By Carina Julig
The Santa Fe New Mexican
ALBUQUERQUE, N.M. — Asphalt gives way to dirt roads in a tiny corner of Albuquerque’s South Valley, where a crowing rooster adds to a sense of a rural enclave in busy Bernalillo County.
But suspicious behavior is not limited to city streets, and on this spring day, someone has called 911 to report the presence of a homeless man outside the mobile home where an elderly woman with dementia lives.
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Several Bernalillo County Sheriff’s deputies have responded, their vehicles parked in front of the mobile home. But it’s not a sheriff’s deputy who speaks to the man outside the residence. They hang back and leave the questions to Jennifer Moya, a clinician with the Behavioral Health Unit of the sheriff’s office, which responds primarily to 911 calls dealing with incidents involving behavioral and mental health issues.
The man explains the elderly woman is his aunt, and he’s just there to do laundry.
The Bernalillo unit has continued to add staff members since its inception in summer 2023 and responded to more than 3,000 911 calls last year. Clinical manager Michael Lucero said he did not know how many calls the unit responded to in its first year but it “absolutely” saw an increase.
By contrast, a similar initiative in Santa Fe, the Alternative Response Unit, has dwindled since its launch in 2021 — losing employees and responding to fewer calls.
“We are expanding … because our model is working,” Lucero said in an interview at the Behavioral Health Unit’s headquarters in the Bernalillo County Public Safety Center.
The Behavioral Health Unit in January expanded its medical capacity, with paramedics receiving authorization to administer the antipsychotic drug olanzapine in the field to stabilize patients experiencing mental illness or drug-related psychosis, a move Lucero described as a “game changer.” That same month, Santa Fe removed paramedics from its ARU.
There are still few nationwide standards for alternative response programs to address nonviolent behavioral health crises and relieve pressure on law enforcement and emergency medical responders, even as the prevalence of such public safety efforts grows. This leaves alternative response teams with varied staffing, practices and powers.
As Santa Fe prepares to overhaul its struggling ARU, Bernalillo County’s Behavioral Health Unit could serve as a model for creating a successful initiative.
‘Reduce calls for service’
After Bernalillo County deputies left the South Valley home, Moya continued speaking with the man, who said a methamphetamine addiction had led him down a path to homelessness, and he was dealing with injuries to his feet from a stint in jail.
He apologized for going on so long, a concern Moya gently rebuffed.
“I get paid to be here, so take your time,” she said, then asked if he was willing to go to rehab (no), if he had a medical provider who could help him get treatment for his feet (yes) and where he usually spends his time, so a case manager with the unit could follow up with him for a longer conversation.
It was a standard 911 call for the Behavioral Health Unit in which a detective, a paramedic and a clinician respond to incidents that do not require an arrest. They sometimes spend lengthy amounts of time responding to mental health crises and reports of people struggling with addiction and other behavioral health conditions.
The people they contact are paired with a case manager who can connect them with services and resources.
Funded through a Bernalillo County gross receipts tax for behavioral health services, the unit has expanded significantly since its inception. It now has 19 employees, including five sheriff’s detectives, five independently licensed clinicians, four case managers and three Bernalillo County Fire & Rescue paramedics, who are assigned to the unit under an agreement with the sheriff’s office.
Lucero described the unit’s mission as twofold: To get people in crisis the help they need, and to reduce the strain of addiction and behavioral health problems on the region’s other first responders and frontline medical providers.
“The big thing for us is trying to reduce calls for service for our deputies,” Lucero said, noting someone who is in a behavioral health crisis can generate multiple 911 calls in just a single day.
The unit’s ability to take time with people is one of its superpowers, said sheriff’s office Detective Steve Aldredge , who is assigned to the unit.
While deputies arrive at a scene first to conduct a safety assessment, they can leave relatively quickly to respond to other calls if there is no threat of violence, while the behavioral health team can stay as long as needed.
The unit’s services sometimes extend to driving a person to a homeless shelter or a rehab facility and staying with them until they get a bed, which has a much higher success rate than simply dropping them off, Aldredge said.
“We found that if we don’t walk in and advocate for them, they’re all of a sudden now having to retell their story again to another stranger, and they may or may not even stick around,” he said.
Because the unit’s primary focus is decreasing the call volume for the sheriff’s office, Lucero said people outside the office cannot specifically request the Behavioral Health Unit, though it does accept referrals from the University of New Mexico’s Psychiatric Emergency Services through an agreement.
