Filling in the gaps: the Mobile Integrated Health Team

Monday, April 18, 2022

MIH Team members Bethel Spagnolo and Annie Drummond with their little red van
Photo courtesy Shoreline Fire
By Diane Hettrick

Most of the calls that Shoreline Fire responds to are not full blown fires, but less dangerous things if caught in time. A dryer fire, a pan forgotten on the stove, perhaps a cigarette tipped out of an ashtray.

People fall and break bones. They fall and can't get back up - perhaps they are disabled or hoarders or in an awkward position. 

Fire responds and takes care of the immediate problem. But they realize that there are other issues. 

The resident seems a bit confused. They might have mobility issues. The responder suspects drug, alcohol, or mental health issues.

The firefighters have done their job, but are troubled. 

Firefighters are haunted by the people they saw and had to walk away from. Officer Doug Thornburg says that he drives by houses he has been to in the past and still wonders about what happened to the resident.

Every firefighter who has been on the job more than five years has those ghosts.

But five years ago, that all changed with the creation of the Mobile Integrated Health (MIH) team. It currently consists of two social workers and a firefighter / Emergency Medical Technician (EMT). Their job is to follow up on those troubling calls.

Annie Drummond is the Clinical Coordinator for the Community Outreach Division which includes the MIH.

Annie has been part of the MIH team since the beginning five years ago. She is called in by medics or firefighters who have found someone in a situation where they need help.

They have a low barrier for calls. It's not a formal system. No one has to prove need or meet criteria or fill out forms. 

Sometimes, it's just a sense the responders have after a 911 call that makes them ask the MIH team to make sure everything is all right in that household.

We believe that the right intervention at the right time, said Annie, can prevent more serious problems in the future.

The team works normal hours, Monday to Friday. 7:30am to 5:30pm

Firefighter / EMT Doug Thornburg is part of the MIH team
Photo courtesy Shoreline Fire

18 months ago the volume of calls was so high that a second social worker, Bethel Spagnolo, was hired. In addition, firefighter Doug Thornburg is part of the team. Last year the team handled 604 referrals.

Annie said that they go in with an open mind - a blank slate. We want to hear their story. We sit down with the person and ask - what do you need? what do you want? how can we help you?

It doesn't matter if the person is a hoarder, mentally ill, an alcoholic, or a drug addict.

The process is the same. We want to hear their strengths. And we want to connect them to the services they need and want.

The MIH team responds to calls in the areas served by fire departments in Shoreline, Northshore, Bothell, and Woodinville under letters of agreement.

The team makes use of all local services. They overlap and coordinate with local police departments, the RADAR unit, NUHSA, HOPE therapy dogs, and Reading for Rover. They partner with the SL-LFP Senior Center.

Often the team members provide the services themselves. They have a "little red van" - a Ford transit van. They take people to medical appointments, deliver groceries, bring people home from the hospital. 

Working with the Senior Center, they make sure the person has meals and food delivered. They get people into the fall prevention classes at the Center.

MIH Team: Doug Thornburg, Annie Drummond, Bethel Spagnolo in a recent meeting

They recently worked with HOPE therapy dogs to find a foster placement for a beloved dog when the owner went to the hospital for surgery. Then they took photos of the pet in its temporary foster home and showed them to the owner. Although this is not normally part of HOPE's mission, they used their contacts to help with this specific problem.

For people who love dogs but are unable to care for or afford one of their own, the team brings in Amber the therapy dog from Reading for Rover.

They help in adult family homes, where there is a lot of need.

With the majority of people we are time limited – soft case management. There are two people we see weekly, both developmentally delayed.

The frequent 911 callers are a small part of what we do. The other needs have grown so much.
Every year the need doubles and it will continue to grow.

An Irons Brothers 2014 ramp built for Mimi Brown and her family. Photo courtesy Irons Brothers.

What is on their wish list?
  • Ramps. "The Rampathon program is wonderful, but it's only once a year."
  • Subsidized caregivers.
  • Help with adult family homes.
  • And "Why doesn't Medicare pay for ongoing rehab?"

But they love their jobs. They love to come to work. They feel supported in a "lovely environment."

And the stress level has decreased for firefighters. They never again have to walk away from someone who needs help they can't give. They have a MIH team.

Update: HOPE provides animal-assisted crisis response teams.


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