In its first year, the Round Rock Fire Department's Crisis Response unit helped hundreds of residents undergoing mental health crises and in many cases diverted them from jail.

In addition to handling incidents related to behavioral health, the CRU partners with other city entities to ensure Round Rock residents' needs are met. Round Rock City Manager Laurie Hadley said these services strengthen ties to vulnerable communities in the city, such as those experiencing homelessness.

“Prior to having the CRU, most of the mental health-type calls were ending up with the person landing in the hospital or in jail, which isn’t the best place for them to be,” Hadley said. “There were times where an officer would sit for several hours with a patient waiting to get them into a mental health facility.”

Hadley said she has seen the program achieve great success in the community as a dedicated crisis unit also helps divert those in crisis from unnecessary trips to the hospital or spending time in police custody.

City priority

Prior to the launch of the CRU, a division of Williamson County Emergency Medical Services served the Round Rock area. Hadley said the team provided similar services to the new CRU but with variable response times and resources spread countywide.

While Hadley said the main reason for the CRU centers on better serving residents experiencing mental health issues, fire Chief Shane Glaiser said the move is becoming more popular as discussions around police response to mental health crises continue.

“How do we help take some of the workload off of [the police department] and develop a team that can put people out there trained in case management and to communicate with somebody that’s in a mental behavioral crisis?” Glaiser said.

The city recruited Program Director Annie Burwell, formerly of the Williamson County Mobile Outreach Team, the county’s version of the CRU that provides similar mental health and behavioral response, to lead the program, bringing some members such as CRU paramedic Daniel Sledge with her.

Burwell said she is part of a team establishing a full spectrum of new services, including helping residents find care, crisis counseling, de-escalation and initial assessment of those experiencing mental health crises at no cost in Round Rock.

“It’s everything from, ‘Do you need a ramp installed in your home?’ Or, ‘Do you need to go to a psychiatric facility?’” Burwell said.

Calls to the CRU have more than tripled since March 2022 from 49 call responses that month to 178 calls in February 2023, per city call data.
Months before the unit launched, city officials allocated $2.03 million in American Rescue Plan Act grants to fund the program. That dipped to $1.07 million in fiscal year 2022-23 and is projected to drop further to $589,800 in FY 2023-24 with equipment already acquired.

In September, U.S. Rep. John Carter, R-Round Rock, secured $1 million in federal funding for the program. When the grant funding runs out, the city will absorb the unit’s operation costs into the fire department’s budget and allocate additional funds for it, said Sara Bustilloz, Round Rock communications and marketing director.

Redefining community care

Glaiser said the fire department has used its Community Risk Reduction initiative since 2021 to connect with residents who may not have consistent access to mental health care as well as other unmet needs that may contribute to a behavioral health issue.

“The vulnerable are not just the elderly,” Glaiser said. “It’s also those who are having issues coping with day-to-day life.”

The CRU offers free phone counseling and can connect residents with nonprofits and other organizations providing assistance with mental health care, utility bills, rent and other sources of strain.

After residents receive services from the unit, behavioral health specialists will follow up to see if there are any additional support needs, Burwell said.

“It’s really different from being a therapist in an office,” Burwell said. “We might hear some of the same things that a therapist does, but we’re on the side of I-35, or we’re behind the 7-Eleven.”

As the unit works to establish itself within the community and hone its existing services, staff members are combating the countywide rise in incidents involving fentanyl by carrying a medication that reverses an opioid overdose—Narcan, the brand name of naloxone—in emergency kits that are available to residents by request.

Data regarding calls for fentanyl concerns was not available, but Sledge estimated the unit receives around one per day. The unit also works with those impacted by fentanyl use to coordinate access to long-term treatment.

“Where there is higher risk, we want to target that Narcan,” Sledge said. “Narcan keeps somebody alive, but it’s not a treatment.”

A majority of CRU calls center on mental health crises, Burwell said.

Round Rock resident Renata Kreider said she received services for a mental health crisis in 2021 from the Round Rock Police Department’s Crisis Intervention Team.

The CIT provides the same services as the new CRU, and she added that if she had to, she would choose the crisis intervention option again.

Kreider said stigmas around those experiencing mental health crises and the representation of mental health crisis response on television may cause some people to not seek help. However, she said her experience with emergency responders was overwhelmingly positive.

“It wasn’t scary, and they weren’t there to judge me,” Kreider said. “They were literally just there to lend an ear and provide safety if it was necessary. I’m thankful for that because I’m still here with my family.”