Frequent Utilizers of Services in Allegheny County

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

Current report and dashboard

What information about overdose deaths is available?

  • A report describes accidental overdose deaths that occurred in Allegheny County from January 2016 through June 2020 with a look at trends in numbers of deaths, demographics, and substances involved, like opioids and fentanyl.
  • An interactive dashboard provides data from 2008 and allows users to filter data for a closer look at particular years, substance types, demographic groups, and neighborhoods. The dashboard also provides information about fatal and non-fatal overdoses that resulted in hospital emergency department visits or administration of naloxone by EMS.

The report and dashboard are joint efforts of the Allegheny County Department of Human Services (DHS) and the Allegheny County Health Department (ACHD), present an analysis of deaths resulting from opioid overdose.

How is this data used?

Data on victims and potential risk factors can help County government and other stakeholders implement evidence-based strategies to address the ongoing opioid epidemic. The reports, maps and dataset are provided in an effort to inform and stimulate discussion about substance use treatment and prevention.


Related materials

Previous reports about accidental overdose

Dataset

  • Overdose deaths by Allegheny County municipality: 2008-2014

Maps

Throughout the United States, people experiencing behavioral health challenges are overrepresented in the criminal justice system and Allegheny County is no exception. To better understand the state of our current system and to learn more about promising approaches in other jurisdictions, Allegheny County sought an independent evaluator to conduct a study. From among a number of proposers, the county selected researchers from the University of Pittsburgh who interviewed dozens of stakeholders, analyzed justice system data, examined models from other jurisdictions, and solicited feedback through a series of workshops.

Select from the links below to learn more about the researchers’ findings and recommendations:

One way that Allegheny County promotes the provision of high quality behavioral health services is through value-based contracting (VBC), which pays providers of behavioral health services based on quality of care rather than quantity of care. This type of contracting can reduce system costs while also providing financial incentives for high-performing providers. The Pennsylvania Department of Human Services (PA DHS) has implemented a series of VBC requirements for the Medicaid-funded behavioral health program statewide. This report outlines these requirements, highlights Allegheny County’s various VBC initiatives, and discusses next steps.

Click here to read the report.

Suicide Data, 2002–Present: Interactive Dashboard

Access the dashboard

The dashboard below displays information about Allegheny County suicides since 2002. View trends in yearly suicides, demographics of people who died by suicide, and locations within the county. The data is updated monthly.

A related data brief is also available.

Problems viewing the dashboard? You can view it directly here.


Related materials

Allegheny County Suicides, 2008–2017: Data Brief

Suicide rates have been rising in nearly every state in the U.S. in recent years, and in Pennsylvania and Allegheny County, suicide rates are higher than the nation’s. This data brief explores Allegheny County suicide trends since 2008 as well as demographics, causes of death, and publicly funded service usage of those who died.

Click here to view the data brief.

Click here to view a related interactive dashboard.

In 2016, the Allegheny County Jail began offering naloxone, a life-saving medication that rapidly reverses opioid overdose, to people exiting the jail. Since then, the jail has distributed over a thousand naloxone kits. This data brief describes the naloxone distribution program and provides information on the people who received naloxone, including their demographics, the communities they lived in after leaving jail, and how many died of an overdose following their release from jail.

Click here to read the data brief.

People struggling with unhealthy drug or alcohol use sometimes face challenges when it comes to accessing treatment. Research has found that lack of insurance, unfamiliarity with treatment options, a shortage of available treatment slots, and concern that treatment will not work can all contribute to a person hesitating to seek help.

The Allegheny County Department of Human Services wanted to learn more about the barriers that people face when accessing publicly funded treatment in our region, so we interviewed more than 60 consumers, family members, and staff who had experience with the treatment system. Using a human-centered design approach, we summarized the information from the interviews into insights and then used the insights to ask “how-might-we” questions related to future system improvements.

Read the full report here.

The Allegheny County Consumer Action Response Team (CART) gathers feedback from consumers of publicly-funded behavioral health services, which include mental health services and drug and alcohol treatment for adults, children and families. CART conducts face-to-face or telephone interviews with service recipients and their families and summarizes the feedback so that it can be used for quality improvement by the Department of Human Services and its treatment providers. The annual reports below highlight significant trends and findings as collected by CART during its interviews.

2012 Annual Report
2013 Annual Report
2014 Annual Report
2015 Annual Report
2016 Annual Report
2017 Annual Report
2018 Annual Report
2019 Annual Report
2020 Annual Report

Access the dashboard

An involuntary commitment, also known as a 302, may occur when an individual is exhibiting symptoms of mental illness that are unmanageable and may result in danger to themselves or to others. The dashboard below displays data about the involuntary commitment process in Allegheny County from petition to examination to inpatient admission. Data ranges from May 2014 to the present and is updated daily.

A related report is also available.

Trouble viewing the dashboard? You can view it directly here.


Related materials

Allegheny County, like much of Western Pennsylvania, is in the midst of an opioid overdose epidemic and it is vitally important that County residents have access to the best and most effective treatment to support their recovery from opioid use disorders. Medication-assisted treatment, or MAT, combines medication and counseling/behavioral therapy and, when clinically appropriate, is a standard of care in the treatment of opioid use disorders. Research has proven MAT to be highly effective in improving recovery outcomes and reducing criminal behavior and risk of infectious disease.

The Allegheny County Departments of Health and Human Services, together with Allegheny HealthChoices, Inc. and Community Care Behavioral Health, issued a Joint Position Statement on Medication-Assisted Treatment for Opioid Use Disorders in Allegheny County, describing their expectations for contracted treatment providers and others who encounter or serve individuals with opioid use disorders. It states that every person entering substance use treatment for opioid use is entitled to the opportunity to learn about and consider MAT as a treatment option. It is intended to dispel ambiguity and should be understood as a clear statement in support of an effective treatment continuum that includes MAT.

Click here to view the full joint position statement.

Mental Health Involuntary Commitment: Report

An involuntary commitment is an application for emergency evaluation and treatment for a person who is considered to be a danger to self or others due to symptoms of a mental illness. In Allegheny County, petitions for involuntary commitment are managed and authorized by the Department of Human Services (DHS), through its Mental Health Information, Referral and Emergency Services (IRES) 24-hour phone line.

This report presents an analysis of all involuntary commitment petitions received by DHS from 2002 through 2013, during which time petitions were filed on 37,750 individuals, most commonly involving teens and young adults. African Americans experienced higher rates at almost every age and men experienced higher rates than women of the same race.

Click here to read the full report.

Click here to view a related data visualization.

An initial assessment is often a client’s first service experience, and, as such, it plays a major role in the perception, comfort and outcomes of the service. Simultaneously, the assessment can set the tone for the eventual outcomes of the  This report describes the process of adapting and/or developing common assessments for use in Allegheny County, the implementation process, and the impact on consumer engagement and service delivery.

Click to read the full report.

The high percentage of inmates with mental health and/or substance use issues presents significant challenges to the correctional system. Untreated behavioral health issues contribute to higher rates of recidivism as well as a myriad of other barriers to successful community re-entry. To begin to address these challenges, the Allegheny County Jail Collaborative convened a workgroup to review behavioral health services available in the Allegheny County Jail, identify gaps and challenges, and create “maps” of the service navigation process.

Click here to view the full report.