Douglas County’s Mobile Response Team was touted as an alternative to dispatching law enforcement and emergency services to people in crises and a conduit to help community members tap into suicide prevention and mental health resources. Two years since MRT’s launch, former employees say the service remains crucial, but its reach has been hampered by an environment filled with high turnover and retaliation.

When Melanie submitted her resignation to Bert Nash Community Mental Health Center recently, she gave more than twice the customary two weeks’ notice.

Instead, within days, she and two coworkers who’d also submitted 30-day resignations were told their employment would end immediately, she said. 

“I gave a month specifically because it is so short staffed,” said Melanie, a pseudonym she requested we use to protect her privacy and future career opportunities. “I mean, we’re less — or they — they are less than bare bones. And I did that to truly give them time to find my replacement. And, no, it is not customary whatsoever for people to be walked out and to not work their notice.”

Melanie was shocked. Not only would she miss out on a month’s worth of pay, but she’d lose her employer-provided health insurance benefits within days. Melanie said the departures ultimately left a handful of frontline MRT staff members for an operation scheduled to run 18 hours a day, from 8 a.m. to 2 a.m., every day of the year.

Since then, Melanie said, MRT service hours have been reduced on some Thursday and Friday evenings this month from 8 a.m. to 9 p.m. Lawrence Police Department call logs list five suicide threat calls and one suicide attempt call during the windows of 9 p.m. to 2 a.m. on Thursdays and Fridays so far this month.

Melanie said the temporary reduction wouldn’t have been necessary had she and her former coworkers been allowed to work through their notice periods.

“Take that month that I’ve given and use it to hire my replacement and also to keep morale, instead of, and not just unceremoniously/essentially, fire three people on the spot when you’re already critically understaffed,” she said.

The Times emailed a list of questions to Jeff Burkhead, spokesperson for Bert Nash, and asked for confirmation about the dates and times MRT had reduced its hours, whether the reductions occurred during peak or non-peak times and for data about staff vacancies.

Burkhead said in an emailed response Tuesday that MRT had reduced its “operational hours on five occasions due to staffing needs.” He didn’t provide specific dates and times, but said “The dates and times we had to temporarily remove MRT deployment from our broader crisis continuum were based on staffing patterns.”

Burkhead said the changes had been communicated to community partners proactively, and MRT currently operates from 8 a.m. to 2 a.m. seven days a week with no plans to limit those hours.

“As part of our partnership with the Emergency Communications Center, we can ‘activate/deactivate’ as needed,” Burkhead said via email. “In the limited times the MRT has been offline, it’s important to know that crisis support was still available through the TRC (Treatment and Recovery Center), the Lawrence Police Department’s mental health team, the Douglas County Crisis Line at 785-841-2345 or 988, and the LDCFM (Lawrence-Douglas County Fire Medical) Mobile Integrated Health Teams.”

In response to a question asking why employees weren’t allowed to work out their 30-day notices, Burkhead said, “Our policy is to respect the privacy and confidentiality of current and former team members, aligning with standard industry practices by refraining from public comment on such matters.”

As for job openings, Burkhead said MRT had eight open positions as of Monday. Currently, he said, there are six MRT members and two program managers on staff. Based on those figures, the MRT would number 16 at full staffing levels.

“There have been 12 separations from the program this year,” Burkhead wrote.

At publication time, Bert Nash’s website listed 42 job openings across the organization.

Mobile Response Team services and funding

MRT services are designed to meet clients in the community, whether that’s where they live or in a public setting. It’s partially funded by Douglas County and the quarter-cent sales tax voters approved in 2018 for behavioral health projects touted as jail alternatives, including MRT and the Treatment and Recovery Center.

When MRT launched in fall 2022, it served people through referrals from HeadQuarters Kansas Crisis Line, 988 or locally at 785-841-2345, who gave consent to accept services at their location.

This year, MRT expanded its reach to include third-party requests, such as community members requesting help for an individual they’ve encountered within the community. It also dropped the consent requirement.

MRT now receives referrals from the Douglas County Emergency Communications Center (ECC) in addition to referrals initiated through crisis lines. A memo from Bob Tryanski, director of behavioral health projects for Douglas County, to county commissioners in the June 26 meeting agenda packet about this change reads, “MRT is underutilized” and “ECC is recommending that the initial phase of this plan focuses on redirecting non-emergency MRT dispatch requests from first responders to ECC.”

