The new Island Intervention Center that opened less than two years ago has already made significant inroads into mental health and substance abuse treatment on the Island, a report from Martha’s Vineyard Community Services shows.

Among other things, the report shows the number of people seeking treatment in the hospital emergency room for mental health-related issues has dropped sharply, especially among young people. Overnight stays at the hospital and placements in off-Island inpatient facilities have also dropped, according to the report.

Located on the Community Services campus in a former office space that was renovated with the needs of emergency mental health care in mind, the intervention center opened in July 2017 with funding from the state Department of Mental Health. It is a pioneer program of its kind in the state. Services include urgent care for mental health and substance use issues, suicide prevention, medically assisted treatment for addiction and an on-call emergency services program for people in crisis.

“What we were looking to do is set up a service where we could embrace people as they were escalating in substance use or in mental health well before the police dropped them off at the ER,” said Community Services executive director Julie Fay, who met with the Gazette this week, along with intervention center director David Araujo, to discuss the report.

Thanks to state funding administered through a contract, urgent care services at the center are free. Mr. Araujo said this has been a key factor, even for people with insurance plans.

“It’s such a huge weight off their shoulders, as opposed to going to the ER where you’re already in crisis and then all the sudden you have to think, I have to pay my copay; If I get sent out of here, I have to pay for the ambulance,” he said. “Just knowing that when they come into the office, it alleviates their fear.”

Before the center opened, the hospital emergency room was the only place where people experiencing acute mental health or substance use problems could seek help. The stigma and potential expense often led people to avoid treatment until their situations grew dangerous, Ms. Fay said.

If a person in crisis ended up at the hospital, an on-call clinician from Community Services would be contacted to perform a psychiatric evaluation to determine whether the person needed to be taken off-Island to an inpatient facility.

“Having 35 years worth of trend data around hospitalizations and evaluations, it was apparent to us that we were off the charts as far as the mainland was concerned in terms of hospitalization rates,” Ms. Fay said. “That’s not because our people are sicker. It was that there were no other alternatives.”

Nearly two years after the new center opened, numbers tell the story.

In fiscal year 2017 before the center opened, 142 people in crisis were placed in off-Island inpatient facilities after being evaluated in the emergency room. After the center opened the following year, the number dropped to 90.

The number of people in crisis who were evaluated in the emergency room also dropped from 267 to 211.

The report shows adolescents in particular have benefited from the center, which is located across the road from the regional high school. Before the center opened in 2017, 44 youth were placed at off-Island treatment facilities for mental health issues after going to the ER. The following year the number dropped to 25. Six weeks before the end of the fiscal year ending June 30, there have so far been 12 placements.

The center began a pilot program last spring to embed services directly in the high school, sharing clinicians and recovery coaches during part of the school day. Ms. Fay said they hope to expand that program to the lower schools next year.

Redirecting people in crisis to the new center rather than the hospital required a culture shift on the Island that has included law enforcement, first responders and school educators, Ms. Fay and Mr. Araujo said.

“We’ve worked really hard in the last couple of years to take down silos,” Ms. Fay said. “Our first thought when we’re trying to do something is, Who can we partner with to do this?”

The center includes bilingual staff. Of the 164 initial visits provided so far this fiscal year, 32 have been people from the Island Brazilian community. Mr. Araujo said is working to continue to improve access within that community.

Beyond mental health intervention, suicide prevention and awareness are also part of the center’s mission. The Vineyard has a high rate of deaths from overdoses and suicides among year-round residents compared with the state, Ms. Fay said.

“It’s known anecdotally on the Island, and the numbers that are reported to the Department of Public Health . . . are underreported from the Island in a very significant way,” she said.

Mr. Araujo is working on outreach to spread the word about resources available at the center and about how to treat someone who appears to be in danger of self harm. In 2018, he organized a 40-hour training session for law enforcement on suicide prevention.

“From there what they did is instead of seeing everything as a legal issue, they started to be able to see things more as a mental health issue,” he said.

Open Monday through Friday from 8 a.m. to 8 p.m., the center allows for patient privacy with a separate entrance. It employs four therapists and an administrative assistant on its clinical staff. A cohort of about 13 clinicians cover on-call emergency services and there are about two dozen trained recovery coaches, Mr. Araujo and Ms. Fay said.

Hiring and retaining staff remains an ongoing challenge, Ms. Fay said. She said the Vineyard Vision Fellowship program has helped by providing strategic fellowships that allow Islanders to pursue higher education, including in social work, and return home to work, unburdened by heavy student loan debt.

And as the Island intervention center nears its second birthday, Ms. Fay said the early success of the program is a testament to the power of early intervention.

“The idea is to at the earliest possible moment . . . get a handle on assessing and redirecting and providing services,” she said.