Content warning: This article discusses mental illness and has mentions of hospitalization, substance use and suicidal ideation.

When someone in crisis calls Trilogy Behavioral Healthcare’s First-response Alternative Crisis Team, a mental health professional picks up the phone. Pairs of FACT responders drive out to Evanston, Skokie or North Chicago to make safety plans with callers.

“What we’re doing is trying to help that person who is in crisis figure out essentially the warning signs for when they’re in crisis,” said Jenna Shwaiko, a FACT peer engagement specialist. “And, more importantly, what they can do when they’re in that crisis.”

What is FACT?

Trilogy, a Chicago-based mental healthcare organization, won an Illinois Department of Human Services/Division of Mental Health grant to develop a mobile response crisis team that provides an alternative to 911 for people in mental health emergencies. FACT launched on Jan. 10 and responds to people from northern Chicago to Evanston and Skokie. 

The crisis line number is (800) FACT-400 or (800) 322-8400. FACT actively responds to calls from 8 a.m. to 4:30 p.m., though the crisis line is staffed for 24 hours. Caitlin Smeele, an engagement specialist for FACT, said the team plans to expand hours in mid-March and then operate at 24 hours a day in the next few months.

Smeele said calls to FACT have increased since early January. They now get at least two or so calls a day, she said.

“The more we get the calls, the more we see that there really is a need for this type of service,” Smeele said. “There’s a lot of people that I think we’ve been encountering that have kind of gone for quite some time without any mental health assistance.”

How does FACT relate to the police?

Former Ald. Cicely Fleming (9th) said a community call to defund the police sparked the formation of the Alternative Emergency Response Subcommittee in 2020. The subcommittee was responsible for developing a non-police response for community members in need of immediate support. 

Fleming and Ald. Eleanor Revelle (7th), who also serves on the subcommittee, said they wanted to avoid a co-responder program where mental health workers accompany police officers.

“We’re looking for the first step of a holistic treatment service provision, and one that was not a co-responder model,” Fleming said. “That was really important to the community and really important to us, because even having a mental health specialist there with the police really sent mixed messages.”

While City Council pushed for the program, the money for the program doesn’t come from the city. The state offered grant money for crisis services, which Trilogy applied for and won.

Other communities have instituted similar programs. In Eugene, Oregon, a mobile crisis intervention program has run for almost 30 years. 

FACT largely operates independently of the police. FACT responders are sometimes escorted by police in situations FACT deems dangerous, but they try to avoid it, according to Team Lead Zahra Ahmed. The team already meets people at their most vulnerable and doesn’t want to escalate the situation, Ahmed said.

Richard Eddington, the Evanston Police Department’s interim police chief, said he supports the development of an alternative mental health crisis response.

Officers can’t currently transfer calls directly to FACT, he said, but police could contact them after responding to a call. Police could also direct FACT to a community member for a wellness check, Eddington said.

What does FACT do when you call?

FACT aims to help people in crisis avoid hospitalization. However, when the team is unable to make a safety plan with a caller and thinks they have active intent of harming themself or others, they sometimes do decide to hospitalize people, Smeele said. Depending on risk, comfort levels and police involvement, the team or an officer drives people to the hospital, she said.

Peer engagement specialists like Shwaiko also respond to each call. Peers are people who are themselves in recovery from substance use or mental illness.

“If working with somebody who we really think needs to be hospitalized, it’s helpful for me to say, ‘Hey, I’ve been there, I know that it can be really, it can be a really hard experience,’” Shwaiko said. “‘And I also know that it can be really helpful and it can be a short term thing that will ultimately help you get better.’”

Moreover, Ahmed said the team often follows up on people’s cases after they’ve been hospitalized. Recently, she worked with a hospital social worker to ensure a patient had a place to stay upon being released.

“A lot of people think about crisis as just suicidal ideation and/or a psychotic break, but it’s not,” Ahmed said. “It’s housing issues. It’s lack of employment in the community. It’s the lack of resources.”

Ahmed said FACT is still developing its workflow as the program expands and settles. Because it covers a large area, one of the largest challenges has been building resource lists in the communities they serve, she said.

As the program grows, Smeele said she’s been happy to see the support it’s offered to community members in need.

“I definitely think it’s been going well,” Smeele said. “And I think it’s going to get even better.”

Email: [email protected]

Twitter: @avivabechky

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