POLICE AND HEALTH AGENCIES MUST WORK TOGETHER
It’s become nearly cliché to describe the United States as polarized, and recent public debate about the roles of law enforcement agencies and mental health care is an unfortunate example.
In May, with the tragic murder of George Floyd, the national conversation around these issues has included both calls to defund municipal police departments and opposing calls for the preservation of law and order.
I would argue for policy and investment discussions to be less focused on specific institutions, and more about how all our resources, collectively and with potentially changed parameters, can achieve the outcomes that we all truly value.
With respect to the handling of mental illness and emotional crisis, we know that our communities want humane care for those in need as well as ensuring public safety.
Our municipal governments need to continue moving toward more coordinated care and response across law enforcement and health care, and we need to demand that the work that governmental and service providers do, taken together, is measured against these metrics.
In San Diego County, the spirit of this approach may be best reflected through longstanding investments in the psychiatric emergency response team (PERT) program.
Launched in 1995, PERT is a countyfunded program in which specially trained law enforcement officers and deputies are paired with licensed mental health professionals to respond to and deescalate psychiatric crises. PERT also provides ongoing law enforcement training in mental health response in support of the county District Attorney’s Office’s initiative to train all law enforcement in mental health crisis deescalation.
In the last fiscal year, PERT’s nearly 35,000 community contacts included over 12,000 crisis interventions, 48% of which were resolved without requiring hospital transport under Section 5150 of California’s Welfare and Institutions Code.
PERT alone, however, is not a complete solution.
Despite the program’s demonstrated success, significant gaps remain within the local mental health crisis response continuum.
Frequently, calls to 911 result in the dispatch of PERT where the presence of law enforcement is not necessary and, in fact, can have adverse impacts on client and community wellness.
To properly respond to mental health crises where there is not an immediate threat of violence, the county has begun making significant investments into nonlaw enforcement mobile crisis response teams (MCRT).
MCRTs include mental health professionals who provide clinician-driven and peer-supported crisis intervention, assessment and connection to behavioral health care.
Deployment of MCRTs, which is in the planning and design phase now, will be coordinated with law enforcement, and accessible through both the Access and Crisis Line (ACL) and 911 dispatch. The clinical composition of MCRTs, along with law enforcement coordination, will enable a tailored approach to situations on the ground that can shift as circumstances evolve.
Modeled generally after the CAHOOTS (Crisis Assistance Helping Out on the Streets) program, launched decades ago in Oregon, and mirroring similar programmatic efforts in San Francisco and New York City, MCRT will be established throughout the region.
By complementing the PERT program, CAHOOTS will give San Diego County a uniquely robust continuum of mobile crisis services.
Achieving this result is only possible through engaging our law enforcement and health care resources in a collaborative, cohesive way, with the shared goals of achieving optimal client care and overall community wellness and safety. I am confident our region is on a path to a successful outcome.