s Office (ACSO). The office started with one team in 2021 and added a second in November 2022. A team is comprised of one ACSO deputy with one clinician from Meridian.
The teams respond to mental health calls, serving as the first to begin dealing with individuals in crisis.
Though law enforcement isn’t trained to give treatment and mental health issues aren’t criminal, someone dials 911 and deputies respond. If it’s a mental health issue, deputies call on the co-responder teams.
Nicole de la Cruz serves as the clinician with Maynard. She said the foundation of the program is that individuals with mental illness will inherently interact with the criminal justice system.
“Our whole program purpose is to divert people from the highest restrictive methods to the least,” de la Cruz said.
The teams work with the subject of the call to move from a restrictive Baker Act to voluntary treatment check-in or from jail to a Baker Act. Often the teams work with “high utilizers,” individuals who they’ve responded to multiple times.
From April through June, the two teams had 615 calls for service. Those calls for service resulted in nine voluntary transports, two jail diversions, 32 Baker Act diversions and two emergency room diversions.
The teams also signed off on 31 Baker or Marchman acts (laws that trigger involuntary examination), requiring transport to one of the four approved facilities.
With central receiving, the teams won’t need to choose a facility. They drive to Meridian where healthcare staff takes over.
Savoie said the facility will have two entrances, one for law enforcement drop offs and one for people who walk in. In test runs, he said the process for law enforcement takes eight minutes. Then the officers can return to their jobs.
For Gainesville and Alachua County, drive time to Meridian is short. But for Levy or Dixie counties, a Baker Act transport could mean multiple hours that an officer is out of service.
The quick transition also helps patients. Maynard and de la Cruz said law enforcement presence, especially for people in crisis, can cause more anxiety.
With the new system, Meridian can see if the person has been to the central receiving facility before and what treatment they entered. Savoie said Meridian can then call up the patients’ doctor at Shands or HCA Florida and arrange for transport to their care or treatment.
Savoie said Meridian and its partners took a step of faith when starting the project. Alachua County and the city of Gainesville both invested $500,000 for construction costs, and Meridian had enough funds to operate for 18 months.
Then, the Florida Legislature approved more than $1 million in May for annual operations. The state has previously funded nine other central receiving facilities.
Meridian hopes to finish construction next summer. The construction will add the facility onto the current Crisis Stabilization Unit building.
The Meridian team still has work to do, like finalizing construction plans and even creating a name.
Lauren Cohn, Meridian’s chief operating officer, said they want to soften the term ‘central receiving facility.’ It’s the wording used by state law, but she said the terminology is cold and often requires more education.
Savoie said Meridian will hire 29 additional staff for the facility amid shortages in the healthcare—especially behavioral healthcare—sector.
Still, he’s ready to put a plan 13 years in the making into action, despite the added pressure that will come.
“It's a little scary,” Savoie said. “It's a lot of responsibility for the staff of Meridian to provide this level of coordinated treatment and to get it right all the time for the folks that we're serving.”