At some times, Melanie said she felt bored on the job. She and another former employee said they went weeks without receiving a referral or interacting with any clients.

“We instead spent the evenings in the office playing board games or watching movies for six and a half straight weeks on my shift,” Melanie said.

She said that time could’ve been better spent educating members of the public and community organizations of MRT’s services or following up with clients. Instead, she said she and coworkers were limited to two subsequent contacts with a client — one at 24 hours, the other two weeks after the initial referral.

The former employees interviewed for this article said they had approached Bert Nash management with ideas to publicize and enhance MRT’s services in the community.

“And we were always told no, that’s not our role. Or ‘No, that’s the role of the community outreach program at Bert Nash,’” Melanie said.

MRT referrals have increased in 2024. Through Aug. 19, Burkhead said, MRT had received 450 referrals for 262 unique individuals — numbers that had already surpassed last year’s totals. In 2023, MRT received 414 referrals for 246 unique individuals, according to stats Burkhead provided.

Frontline MRT staff who work directly with clients in crisis and during follow-up interactions include case managers; qualified mental health professionals such as social workers, psychologists and therapists; peer support specialists with lived experience in behavioral health crises; and co-responders, who collaborate with MRT and law enforcement to help people in crisis.

Douglas County provided $50,000 in operational support for MRT’s 2022 expenses and $181,740 for 2023, according to Karrey Britt, a spokesperson for the county. “In the first year of operation, Bert Nash was able to leverage CCBHC grant funds to significantly offset MRT operational costs,” Britt said in an email.

CCBHC stands for Certified Community Behavioral Health Clinic, a model of integrated care for mental illness, addiction and substance use disorders that must serve all — not just Medicaid beneficiaries. CCBHCs cannot refuse services based on an individual’s residence or ability to pay. Read more about the CCBHC program in this article.

Figures provided by Burkhead showed total expenses for MRT in 2023 were $940,492, with Kansas Department for Aging and Disability Services (KDADS) providing $189,781 of that amount.

For 2024, Douglas County Commissioners approved an amount not to exceed $445,000 for MRT operational support, Britt said. Total MRT expenses through June of this year were $566,000, according to Burkhead, with KDADS funding $323,323.

“The balance of expenses is covered by the CCBHC program using State Medicaid dollars and an agreement with the Lawrence Police Department to fund a portion of one MRT team member dedicated to the co-responder program,” Burkhead said. “When possible and appropriate, individuals Commercial, Medicaid or Medicare insurance is billed.”

Burkhead said the bulk of funding for 2024 would come from CCBHC funds leveraged by Bert Nash and a year-end rate comparison to recoup administrative costs associated with MRT.

Douglas County Commissioners have budgeted $425,000 for MRT in 2025, Britt said. Altogether, that’s about $1.1 million the county has paid or budgeted for the MRT for 2022 through 2025.

‘We tried doing everything right’

Four former MRT employees interviewed for this article said high turnover, retaliation and favoritism permeated their work environment, and they didn’t feel consistently supported by their supervisors, Bert Nash executives or human resources. They provided copies of correspondence in which they shared some of those concerns with Amalia Mendez, Bert Nash human resources director; their supervisors; and other staff members.

Two former MRT employees said they were fired months after sharing their concerns with “MRT and Bert Nash top leadership.”

Two sources said they repeatedly witnessed an MRT coworker nodding off and slurring their speech at work. They worried the coworker might endanger themself, clients, coworkers or others while driving one of two MRT vehicles. When they told program managers about their concerns, they were gaslit, said one of the sources. It wasn’t until they went over their supervisors and informed Mendez, they said, that their concerns were taken seriously and finally addressed.

Autopsy records show the former MRT employee later died of an accidental drug overdose.

“I really wanted to point out that we tried doing everything right,” a source said. “We were so confused by what we were witnessing that we tried to figure out if (they were) having medical issues. But we’re not used to seeing that in our field. Like, you don’t show up to work high or drunk doing what we do. So you had people confused by what they were seeing, uncomfortable asking. But it happened over and over and over.”

A former employee to whom we agreed to refer by the pseudonym Angela said the MRT work environment changed 180 degrees from encouraging staff autonomy to toxic, unhealthy and more stressful during her tenure. She attributed the shift to management changes.

