Keeping the peace
Social workers pair with police to de-escalate crisis calls
Michael Hawkins and his partner, a Houston police officer, pulled up to a Memorial City gas station last week, responding to a report of a possibly suicidal man.
Hawkins, a social worker, calmly inquired about the man’s condition through a cloth mask while he rested his hands on his bulletproof vest. The man, who was sitting on a concrete box, told Hawkins he had been drinking straight vodka since 6 a.m. He hadn’t eaten in several days. He said he was diagnosed with schizophrenia and saw images of a naked woman.
“Are you hearing voices, too? Anything like that?” Hawkins asked.
“Yes.”
“What are they telling you to do?”
“To kill myself.” The man swayed in the heat.
“I’ll hold off on the questions,” Hawkins said. “I know you’re not feeling well, and we’ll get EMS out here.”
Hawkins and his partner, Officer Richard Pietruszynski, are on the Crisis Intervention Response Team. Hawkins is one of 21 social workers, each paired with officers from the
Houston Police Department and the Harris County Sheriff ’s Office.
The program started in 2008 in collaboration with the Harris Center for Mental Health. At the time, the city hailed it as “the first co-responder concept in Texas” and one of only three similar programs in the nation.
Following CIRT’s success in diverting people away from jail and into treatment — so many that CIRT units often run into a shortage of beds at local psy
chiatric facilities — the role of social workers has grown within Houston-area law enforcement. They now work with police on teams that focus on homeless outreach and domestic violence.
At a time when calls to “defund the police” reverberate throughout the country — and cities explore ways to reduce violent encounters between law enforcement and Black Americans — criminal justice experts and local officials point to that collaboration as a step toward easing tensions between police and communities of color.
“Social workers by nature focus on the root cause of the problem,” said Howard Henderson, director of the Center for Justice Research at Texas Southern University. “They are focused on de-escalation.”
He said such collaborations should be “the wave of the future.”
More training
Police say mental health calls are considered among the most volatile, largely because of the unpredictability of a person’s behavior. A 2015 report from the Treatment Advocacy Center found that people with an untreated mental illness are 16 times more likely to be killed during a police encounter than other civilians approached or stopped by law enforcement.
In Houston, encounters between police and people with mental illness ballooned over the last decade from 23,913 mental health calls in 2009 to 40,884 in 2019.
All incoming Houston police officers and Harris County sheriff ’s deputies are required to receive at least 40 hours of mental health training. By comparison, social workers on CIRT tap into years of education and experience.
Social workers on CIRT have undergraduate degrees in psychology or a related field, as well as master’s in psychology or social work. They’ve also earned their license as a professional counselor and have experience working with people in mental health crises.
CIRT clinicians ride with a sheriff ’s deputy or a police officer like other two-person units as they monitor radio traffic and mental health-related 911 calls. Hawkins wears a bulletproof vest and Navy blue attire like a police officer but doesn’t carry a weapon, and a closer look at his vest reveals a Harris Center for Mental Health emblem.
Hawkins’ role differs from his law enforcement partner, whose primary job is to ensure the scene is safe. Hawkins focuses on making the person comfortable and digging into what caused the episode. He also has access to public medical databases, which often tell him more about the person’s underlying conditions.
“We get to be there at the most critical, difficult moments possibly in a person’s life and intervene and give them hope,” he said. “So my focus is I’m trying to help him or her through that. I’m not necessarily trained like the officers, who might be scanning a room, or might be looking for a certain behavior that indicates potential violence. It allows me to really focus on that individual and get them help.”
CIRT calls rarely end with an arrest. Of the 5,519 mental health calls handled by CIRT last year, 29 people were arrested, according to the Houston Police Department's Mental Health Division. Another 2,174 people — nearly 40 percent of the calls — were involuntarily taken for psychiatric treatment because of the severity of their illness. Among those, 182 people were suspected of criminal activity but diverted from the jail. Many calls result in police filing a report without any action.