The unit does not conduct proactive street outreach.
Lucero said its teams used to go to Albuquerque’s International District, a neighborhood that has become known for a high prevalence of drug use and homelessness, to try to connect people with addiction resources but stopped because too few people were receptive to services to justify the use of the unit’s resources.
Aldredge said many people on the street are too deep in their addiction to be open to treatment, although he said the unit avoids describing them as unwilling to seek help.
“We don’t like to say that ‘they don’t want it’ as much as ‘they’re not ready,’ ” he said.
‘Work some magic’
The unit has made adjustments over the years as it worked to best meet the needs of the sheriff’s office, but one of its biggest changes came in January when the state Emergency Medical Systems Bureau, a division of the New Mexico Department of Health, granted the Bernalillo County Fire & Rescue paramedics on the unit approval to administer the antipsychotic drug olanzapine in the field, also known by the brand name Zyprexa.
Placed under the tongue and dissolved, Lucero said it takes about 20 minutes to take effect and is used to stabilize people who are exhibiting signs of mania or psychosis, either from a mental health condition or as the result of drug use.
He said people “must consent” to taking the drug and noted the unit received training, and the paramedics had to pass a written test before they could begin administering it.
“I’ve seen it work some magic,” Moya said, noting one of the people it was administered to was a man having a manic episode at the Albuquerque International Sunport.
The man was able to get on his flight and go back to his family in another state, Moya said, adding she spoke with members of the family, and they were working to get him into a treatment facility after he landed.
If the situation continued to escalate, Lucero said, the man might have been barred from flying and stuck in an unfamiliar city.
Lucero said the unit developed its protocol based on the crisis response unit in Round Rock, Texas, which has been administering the drug for two years. Case managers must follow up with anyone given olanzapine within 24 hours, he said.
The innovative treatment method has received notice from other behavioral health providers in New Mexico.
Kate Field, the director of crisis services with New Mexico Solutions, a nonprofit contracted by Santa Fe County to operate the La Sala Crisis Center, described Zyprexa as “very safe and very effective” and lauded the Behavioral Health Unit’s use of the drug.
Because Santa Fe no longer has paramedics on its Alternative Response Unit, “that certainly can’t be done now” in Santa Fe , she noted.
Wins and losses
Lucero said the ability to give the drug and conduct medical assessments in the field is part of what makes the paramedics helpful to the unit, while the detectives can look up what someone’s interactions with law enforcement have been.
“Having all three has been absolutely beneficial,” he said of the co-responder model.
Its employees also spoke positively of the model, including new paramedic Joe Drevenak, who joined the Behavioral Health Unit in December after 20 years in emergency medical services, 12 with Bernalillo County Fire & Rescue.
He said the Behavioral Health Unit is “much less stressful,” and he loves the return to a normal 40-hour workweek after years of working overnight on 48-hour shifts.
The fire department is increasingly supportive of the unit, Drevenak said, noting it picks up calls that otherwise would go to other members of the department. “The more they learn about it, the more they really appreciate the program,” he said.
On the same day in May when the team spoke with the homeless man at his aunt’s home in the South Valley, it responded to a complaint of a homeless man trespassing at a Maverik gas station.
“Had I not been there, they probably would have called out a rescue to evaluate that guy,” Drevenak said. “But since I’m there and there’s no medical component, the fire department doesn’t even get that call.”
Drevenak said he has administered olanzapine three times in the field since January.
“It’s pretty crazy,” he said of the antipsychotic, which he described as “Narcan for meth,” referring to the medication used to reverse opioid overdoses.
Two of the three times, things went as expected. The other time, he said, he administered the drug to a woman on methamphetamine who said she was willing to go to rehab right then and there.
As soon as the drug’s effects took hold, however, “she was brought back to reality and wanted nothing to do with reality,” he said. Instead of going to a treatment center, she turned around and walked away.
In the following months, Moya has tried to find her. So far, she hasn’t succeeded.
Not every day is a win. But as Aldredge watched Moya interact with the homeless man at his aunt’s house, he said the interaction points to what makes the program special.
When the unit arrives, most of the people they come into contact with immediately assume the presence of first responders means they’re about to get in trouble again.
When they realize the unit is there to help them, their demeanor changes, to the point at which Aldredge said he can physically see tension leave their bodies.
“That’s what I look for,” he said, gesturing to the man. “Now looking at him, he’s happy — someone actually gave him a chance.”
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