New units designed to avoid violent and often deadly encounters lack both funding and institutional support

Dispatchers at the 911 center in Mesa, Ariz., have three levers to pull: fire/medical, police or mental health. The last one is a relatively new addition, adopted by dozens of police departments around the country and aimed at avoiding violent and often deadly confrontations between police officers and the mentally ill.

“No hose, no gun,” said Mayor John Giles. “Just somebody with a clipboard and an argyle sweater who wants to ask how your day is going.”

In theory, the new teams are designed to better help people in distress who pose little if any threat to others. In practice, these teams have struggled to make much of a dent in what remains a chronic problem in U.S. policing.

The mayor recently saw a woman downtown who was talking to herself. “In my heartless way, I ignored her and walked away,” he said. Hours later, she was still there. Giles thought she had schizophrenia. He called 911 for an officer. Police were dispatched to the scene and said she was high on methamphetamine. She refused mental-health help, and the cops let her go.

“I don’t know what would have been the outcome if a mental-health provider had gotten that call,” Giles said. “I would have liked to know.” Out of about 250,000 total 911 calls last year in Mesa, dispatchers went with nonpolice mental-health units 3,500 times, according to the city.

Getting clinicians to the right place at the right time is proving difficult, local officials and behavioral-health experts say. Cities often don’t have enough of them to make a difference, blaming funding shortfalls. In addition, knowing when to send clinicians involves a large degree of guesswork. Dispatchers often err on the side of sending police, particularly when details of 911 calls are sketchy.

“Unfortunately with only one team, sometimes it means that we’re not available,” said Roger Astin, a San Antonio police officer who is part of a three-member mobile team that also includes a paramedic and a mental-health clinician.


San Antonio police officer Roger Astin and Chris Edwards, a paramedic with the city’s fire department, are part of a mobile crisis team that aims to de-escalate mental-health calls.
Mobile crisis teams—a mix of police and clinicians, or just clinicians—became more popular after the murder of George Floyd in 2020 by police officers, when law-enforcement tactics came under scrutiny. In the past few years, about a hundred municipalities nationwide have formed or announced plans to roll out nonpolice emergency-response teams, according to a tally by Indivisible Eastside, a liberal activist group in Washington state. In addition, some police departments have boosted the ranks of their own behavioral-health units.

There is scant comprehensive data on police killings of people with mental-health issues. The available numbers suggest a continuing overreliance on law enforcement, a finding backed up by local officials and behavioral experts.

Every year since 2015, police in the U.S. have killed between 200 and 300 people who showed signs of mental illness, according to the nonprofit Mapping Police Violence, which analyzes news accounts and official records. Since 2020, the number has declined 15% to 206 last year. It is an imperfect method for tracking mental-health-related police killings and doesn’t account for use of force that doesn’t result in death.


In Mesa, Ariz., only a small chunk of 911 calls are dispatched to nonpolice mental-health units.
“These programs have failed to live up to their potential,” said Rebecca Neusteter, executive director of the University of Chicago Health Lab and lead investigator of Transform911, an initiative to rethink the nation’s 911 model. She cited inadequate and inaccurate call coding that can leave 911 operators without enough information to send the best response, as well as resource shortages.

In Minneapolis, almost 10% of 911 calls between 2016 and mid-2022 related directly to a behavioral-health issue. Most of the time, the Minneapolis Police Department was the primary or sole responder, mostly because a behavioral-health team wasn’t available, according to a U.S. Justice Department report released in June.

Part of the conundrum cities face: Sidelining police carries some risk. Two years ago in Tucson, Ariz., two social workers were abducted at gunpoint and then later released physically unharmed by the man they were sent to assist.

Orange County, Fla., Sheriff John W. Mina pairs mental-health workers with a deputy because he doesn’t feel comfortable sending them out alone. Since the joint teams started in January 2021, they have responded to 8,100 calls and have made no arrests. No mental-health workers have been harmed.

“That tells me this is a better way,” Mina said.


Police officer Roger Astin, crisis-response clinician Samantha Gabriel and fire department paramedic Chris Edwards in San Antonio.
When police in San Antonio on June 23 confronted Melissa Perez, a 46-year-old mother of four with schizophrenia, she told them she thought the Federal Bureau of Investigation was spying on her. They tried to arrest her for cutting fire-alarm wires at her apartment complex. Perez barricaded herself in her apartment, threw a glass object at an officer and broke a window with a hammer.

“You’re gonna get shot!” an officer can be heard in body-camera footage shouting at Perez, about 20 minutes before three officers opened fire into her apartment, killing her. The three, who have been suspended, haven’t yet entered pleas to murder charges.

Perez lived alone. Neighbors recalled her making odd comments from time to time, but also said she would bring them home-cooked enchiladas. Relatives described a loving, boisterous mother with a taste for McDonald’s coffee and clothes from Ross.

Perez began exhibiting signs of paranoia in 2021, according to family members who say they paid for online psychiatric care and medication. City police twice took her to a psych unit on an emergency detention, said Daisy Nieto, Perez’s former sister-in-law who remained close to her.