“We are in a position where we’re dealing with people in their worst days and we’re at, half of us are not even in a good mindset because we are not happy in our position or with our supervisors,” Angela said. “So we’re supposed to go out and help people but none of us are really helping each other or helping ourselves because even if you do, go and talk to the higher-ups like we did, you’re kind of bullied for it.”

“It was a very negative atmosphere, retaliation,” said Samantha, a pseudonym we agreed to use to protect her privacy. “Someone pushed back or didn’t agree, then that person was targeted.”

Samantha said she wanted to see taxpayers getting the most out of a vital service she thinks has “so much potential” in Douglas County. She hoped talking with news media would prompt changes in working conditions at MRT and eliminate the workplace retaliation she said she’d endured.

“What I really want is for people who work at Bert Nash to be treated nicely,” she said. “Just the way people are treated, how things are run. If you bring up ideas, they fire you.”

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At times, Melanie said, messages and responses she received from her supervisors were aggressive in tone. Other former MRT employees said they’d received communications from supervisors they interpreted as hostile and unprofessional.

In one case, a text message sent after hours from a program manager to a frontline employee read, “I read your email today when I returned to work we can talk next week I am unsure if this is the right position for you I really like you but this is the process for this team and you could either get on board or leave.”

Burkhead said in his emailed response, “Our policy is to respect the privacy and confidentiality of current and former team members, aligning with standard industry practices by refraining from public comment on such matters.”

An evolving program

Former MRT frontline employees interviewed for this article said some of the changes MRT had experienced over time were necessary due to the newness of the program in Douglas County, while some changes were attributable to management at the time.

Melanie said her frustrations had been accumulating for months about various MRT policies and practices — including being required to monitor communications during her unpaid meal breaks. She said she “wanted to be able to disconnect for 30 minutes.”

Burkhead said of the requirement, “Team members are expected to monitor crisis referrals during their shifts, as crises do not pause for breaks or lunch. Leadership steps in to assist with monitoring during team breaks as well.”

Asked about the limit of two follow-up contacts with clients, Burkhead said MRT follows up with individuals, as a best practice, at least twice after the initial contact — within 24 hours and again at 14 days.

“When clinically indicated and appropriate, more contacts are completed,” Burkhead said. “There is not a limit on the number of services a person can receive.”

Internal communications shared with the Times (with client information redacted) showed that some follow-up interactions with clients were discouraged by program managers. Angela said going “above and beyond,” such as making a quick call to ask how a client was doing, was discouraged unless a new MRT referral came through the system. 

“It was a ‘you go deal with the crisis and then you let the person go and go to the next.’ So we were kind of in the wrong, apparently, for building a relationship to help those people,” Angela said. “Because it was very known that that’s not what they wanted us to do.”

Ultimately, Melanie blamed the recent implementation of a new staffing policy as the impetus for her resignation.

A copy of an internal Bert Nash memo reads, “The purpose of this protocol is to ensure MRT is staffed for all shifts during hours of operation, 18 hours a day per 365 days a year, and that in case of absence the services provided by the MRT will not be disrupted” and “All MRT members will be providing at least 2 weeks advance notice to MRT Leadership regarding planned time off.”

Melanie said the policy instituted mandatory overtime for MRT staff, who typically work four 10-hour shifts per week.

“The backup shifts we signed up for had to be shifts that needed the coverage, and so that effectively mandated us to work 50-hour work weeks for three out of four weeks a month,” Melanie said.

The new requirements, she said, would essentially nix her and her coworkers’ paid time off, due to MRT’s high number of vacancies and the onus for coverage falling on frontline employees instead of supervisors.

Burkhead said Bert Nash’s organizational policy states all staff are expected to provide two week’s advance notice for vacation leave and a coverage plan. He said many crisis management teams across the industry have certain staffing requirements.

“This is consistent with the operations of other Community Mental Health Center crisis teams in Kansas, which generally require staff to arrange their own vacation coverage to ensure continuous service,” Burkhead said. “Sick leave, however, does not require prior planning. There may be times when shifts are mandated to maintain commitments to public service. Mobile response is a critical component of the behavioral health response system in Douglas County.”

Tricia Masenthin (she/her), equity reporter, can be reached at tmasenthin (at) lawrencekstimes (dot) com. Read more of her work for the Times here. Check out her staff bio here.

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