Frequent Utilizers of Services in Allegheny County

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What are these reports about?

Nationally and locally, policymakers and practitioners are interested in the people who frequently use publicly funded services, particularly crisis services. Most people who use crisis services do so infrequently during a year. A small number of people, however, use crisis services frequently, and sometimes they use more than one type of crisis service.

Allegheny County’s rich integrated data allows us to look at the people who use crisis services. This report summarizes key findings about the people who were involved with one or more of the following four crisis services in the years 2016 through 2017: hospital emergency departments, emergency homeless shelters, mental health crisis programs, and the criminal justice system. This summary report will be followed up by reports examining each of these four service areas in more detail.

What are the takeaways?

  • Of the people who used at least one of the four crisis services examined, 6% (10,655) met the definition of frequent users in at least one system. They accounted for 26% of all service episodes during this period.
  • There is little overlap between frequent utilizers of one type of crisis service and another. Just 9% of users were frequent in multiple systems. This does not mean they didn’t use other services, just that they were not frequent users of those systems.
  • Nonetheless, 26% of frequent users of mental health crisis services were also frequent users of hospital emergency departments, indicating that the emergency room might be a point of intervention for people in mental health crisis.
  • All frequent users of emergency shelter were connected to other human services prior to their first shelter stay during this period. This overlap suggests that although frequent utilizers of emergency shelters were connected to supports, the reasons behind people’s continued use of shelter were not adequately addressed through the services they were receiving.

Black residents are using crisis services at disproportionately high rates, and the disproportionality is more pronounced when looking at frequent utilizers. While 13% of the Allegheny County population is Black, 42% of people who used crisis systems (both frequent and non-frequent) were Black, and 49% of frequent utilizers were Black.

How is this report used?

This work is meant to be exploratory and descriptive in nature to help continue and expand the conversation about how we look at frequent utilizers and potential interventions going forward. By looking more closely at this population of frequent utilizers, we hope to gain insight into their needs, identify key intervention points, and find ways to encourage long-term wellness while reducing the need for repeat intense service usage.

Where can I go for more information?

For questions or suggestions, please reach out to DHS-Research@alleghenycounty.us