Nieto, a licensed clinical social worker, said she doesn’t understand why officers on the scene apparently didn’t learn about Perez’s psychiatric history during the more than an hour they were outside her apartment.

Alexis Tovar, Perez’s 24-year-old daughter, said the fatal shooting has shaken her longstanding confidence in law enforcement. “I’ve called them before and you think, ‘Oh, the police are there, she’s fine,’” she said.

San Antonio Police Chief William McManus said Perez’s actions that night constituted an escalated mental-health call. He said SAPD officers know to contact the mental-health unit, which operates from 7 a.m. to 11 p.m. and has members on call overnight. He said a lack of supervision led to the incident, as well as a failure to follow protocols.



Melissa Perez with her daughter Alexis Tovar in 2019. Flowers and candles sit outside the home where Perez was shot and killed.


A wrongful-death lawsuit filed on behalf of Perez’s children alleges systemic problems with the police department. A lawyer for one of the charged officers said that his client was being scapegoated and that his actions were lawful. Lawyers for the two other officers didn’t respond to requests for comment.

Police in Los Angeles and Albuquerque have also killed people with mental-health problems in the past 12 months.

Mental-health-related 911 calls in San Antonio soared during the Covid pandemic, rising from about 21,400 in 2019 to roughly 32,000 last year. The police department’s mental-health unit was formed 15 years ago. It consists of 20 officers assisted by three clinicians, who together last year responded to about 5,200 calls across the city of about 1.5 million residents. Members, some of whom have advanced training, say they are stretched thin.

“We have to really be dependent on training our patrol officers departmentwide on handling what would be a typical mental-health disturbance,” said Lt. Paul Castillon, who oversees the unit.

One July afternoon, two officers in the unit—not in uniform but with guns holstered and badges visible—drove to northwest San Antonio in response to a text message from Vanessa Sandoval. The 37-year-old said she asked for the visit because she had been feeling depressed.

As the trio chatted in the triple-digit heat, Det. Cody Smith asked her a series of questions and encouraged her to reach out anytime. If need be, he said, a patrol officer could always stop by—a prospect Sandoval found unnerving. She brought up the Perez killing, which she said scared her.

“I don’t want them to Melissa Perez me. I get very confrontational when it comes to uniformed officers,” she said.


Vanessa Sandoval has called mental-health teams in San Antonio during a bout of depression.
“We’ll try to avoid that as much as we can,” said Officer Cynthia Lindley, who wore jeans and a button-down shirt.

San Antonio’s Astin—who primarily works on a different team comprising a police officer, paramedic and clinician—scanned a log of 911 calls one morning looking for a good fit for his co-response team. He saw one caller had mentioned a runaway robot before hanging up. He recognized the address: The team carried out an emergency psychiatric detention of a woman there in January.

The crew piled into two unmarked white SUVs. Astin radioed to have a uniformed officer sent as backup. Outside the home, the team met the stepfather of the woman the team had assisted in January. The 22-year-old was faring better, the stepfather said, though she believed she was a robot who had fled the government.

Astin said the team would like to see her if it wouldn’t rile her up. Moments later she walked up the driveway from the back of the house, her brown hair mussed and her gaze vacant. “I’m OK,” she said quietly, gave two-thumbs-up and backed away.

Such an approach helps safeguard clinicians. It can also tie up officers who might otherwise be dispatched to deal with serious crime.

In Houston last year, dispatchers diverted from police roughly 8,000 of the 1.1 million 911 calls, though officials say 46,000 calls—more than five per hour on average—involved mental health in some way, meaning cops handled an outsize share of such cases.

Tucson has been able to strike a balance between the competing needs of mental-health and crime calls, behavioral experts say.


Members of a mobile crisis team in San Antonio.
When police get involved in mental-health calls there, officers can take people to the Crisis Response Center, a nonprofit-run stabilization unit where a handoff to a clinician takes minutes. The center is a better option than a hospital emergency room, let alone jail, officials say. Quick handoffs mean officers can get back on the street faster.

Police dispatchers, and therefore police officers, are often bypassed altogether. In 2019, Tucson placed crisis specialists at the 911 center itself. In nearly all cases, officials say, they either resolve 911 mental-health calls over the phone or dispatch clinicians to the scene.

“Back in the day, we would send some brand-new, bright-eyed, bushy-tailed cops with a gun on their hip to go deal with somebody who’s in a mental-health crisis,” said Sharon McDonough, who directs the city’s Public Safety Communications Department. “And we’ve all seen the headlines of how that doesn’t work well.”



LINK; https://www.wsj.com/us-news/po...0d4369?mod=wknd_pos1

You know what job I would call in sick for every day? The LEO in that cop, paramedic, mental health guy sandwich. The cop is fooked in almost every scenario. The crazy guy gets violent and he responds, bad. The crazy guy gets violent and he doesn’t respond enough, bad. It’s like a lose lose situation.

