Contra Costa County recently unveiled its new A3 (Anyone, Anywhere, Anytime) community crisis initiative that will use mostly Measure X funds to bring mental health professionals into the field of county first responders.

County leaders and members of Contra Costa’s health services department gathered virtually Jan. 12 to discuss A3’s rollout, its significance, and how the county hopes to become a model for other municipalities to prioritize getting the right responders in front of metal health emergencies.

The system will start with the Miles Hall Community Crisis Hub, a call center named after the young African American man shot to death by Walnut Creek police in 2019 while having a mental health emergency in front of his family’s home.

Hall’s death strengthened local calls to have trained metal health experts available to deal with such situations, instead of untrained police.

“We realized that sending a police officer to respond to every crisis situation is not what is needed,” said county Supervisor Candace Andersen, in whose district Hall’s family lived. “When we saw the tragedy that unfolded in Walnut Creek with the death of Miles Hall, in June of 2019, the board of supervisors requested that county health do more. Do it a little bit faster; this became an urgent priority.”

Pilot project with plans to expand

A3 is currently a pilot program that will expand into a fully staffed, 24-hour service over the next 18 months. Calls will be triaged by trained personnel and response teams will include behavioral health specialists, who will coordinate with other first responders.

The new system comes after two years of brainstorming between health officials, police and fire agencies, county supervisors and officials from various Contra Costa cities.

“In designing this initiative, we put the experience of those with ‘lived’ experience and those in need in our community at the forefront; that was really the driving force behind the design,” said Anna Roth, Contra Costa’s health services director.

“It’s not a program just to address crisis needs; it’s really aimed at transforming the entire mental health care system and emergency response.”

“These are the kind of programs that will transform and save lives that, for generations unfortunately, have had to struggle to survive, along with their families, and their communities.

Rep. Mark DeSaulnier

The program got a boost at the end of 2021, when supervisors directed $5 million of one-time Measure X funds its way, while dedicating the program another $20 million in ongoing funds.

Local Congressman Mark DeSaulnier, D-Walnut Creek, got $2 million in federal funding for the program. He spoke at Wednesday’s unveiling, saying the issue was personal for him as he approaches the 32nd anniversary of his father’s suicide.

“These are the kind of programs that will transform and save lives that, for generations unfortunately, have had to struggle to survive, along with their families, and their communities,” DeSaulnier said.

He said it has been “wonderful watching this county show leadership.”

“It will be a national model — it is a national model, and I’m happy we’re contributing to it,” DeSaulnier said.

A flow chart illustrates how mental health calls routed through the A3 crisis response team are handled, with some going to 911 while others are processed through the Miles Hall Community Crisis Hub. (Image courtesy of Contra Costa Health Services)

The ‘fourth arm’ of emergency services

Chad Pierce, a county mental health programs manager, laid out how the program will function, as it becomes the “fourth arm” of emergency response, along with police, fire and paramedics.

“Sometimes they don’t have the skills, training and knowledge to appropriately address a mental health crisis that impacts so many in Contra Costa,” Pierce said. “So what happens is, instead of appropriate care, compassion and support, far too often people during a metal health episode are stigmatized and criminalized, preventing them from getting the help they need.”

Pierce said one in five U.S. adults have behavioral health issues, which are the third most common ambulance calls nationwide. Calls will go to either 911 or the hub, which will refer the call to one of three teams based on severity. Some will be managed through the phone, others will require dispatching a team to the scene for an assessment, which could involve traditional responders.

“While we want to lessen the need for law enforcement, we do recognize that sometimes that is an appropriate response,” Pierce said.

The team will also determine whether the patient needs to be transported to a health facility or another destination.

There’s a mobile response team already in service, and more call center personnel will be hired by spring. Response teams will start expanding this summer, as software and other technology gets added to the hub. The system should be fully staffed and operating 24 hours a day by June 2023.

Currently, anyone experiencing a mental health emergency in Contra Costa can call 911 or contact the county team at 833-433-2672 or 877-441-1089 for those under 21. Communications will eventually be consolidated.