Henderson, the Center for Justice Research director, suggested that social workers’ education allows them to better understand different cultural backgrounds. That’s key in an emergency situation involving minorities who might behave differently around law enforcement, he said.
“(Social workers) understand the person’s bravado may be different,” he said. “These situations can turn bad because a police officer feels disrespected in their mind, and the event turns on the drop of a dime.”
Victim-centered responses
Another group working to bring expertise to victims who come into contact with law enforcement is the Texas Forensic Nurse Examiners.
The nonprofit, formed in 2019 in Houston, provides trauma-informed medical forensic exams, forensic interviews and evidence collection to victims of sexual assault, domestic violence, human trafficking as well as child and elder abuse in Southeast Texas. Law enforcement agencies, such as the Harris County Sheriff ’s Office, use the evidence collected by the organization in criminal cases.
Founder Khara Breeden said she saw the need for such a program when she worked for the Harris County Health Department. Instead of going to a police station victims can go to the TFNE office to talk to forensic nurses in interview rooms.
“If you go to a police station to make that initial report, you might be out in the open for other people to hear everything you’re saying,” said Forensic Nurse Examiner Heather Simon, who works for the nonprofit. “Or you could have a trafficking victim worried about talking about their abuse because their trafficker is feet away.”
The experience of having an exam and interview conducted by a forensic nurse is also more victimcentered than it would be at an emergency room, said Simon.
“Forensic nurses can home in on specific areas that need to be collected,” she said. “Often, ER nurses will swab a victim from head to toe, when it’s not appropriate for each victim.”
When victims feel more comfortable, they are better able to accurately recall their trauma, said Simon.
‘Defunding’ police
The calls to “defund the police” that increased after the in-custody killing of former Houston resident George Floyd in Minneapolis have taken on different meanings. Some advocate dismantling local police departments entirely while others take a more measured stance, proposing to keep departments intact while reallocating resources.
Harris County Commissioners Court last month approved $5 million in grants for any Harris County city that implements an emergency response unit supporting public and mental health.
Houston city council member Letitia Plummer advocates using those funds toward a citywide initiative similar to CAHOOTS, a 30year-old program in Eugene, Ore., that pairs EMTs with behavioral health experts to handle mental health calls without police.
She envisions that program supplementing CIRT, which only handles about 12 percent of the citywide mental health calls.
Sheriff Ed Gonzalez has been analyzing alternative forms of policing since he took office in 2017 and said he’s always looking for ways to focus on mental health and addiction.
But simply adding more social workers comes with its own set of complications, he said. Harris County doesn’t have enough capacity in psychiatric hospitals to support a major increase in the number of people taken in for treatment, he said.
“I think we have to be smart, and I do think there are opportunities to re-examine policing.”
Houston CIRT units most often take mental health patients to the NeuroPsychiatric Center at Ben Taub Hospital, but the facility doesn’t always have enough room among the 170 staffed beds. Units regularly have to take the patient to an emergency room, which focuses on physical ailments rather than mental.
“They’ll benefit more from an actual psychiatric facility,” said Houston Police Sgt. Julio Silva, who oversees CIRT units during the evening shift. “There’s so many of these types of calls that we’re bombarding these hospitals, but we don’t have a choice. There’s no other option. You can’t just leave them on the street.”
In Memorial City last week, Silva and Hawkins watched as paramedics loaded the man with suicidal thoughts into an ambulance. He was taken to a nearby hospital because of his medical issues.
From there, the doctors and police likely will provide information about the interaction to a judge, who would decide whether he needs to be committed to a psychiatric hospital long-term, Hawkins said.
The man thanked officers before he was taken away. For Hawkins, it’s a small reminder of why he does the work.
“When I’m there, hopefully I provide you comfort and kindness and get you some help, and that’s why I love doing it and that’s why I’ve stayed,” he said.