KALAMAZOO, MI – Police respond to a domestic dispute between mother and daughter find a distraught teenager cutting herself.
A disruptive man in a parking lot appears to be suffering from psychotic delusions.
A frantic call to the emergency services comes from a woman worried that her husband is suicidal or someone whose family member has overdosed on drugs.
In Kalamazoo County, as throughout the country, police calls often involve individuals in the throes of a behavioral health crisis.
“I’d say between 25% and 30% of our calls have a mental health component,” said Deputy Chief John Blue of Portage Public Safety.
In fact, Kalamazoo County Sheriff Ron Fuller estimates that 60% of his inmates have mental health problems, “and it’s a good day.”
In 2021, the Kalamazoo County Emergency Health Services Central Dispatch received nearly 19,000 calls reporting a behavioral health problem, county officials estimate. That’s an average of 51 calls per day.
County law enforcement agencies have been working for years to improve their response to such calls, particularly in the wake of the Black Lives Matter protests two years ago.
But now, backed by a $ 500,000 federal grant, county police chiefs are joining forces with local mental health experts to take reforms to the next level. Instead of a piecemeal approach, police department by department, they are devising county-level collaboration to strengthen the relationship between law enforcement and the mental health system.
“We are not consultants,” Kalamazoo County Sheriff Rick Fuller said. “We are police officers trained to comply with the law. And we’re being called to be mental health counselors on more calls than we ever would prefer.
“Our ultimate goal is for the day to come when many of the calls that come in to law enforcement can be released faster and the mental health system can take over because it’s not a law enforcement function,” he said. Fuller said. “Too many times now, law enforcement is the only answer. We’ve had serious cases where we had to physically hire someone, take them to jail and the caller said,” This isn’t what I wanted, “and neither do we.” .
The new project has four “pillars,” said Lindsey O’Neil, program supervisor for integrated services at Kalamazoo, the county’s community mental health agency. O’Neil is working with the county’s 10 police chiefs to oversee project planning this year, with implementation in 2023.
The first pillar is the creation of “a county-level call response model that has (mental health) doctors to respond in real time to crisis situations,” O’Neil said. “How it looks will depend on the model this group chooses to adopt.”
The second piece is the opening of a 24-hour mental health crisis intervention center to provide rescuers with a place to take people in need of immediate attention, as an alternative to hospital emergency wards. The new facility will be located at 440 W. Kalamazoo Ave. and is expected to open next year
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The third piece is the creation of a county-level group that will meet regularly to focus “on our high-risk, high-need individuals who are very EMS users and have a frequent recurrence rate,” O’Neil said. . “We will try to create a holistic plan where we can wrap services around those individuals and families to reduce the frequency of calls and the frequency of crisis situations.”
The fourth and final piece, he said, is creating a county-level coding system for local police departments to facilitate better collection of data on calls involving behavioral health.
Such a coding system would allow officials and the public to know how many such calls are being received and how many result in an arrest, hospitalization or diversion to other programs, O’Neill said.
It’s an ambitious project, but it bodes well for the collaboration to be led by law enforcement, said Jeff Patton, head of integrated services at Kalamazoo.
The local police chiefs “approached us and said: ‘We are ready. We want to take this next step. Our communities are saying we need it, ‘”Patton said.”
The Memphis model
Kalamazoo County is using the “Memphis model” as a model for the project.
That model was developed after a 1987 Memphis police shooting in which a mentally ill man was shot and killed by police. In the aftermath of the death, the city partnered with the National Alliance on Mental Illness and civic leaders to develop new strategies for managing people going through a mental health crisis.
This has resulted in specialized training to educate the police about mental health symptoms and conditions and how to respond effectively to calls involving behavioral health issues.
Kalamazoo County law enforcement has conducted these Crisis Intervention Team training courses since 2008, most recently this spring when 42 officers from Kalamazoo, Portage, Kalamazoo Township, Vicksburg, Kalamazoo County Sheriff’s Office, and the Michigan State Police participated in the 40-hour program.
The program gets praise from local police agencies.
“In Kalamazoo County, we have built a CIT-based problem-solving culture,” said Captain Rafael Diaz of the Kalamazoo Department of Public Safety. “It’s not like it’s a new program and people are uncertain about its effectiveness and if it has good results. I’ll almost tell you that within hours of class, someone will have an experience where they can use those skills on the street. “
But a U.S. Department of Justice guide on CIT and the Memphis model points out that police training is only part of the program.
“The hardest lesson we’ve learned is the temptation of training,” says the guide. “Law enforcement and prisons continue to be the de facto system for responding to mental health crisis situations and hosting people with mental illness. Law enforcement is under enormous pressure to address this systemic challenge. We hear from agencies eager to learn about CIT training on a daily basis, hoping it will be a solution to their problems. Training is an important step, but CIT’s goal is not to train officers to be kinder and kinder as they take people to jail.
“CIT’s goal is to protect people and that’s not possible if prison is the only destination during a mental health crisis,” says the guide. “A CIT program should help people connect to care and services and offer hope for recovery… Training-only approaches do not improve safety and reflect a misunderstanding of the CIT model. The CIT model is not just about the police; it is about community responses to mental health crises ”.
For Kalamazoo County, the challenge is now taking it to the next level. The four pillars of the new Kalamazoo County project are all elements of the Memphis model.
Of the 10 Kalamazoo County Police Departments, the Portage Department of Public Safety did the most with CIT training – nearly all of their officers followed the CIT program, compared to about 90 of Kalamazoo Public Safety’s 240 officers.
Portage also requires its officers to tag calls with a behavioral health component. A list of these calls is delivered each week to Integrated Services of Kalamazoo, which reviews them to see which are the best candidates for follow-up. On Wednesdays, an ISK social worker goes out with a Portage police officer to knock on doors and direct individuals and families to appropriate services.
To be sure, some police calls require immediate action, such as taking someone to the hospital emergency room, Blue said.
ISK’s follow-up requests are “more things that can go off the radar, where we might respond to a complaint from a barking dog, and find that a senior with Alzheimer’s dementia has never been to a doctor. and there is hoarding in the house, “he said. “The doctor takes the lead on follow-up, but we’re the ones who started it.”
But Portage’s experience also underscores the obstacles that exist, Blue acknowledged. People can refuse mental health counseling or other services. They may accept the offer of help, but then fail to complete. They may not have insurance to pay for counseling or other services. Statewide psychiatric bed shortages remain an ongoing problem. Medical confidentiality laws mean law enforcement may not know what happens once doctors take over.
The new collaboration won’t be a silver bullet, officials acknowledge, but it should improve law enforcement’s ability to connect people with mental health services and make these efforts more consistent across the county.
“As we begin to collect data and look at what’s happening in the community, I hope we can really pinpoint those high-risk, high-need areas and understand who needs what and where,” O’Neil said.
Like Patton, O’Neil said she was impressed by the police chiefs’ enthusiasm to put a plan into action.
“There are a lot of moving pieces in this and they’ve got all their hands on the deck,” he said. “They said, ‘Whatever you need, whoever you need to make it happen, we’ll make it happen.'”
This story is part of the Mental Wellness Project, a solution-oriented journalism initiative covering mental health problems in southwestern Michigan created by the Southwest Michigan Journalism Collaborative. SWMJC is a group of 12 regional organizations dedicated to strengthening local journalism. For more information visit swmichjournalism.com.
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