Minn. county tries new approach for some 911 crisis calls
Mental health professionals provide in-person assessments and assistance over the phone
ST. PAUL, Minn. — A call comes into 911: “My roommate hasn’t been taking his psychiatric medicine. He’s acting strangely.”
Typically, a dispatcher would send a police officer to check with the individual, but such a call will likely be treated differently starting Tuesday in St. Paul and most of suburban Ramsey County.
Some calls about people experiencing mental health problems, which don’t involve a crime or immediate safety risk, will instead be referred to Ramsey County’s mental health crisis line, which has existed for about 20 years. Mental health professionals provide in-person assessments and assistance over the phone.
“People are calling 911 for a police response because they know they need help, but they don’t necessarily know that mental health crisis services are available,” said Alyssa Conducy, who manages the county’s adult mental health and chemical services. “This is an opportunity to connect people to the right resource at the right time, so that they can get whatever services they might need.”
The pilot program, which begins Tuesday, has the potential to head off situations that could lead to a police officer shooting an individual or otherwise using force, said St. Paul Police Cmdr. Mary Nash. Since 2004, at least 29 percent of the people fatally shot by police officers in Minnesota have been mentally ill, according to a Pioneer Press analysis.
Sometimes the very presence of a uniformed officer responding to a call can amp up a person who is in a crisis, especially if the individual is delusional or paranoid, Nash said. That could lead to a person in crisis fighting with the police or brandishing a weapon, she said.
Under the pilot program, people might get help from a mental health professional before their crisis becomes more severe and police are called to respond, said Sue Abderholden, executive director of the National Alliance on Mental Illness’ Minnesota chapter.
“A mental health professional really does know how to de-escalate, how to engage the person and how to support them,” she said.
Two of the three people fatally shot by a St. Paul police officer last year had histories of mental illness, but the calls that drew police to them would not have resulted in a non-law enforcement response under the new system, according to Ramsey County and St. Paul police officials. The pilot program is intended only for calls that meet particular criteria, including ones that do not report a crime, a weapon, and a person having hurt himself or others or threatened to.
In one of the St. Paul officer-involved shootings last year, a 911 caller reported Justin Tolkinen was outside a residence with a rifle; he got into a standoff with police and aimed his weapon at officers, police said. In the other, Philip Quinn’s fiancée reported in her initial call that Quinn had recently cut himself; later in the day, he lunged at an officer with a screwdriver. Grand juries found officers justified in their use of force in both cases.
Abderholden called the 911 pilot program “a good starting place,” but said more needs to be done to train officers responding to calls about people in crisis. In St. Paul, about one-third of front-line patrol officers have been certified in Crisis Intervention Training. The department has said its goal is to train all patrol officers.
Last year, St. Paul Police Chief Thomas Smith asked Nash, who conducts policy work and research for him, to examine the department’s response to calls about people having a mental health crisis. The department had noticed an anecdotal increase in such calls (hard numbers aren’t available because the reports could be categorized in different ways, a police spokesman said).
“If there is a call about someone not taking their medicine, should officers really be sent to tell somebody they need to take their medicine?,” said Nash, a St. Paul police crisis negotiator for 20 years who leads the department’s team of negotiators. “Do we go to something like that and does it go from bad to worse? We were asking, ‘How do we utilize our community partners to have a better response?’ ”
The idea for the pilot program bubbled up during a meeting last fall with St. Paul police, Ramsey County staff and others. The gathering came a little over a month after Quinn was killed, but the internal discussions about crisis calls had already been happening, Nash said. Still, the Quinn case underscored the importance of agencies working together to find better ways to get people the help they need, hopefully before they are in serious crisis, Nash said.
The ECC dispatched 573,600 calls last year, and about 4,400 were coded as involving someone “emotionally disturbed,” according to Ramsey County, an average of 12 a day. The county anticipates the ECC will transfer two or three calls a day to its crisis line under the pilot program.
Conducy said she believes the crisis line can handle the increased volume with its current staff. If they get more calls than expected, “we’ll have discussions about how we need to adapt our systems to make it work,” Conducy said.
The crisis line fielded 19,232 phone calls last year and conducted 1,573 in-person assessments. It had a 67 percent increase in calls compared with a decade ago.
The pilot program will be used in the areas covered by the ECC: St. Paul and all of Ramsey County (except White Bear Lake, which has its own 911 center). Calls to 911 or a police nonemergency number that meet the criteria will be sent to the crisis line between 8 a.m. and 11 p.m. The crisis line is answered 24-7, but the small number of overnight calls is contracted out to Dakota County, Conducy said.
Though NAMI Minnesota pushed in 2009 to make the law clear that 911 operators can make referrals to mental health crisis teams, Abderholden said she has not heard of other 911 centers in the Twin Cities doing so.
At the Minneapolis 911 center, most of the mental health calls are about people in crisis who need an immediate law-enforcement response, said Christine McPherson, Minneapolis Emergency Communications assistant director. Hennepin County has a community psychiatric outreach program that works with the city and county 911 services as needed, and individuals often call them directly, McPherson said.
PILOT PROGRAM WILL BE EXAMINED
In Ramsey County, 911 calltakers have been trained to assess which calls could be referred to the crisis line, said Nancie Pass, the ECC’s deputy director. Operators will ask callers if they feel comfortable being transferred versus having law enforcement respond. If they do, the 911 operator will stay on the line to be sure they’ve connected with the crisis line before getting off the call, Pass said.
Mental health staff conducts a crisis assessment over the phone and then determines next steps, such as talking an individual through a crisis or providing them with referrals, Conducy said. If the crisis line staff decides an individual is at immediate risk to harm himself or others, they will contact the ECC again to ask for a police response. The county’s mobile crisis team already asks officers to accompany them about two-thirds of the time, Conducy said.
Ramsey County will examine how the pilot program goes and make changes as needed, Conducy and Pass said.
Abderholden said she hopes the criteria about what calls to transfer to the crisis line will not be set in stone.
“If someone is suicidal, why wouldn’t you want to send the crisis team out?” she asked.
But Conducy said there will still be times, including when someone is threatening suicide, that an immediate law enforcement response is needed.
“If there’s a health or safety risk to a person or to other community members, that’s not the time to wait for us to respond, and the police still have an important role in that process,” she said.
Dan Bauman contributed to this report.
Copyright 2016 the Pioneer Press