Should Cops and Mental Health Caregivers Work Together?

A Dallas program that dispatches teams of clinicians and social workers along with police officers on 911 calls is the biggest winner of this year’s Police Reform and Racial Justice Grant Program, created by the U.S. Conference of Mayors in partnership with Target.

The Rapid Integrated Group Healthcare Team (RIGHT) Care program, which aims to reduce unnecessary arrests and hospitalization in the city, received $175,000 in grant money to expand the mental health response program into a 24/7 service.

Since the program was launched three years ago, Dallas has seen a 20 percent drop in the number of people taken to the ER and a 60 percent decrease in arrests.

The city of Dallas receives over 13,000 behavioral health emergency calls a year, and the person in crisis often ends up arrested, hospitalized or, on some occasions, fatally shot as police officers are systemically the first responders to the scene.

A study by Meadows Mental Health Policy Institute (MMHPI), a non-profit policy research organization in Texas, found that about 17,000 people with mental illness are booked into Dallas County jail each year.

The number of mental health-related emergency calls to the Dallas 911 center increased by an average of 18 percent from 2012 to 2015, with some areas seeing an 85 percent increase over that time period.

To address the surge, the Dallas Police Department partnered with Parkland Health & Hospital System, the Dallas Fire-Rescue Department and MMHPI to launch the RIGHT Care pilot program in January 2018 in the South-Central Division of Dallas PD that serves more than 120,000 residents in the area.

“It’s a high violent crime area and it’s known that a good chunk of the calls come from this particular division in Dallas,” said RIGHT Care program manager Tabitha Castillo.

Every day from 7 am to 11 pm, a mental health clinician at the 911 call center would flag and monitor any mental health related calls. They would sometimes communicate directly with the caller until a RIGHT Care team arrived at the scene.

Once police officers had made sure the scene was safe, paramedics and social workers would join and begin their assessment.

Within 24 to 48 hours after the interaction, a team member would follow up with the caller to make sure they got the service they needed.

In the first 18 months of the program, about 900 people were diverted from the ER. Roughly 500 people were spared jail time, according to MMHPI.

With the initial success, the city expanded the RIGHT Care team to five teams to serve the whole city earlier this year.

With the grant money and an additional $2 million investment according to the newly released city budget, Dallas will have a designated RIGHT Care team to each police substation and a support team during the busiest 3 pm to 11 pm shift by Oct. 25, and an overnight team to provide service 24/7 by January next year.

“Twenty percent of mental health calls do occur overnight. So we know that’s an important group of calls for service that we need to be addressing,” said Castillo.

Despite the progress and continued investment in the program, many are still critical of having police officers on site when responding to mental health calls.

Crisis Intervention Without Cops

 The Dallas program is one of several examples of the emergence of so-called “Crisis Intervention Teams” (CIT),  which deploy civilian responders to situations where public safety is not threatened.

Dr. Don Kamin, a clinical psychologist and the director of the Institute for Police, Mental Health and Community Collaboration in Rochester, N.Y., argues the Dallas program―which requires police presence at every call― is going in the wrong direction.

The goal of CIT is to minimize the times police are the first responders to individuals in emotional distress, said Dr. Kamin,  who has been working with police departments across New York State in developing CIT training for over 15 years.

“If it is a mental health-related crisis, we ought to have a mental health response,” said Dr. Kamin.

Dallas PD defended its decision to deploy police officers, asserting that officers are there to ensure the safety of social workers, RIGHT Care team members and the community.

“One thing that we found is that folks on our team, like our social workers, they feel more comfortable, you know, working alongside our officers and I think that says something,” said Castillo.

However, Dr. Kamin believes that, instead of making everyone feel safer, the mere presence of police officers could escalate the situation, causing distress for patients before they do or say anything.

“If we’re driving down the road and we see the flashing lights in our rearview mirror. We’re getting pulled over speeding. I know most of us get tense and a bit anxious,” said Dr. Kamin.

“So imagine already being in a heightened state of distress, and seeing a police officer respond. It’s just not best practice.”

He also stressed that the need to have a police presence could further the stigma around mental health patients as the vast majority of them are non-violent. Research by Austin Justice Coalition, a social justice activism group in Austin, Texas, shows that more than 75 percent of 911 calls for service were unrelated to crime and could be better served by non-police resources.

Officers at Dallas PD understand the ongoing debate, said Castillo, and have gone through CIT training to better equip themselves when it comes to working with people in crisis.

“One thing that we have is our officers don’t wear the normal full uniform. They wear…department polos with khaki pants. Just to offer a more approachable appearance,” said Castillo.

But the officers still carry a gun on their utility belt.

She added that the department is aware of the call for an alternative solution but for now officers will still accompany the RIGHT Care team for safety precautions.

“The team members will always stay within their duties,” said Castillo.

This story, originally published in Next City, is reprinted here through the Solutions Journalism Exchange, part of the Solutions Journalism Network’s programs to spread rigorous reporting about responses to problems.