Sending just counselors seems like a bad recipe too. The only guy who wins is the paramedic. Lol He stays in the car soaking up the A/C until it’s all over. He’s the only guy with a clearly defined role.

quote:

New units designed to avoid violent and often deadly encounters lack both funding and institutional support

So after all the talk of defunding the police and replacing them with social services, they can't - or won't - fund the social services, either? Stevie Wonder could have seen that coming.

I could sort of see the "social" part under limited circumstances and with proper funding and training, but not for violent or dangerous EDPs.

Just send the mental health person to answer the call for service and when things go sideways and the mental health person is physically hurt/killed or other civilians then get ready for the legal lawsuits to come out because the police failed to protect the mental health worker/ or public because of the new liberal policies on how to deal with todays problems .. You asked for and demanded these responses now get ready to deal with the fallout. ........ drill sgt.

I watched nine Japanese cops with hand held football blocking dummies surround a nut job then when they got him packed in like a sardine,
Three others wrapped in a heavy blanket and Velcro straps.

It was on YouTube.
The cops
Had every kind of padding ,armor and ballistic covering imaginable.

The nut job had a T-shirt and a 16 inch harry Cary knife.

This message has been edited. Last edited by: bendable,

That is good training. Of course the Japanese typically do not have firearms and this is a nonlethal means of control.

In these potentially violent situations, neither the police nor therapists are the right answer.

We should send lawyers. They make everything better.

^^^^^^^^^^^^^^
I have several lawyers that I can suggest.

So, the only choices are the EMT's, police or mental health folks? I think they are leaving out the real "experts" here......they need to the call animal control folks, with those tranquilizer guns. Just shoot them from 10-20 yards away and then haul their butts to a mental health institution and only then, give the antidote. Seems to work on the Serengeti (besides, it seems kind of sporting this way) .....

But it just feels right.
What could go wrong?

I'm all for it!
I'm pretty much done wrestling around with some half naked, sweaty, SOB thats nuttier than a shit-house rat on a hot August day.
Done doing it when it's -10 in Feb as well...


"But... But... He's got a samurai sword and he's NAKED!"

"Great, you got a clipboard and comfortable shoes, you'll get along just fine! I'm out!"

quote:

Originally posted by bendable:
I watched nine Japanese cops with hand held football blocking dummies surround a nut job then when they got him packed in like a sardine,
Three others wrapped in a heavy blanket and Velcro straps.

It was on YouTube.
The cops
Had every kind of padding ,armor and ballistic covering imaginable.

The nut job had a T-shirt and a 16 inch harry Cary knife.

“It might be, it could be, it is, a home run!” Harry Caray

quote:

Originally posted by mike28w:
So, the only choices are the EMT's, police or mental health folks? I think they are leaving out the real "experts" here......they need to the call animal control folks, with those tranquilizer guns. Just shoot them from 10-20 yards away and then haul their butts to a mental health institution and only then, give the antidote. Seems to work on the Serengeti (besides, it seems kind of sporting this way) .....

For the win!!!

It has been over 20-years and things have changed. Mainly public opinion/outcry towards police.

But I will tell you my experience. I was part of a 2-person mental health car, one of the founding teams ever created in our SoCal area and probably even in the U.S. I had a psychiatric nurse. Our main radio calls were for the mental or Dispatcher feeling calls mental health services were needed. It was fantastic.

If the mental health problem was because of drug use or a crime they committed, they went straight to jail. If they were mentally ill, i.e., off their meds, homeless, etc., the clinician side stepped in. We took people were they needed to go for services and did daily follow ups on the people we contacted.

Instead of all the Officers in a Department bouncing all over town to help these mental issues, our car did it for them, allowing them the typical police jobs.

How much Academy training did one get in this area you ask? 4-hours. But the program came with a weeklong academy for the officer and clinician and monthly inservice training. This concept WORKS!

Having a mental health professional at your fingertips on hot calls, barricades, hostage, etc., is the greatest. This clinician can offer insight into the persons mental train of thought and offer suggestions. Numerous times we received written commendations from Hostage Negotiators due to our input on these types of calls. The Fire Department loved us. Fire was repeatedly going on the mental calls but once we stepped in and did our contact and monitoring of the client, Fire's call for service disappeared.

The drawback..Funding. Basically there is a big pie of money that all the organizations get a slice of. The Officer/clinician programs work if they have the funding instead of say the 'home for pregnant unwed mothers over the age of 40 with drug addictions and who cant hold a job and who have failed at all other treatment programs.' (embellished program but you get the slice of the pie funding issue)

Things change over time. A truly beneficial program is the Officer/Clinician patrol car. That is what times have come too. In the old days of police work, the Officer had a 6-shot revolver. Now we have full auto rifles, ballistic gear etc. We have these newfangled things due to changing ways to do Police work. Its time for the Officer/Clinician cars.

I did this for 8- years and it was one of my most rewarding assignments. These programs will never stop the naysayers about how and why Police responded to a mentally ill call but they are a step in the right direction. And more importantly, we became COPS to help people. These programs actually help the citizens we deal with.