December 2017 Dallas Medical Journal 15
Drs. Ray Fowler and Frank Webster
Daily updates
One activity that worked well was
sending daily (sometimes more often)
updates to as many people as I could.
Information included numbers of
residents at the shelter, number registered
for services, volumes on the medical
and mental health side, as well as the
psychiatrist schedule and operational
issues (parking availability changed daily
and was not easy to understand).
Overall, we were very busy.
Of the 237 prescriber visits, about 20
percent of clinic visits did not involve
seeing a psychiatrist, so total volume for
the clinic itself was about 280.
During the 23-day operation, police
transported six people to a local
psychiatric facility (Apprehension by
Police Officer Without a Warrant—
APOWW) for more intensive
management than could be done safely at
the shelter.
Our mental health folks also were
heavily involved in clinic operations,
including the sharing of crucial
information, and obtaining of necessary
items, such as chairs, tables and printers.
The level of cooperation was
tremendous among the medical team,
infection control, DCMS, Dallas Fire-
Rescue, law enforcement, American
Red Cross, VA Hospital system, North
Texas Behavioral Health Authority, UT
Southwestern, the Emergency Nurses
Association, Parkland, Dallas City and
Dallas County, Office of Emergency
Management, Walmart, Ruby Blum from
Dallas County Judge Clay Jenkins’ office,
and our local mental health personnel,
which was a cooperative effort, as well.
Initiative and a phone call
I think the best story belongs to Stephanie
Chambers from Dallas Metrocare
Services, and Courtney Guhl, LPC,
in private practice. On their first shift
as floor walkers, they encountered a
gentleman recently arrived to Dallas via
C-130 transport, then by bus from Love
Field. He was upset and wanted to let his
mother know he was safe in Dallas. They
helped him contact his mother, who
mentioned that her other son, his brother,
was stranded in Orange and she had
been unable to contact him by cell. She
also was worried that he was out of
medications. Stephanie and Courtney
went to the Command Center at the
shelter, asked questions and eventually
were directed to the Texas State Guard,
who contacted the Emergency Search
and Rescue team in Orange, who found
the man, helped him contact his mother,
helped him get his medications, and,
because he was helping several elderly
people and did not want to abandon them,
assisted the brother and the people he
was helping. It’s truly amazing how one
phone call changed several people’s lives.
This work serves as an example to why
we serve and what we can do when we
approach problems from a viewpoint of
“What do we need to do to help?”
This kind of work is incredibly
rewarding, and the people who do it are
special. It is definitely my privilege to be
involved with them. DMJ
Mental health services provided
The MMC and mental health cinics, either on-site or
transported to local resources, had more than 4,500 patient
encounters. These on-site operations kept Dallas Fire-Rescue
and local EDs from being overwhelmed.
• 24-hour care
• Prescriptions and IV fluids
• Transport for methodone maintenance, infusion therapies
and dialysis
• Referral for detox
• Pediatric services
• Management of K2 intoxication
• Crisis intervention
• Assistance for special needs/developmentally delayed
individuals
• Wheelchairs and DME
• Transport to dental care and vision care
• On-site pharmacy services, including common OTC meds
• Isolation
• ID management
• Use of HIE to coordinate care
By the numbers
Total contacts: 2,007
Adapt Community Solutions
(mobile crisis services): 60
Floor contacts: 1,667
encounters (although about
20% low because some
people were too busy to
complete contact forms)