In Focus: Douglas Fabian of Crisis Services - The Buffalo News

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In Focus: Douglas Fabian of Crisis Services

Some view it as a crisis in the region’s mental health services system. Funding cuts, shortages of beds and psychiatrists, and a fragmented system are leaving some of society’s most vulnerable people underserved, according to advocates.

Crisis Services views itself as a safety net in the system. Douglas B. Fabian is the agency’s executive director. He talked with The Buffalo News’ Brian Meyer about challenges facing service providers.

Here is a summary of some of the issues covered in an interview that is part of the weekly “In Focus” series. Watch the full six-minute interview above.

Meyer: Does the word “crisis” overstate the problem locally?

Fabian: No, not at all. I don’t think it’s overstating. ... In this case, we do have a crisis. Is it solvable? Is it manageable? I think it is. But I think by bringing it to the stage of a crisis, we now have certainly the mental health providers, we have the hospital-based administrators and we have the community talking more earnestly about services for what we consider to be people with serious mental illnesses.

Meyer: Some people might be confused, because they’re hearing about an expansion of the Buffalo Psychiatric Center facility starting next year. They’re hearing about this new program – this partnership between Kaleida and ECMC – to open a facility on the ECMC grounds. It sounds like services are expanding. Is that the case?

Fabian: They’re really not. I would like to think that services are improving, that we’re becoming more organized – better coordinated, better defined. But we’re in a state of what I consider to be kind of a transition from an old model to a new model. And we don’t exactly know what that new model is going to look like. ...

Meyer: In the long term, as I understand it, there won’t be a net gain of beds.

Fabian: Not really a net gain. What that means is that the community-based service providers need to work hand-in-glove with the hospital-based services. And then, of course, we have the Erie County Department of Mental Health, which has been a real leader in the old model and what we’re looking at in terms of the new model.

Meyer: We talked about Crisis Services being viewed as a safety net. Tell us specifically about what you do here.

Fabian: Crisis Services has been in operation since 1968. In many ways, we’ve done some of the same core services ... for those 45 years. We do a lot of work with hotlines, and that work has only expanded and become more sophisticated as the technology has grown. We’ve tried to keep on top of the wave of technology. We do texting. We do online chatting. We’re now becoming a more regional service provider, because phones reach out beyond just Buffalo and Erie County. We actually are the recipient of the hotline calls for Chautauqua County and for the Southern Tier. And we’re doing a lot of partnering with mental health agencies. You call some of the larger providers – the mental health agencies – at 4 p.m. or after, you’re really talking to us. And then we communicate seamlessly through a software package that information to the mental health provider about what’s going on with their clients.

Meyer: You use the word “seamlessly” in this instance. One of the concerns and criticisms over the years has been fragmentation. Is that improving?

Fabian: I’m one who is a little impatient. I think we could do more work in the area of coordination. I’m also one who helps run a pretty sophisticated ... mental health hotline. We think that number (834-3131) should be out in front of the community so that when they need a place to go, they have one number to call. Then we can connect them with a more appropriate and relevant service provider.

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