When crises don’t need police
Albany County pilot program focuses on mental health calls
When Katie Flanigan and her team get a call concerning a person in mental or emotional distress, they arrive in an unmarked vehicle. No sirens, no lights, no uniforms, badges or guns.
Just people there to help.
“It’s intentional,” said Flanigan, clinical director of emergency services and training for Albany County’s Department of Mental Health. “We don’t want to scare people away or tell the neighbors what’s happening.”
Flanigan heads up the county’s 35-year-old mobile crisis team, which formed in response to the 1984 killing of Jessie Davis, a mentally ill man who was gunned down in his Albany apartment by police after neighbors called about a disturbance. His death sparked outrage and was examined in a statewide study of police shootings of Black people.
“It seems right out of the headlines of the current day,” said Stephen Giordano, director of the county’s mental health department.
While the officers were ultimately cleared, Davis’ death prompted the county to alter the way it handles calls for people experiencing a mental health crisis. The mobile crisis team dispatches trained social work
ers to the scene of crises where they attempt to de-escalate things and evaluate the person for whatever resources they may need, from hospitalization to information about community programs.
More than 30 years later, the county is expanding the program in response to national outrage over police violence that disproportionately impacts people of color and those living with mental illness.
The new program, dubbed Albany County Crisis Officials Responding and Diverting, or ACCORD, was launched earlier this month. It will operate as a test designed to improve outcomes for nonviolent emergency calls in the county’s vast and rural Hilltowns. The idea is to remove police from situations where they’re not needed, freeing up officers to handle far more serious crime and reducing the chances of unnecessary harm and death, Giordano said.
“You bring a law enforcement officer who is not trained in handling mental health crises to a volatile situation with a weapon — I think the logic is bad things could happen, and sometimes they do,” he said.
In the years Flanigan has led the county’s mobile crisis program, police were only required at about half the scenes her team responded to. Leaving them out of the equation when they’re not needed can have a big impact when it comes to de-escalating a chaotic situation, she said — especially when the person has a history of poor interactions with police.
“Individuals that are in an emotional crisis, they feel it,” she said of the stigma that falsely equates mental illness with violence and criminality. “They’ll say, ‘Why are the police here? Am I going to get arrested?’ Their mere presence can escalate things.”
As part of the ACCORD program, dispatchers in the Hilltowns were trained in evaluating whether a call requires a police response — a task that often depends on observations from witnesses on the scene. Flanigan, who now oversees ACCORD as well, said that witnesses can be unreliable. (Tamir Rice was shot dead by Cleveland police in 2014 after a caller told dispatchers the 12-year-old had a gun. It was a toy.)
To assist in such evaluations, the mobile crisis team maintained a database in which they could look up the history of individuals who have been the subject of repeat calls. They would sometimes make notes to assist in future responses, such as whether the person reacted poorly to police or became violent.
“Mentally ill people are more likely to be the victim of crime than the perpetrator of crime,” Flanigan said. “And it’s really untreated mental illness — usually in combination with substance abuse — that is the driver of violence, if there is an association at all. Unfortunately, I think most people think if you’re crazy you’re violent — and that’s just not true.”
Joining the ACCORD program are social work and public health researchers from the state University at Albany, who will collect, track and analyze data on the program to see whether it’s working as intended. Giordano said the hope is that it could be used as a model elsewhere in the region or state — especially in advance of the nationwide rollout next year of a 9-8-8 mental health hotline, which will require municipalities to train dispatchers in which calls merit police and which ones require mental health professionals.
While ACCORD was designed to address the needs of people experiencing a mental health crisis, it has already been used to respond to other nonviolent calls that don’t rise to the level of requiring police. Such was the case of an elderly woman with dementia who was repeatedly calling the police to report her caregiver, whom she assumed was an intruder.
“The social worker was able to talk her down and de-escalate the situation, and she had medical complaints so we evaluated her and had an ambulance come,” said Nena Ruiz, paramedic supervisor for the new program. “It was exactly how we imagined ACCORD would work.”
Paramedics are an important aspect of the response team, and not just in the event someone attempts self-harm, Ruiz said. She said many mental health crises are often medical issues in disguise — or vice-versa: A diabetic who is experiencing low blood sugar can become confused and behave irrationally; a person with an untreated urinary tract infection can experience psychosis; panic disorders can look like heart attacks.
“Your brain is almost like a diva,” she said. “Anything that involves the brain or blood chemistry can cause a person to act out, which could prompt someone to think there’s a psych or mental health issue. So if we can make that assessment from the start, that helps.”
Although the majority of mental health calls come from the city of Albany, the Hilltowns were chosen for the pilot because they lack the concentration of services are available elsewhere in the county, Giordano said.
Mental health providers told state lawmakers at a hearing last month that rural communities are some of the hardest places to deliver crisis intervention services. As states, including New York, look to implement more mobile crisis teams, they’re finding that under-resourced mental health departments are simply unable to respond in a timely manner to certain crisis calls, especially if they serve a broad geographic area.
“It’s only a challenge if you don’t have money,” Assemblymember Aileen Gunther told the head of the state’s mental health office. “We have hospitals, we have clinics. A lot of it is the investment of New York state. Do we want to invest on the beginning or on the end? More expensive is getting people hospitalized. Less expensive is putting the down payment on mental health.”