Roundtable: How to develop a successful mental health intervention program
'The magnitude of societal issues has far exceeded what law enforcement and mental health providers can effectively address alone.'
By Nancy Perry
To safely and effectively respond to people with mental illnesses, law enforcement agencies have developed police-mental health collaborations among police departments, mental health care providers and community-based stakeholders.
Currently, these collaborations are part of the national dialogue on police reform, with some cities looking to shift responsibility for mental health crisis response from LEOs to non-law enforcement crisis response teams. Due to the complexity of these responses and the safety risks to both those in crisis and the responders, it is unlikely law enforcement will be removed from the equation. With this in mind, Police1 asked several police leaders engaged in mental health collaborations what advice they would have for a law enforcement agency looking to work with a behavioral health agency to develop a successful mental health intervention program. Here are their suggestions.
Get community buy-in from the beginning
Shortly after taking on the task of researching police mental health collaboration best practices, I met with Sue Abderholden, Executive Director of NAMI Minnesota. My goal was to create a plan to implement changes in how we respond to crisis-related calls for service and was hoping to learn from her expertise.
Director Abderholden told me it was important to not recreate practices or services already available but to think differently. That is, to consider the question of what else can we do and what other services or response could we create. This was sound advice that led our department to a pathway of creating a changed response that is based on collaboration with our community-based resource partners.
We often hear that law enforcement officers find change difficult. I would argue the opposite. Throughout the history of law enforcement, we have found ourselves in a state of change. If we consider our own careers within this field, there has never been a stagnant time where we are not learning, adapting, advancing or making improvements to our protocols, policies and procedures. We now find ourselves in this space again.
Our communities are asking for a change in how we respond to mental health-related calls for services. Some voices can be heard messaging it should not be police officers who respond to these situations. There are many reasons why law enforcement may always be a part of this response. But is it possible that we change our response to a collaborative approach?
My advice to any agency considering making changes to crisis-related call response protocols and procedures is to engage with the community. Ask your community members to partner with you for recommendations on relevant changes. Consider creating an advisory board that includes organizations such as NAMI, community members with lived experiences and officers who have a passion for this type of work, as well as other stakeholders willing to partner with your agency.
Encouraging community buy-in and engagement at the very beginning is a great first step in ensuring you are creating relevant and timely changes to your agency.
— Sergeant Jamie Sipes, Community Outreach and Stabilization Unit, St. Paul Police Department, Minnesota
Develop a steering committee
Developing a successful mental health intervention program has many levels. Often because of limited resources and complexity, organizations tend to operate in silos and don’t communicate outside of them. A successful mental health intervention program requires consistent collaboration across separate resource providers. It’s important to form a group of people who recognize the issues from their area of expertise and are willing to collaborate across the system to improve resource delivery and outcomes for people in crisis.
Cast a broad net and include partners from your state behavioral health authority, local mental health and substance use providers, hospitals, advocates, law enforcement, fire, EMS, dispatch, corrections, probation and parole, and the courts. Develop a steering committee to oversee the ongoing training program and outreach that is necessary to maintain the program.
The steering committee can be local or regional in scope. A state-wide program can focus on certification and training protocols, but cannot replace local training and collaboration. The steering committee should also develop an award and recognition program for first responders, providers and others who are engaged in the day to day work of crisis intervention. A yearly recognition event helps keep the program motivated.
In addition to the steering committee, there should be a problem-solving collaborative that meets regularly to discuss individuals who are having difficulty stabilizing their crisis and challenges related to effective resource delivery.
Develop a drop-in center for crisis-related calls. This allows the community to have a resource for people who are experiencing a behavioral health crisis and reduces pressure on emergency departments and jails.
Most of these recommendations are derived from the Memphis Model of Crisis Intervention and the Core Elements document from the University of Memphis. If you are interested in developing a crisis intervention program in your area, I highly recommend the Memphis Model of crisis intervention.
— Captain Samuel Hulse, Bonneville County Sheriff’s Office, Idaho; Chair, Behavioral Health Crisis Center of East Idaho Advisory Board
Collaboration goes beyond mental health providers
The magnitude of societal issues has far exceeded what law enforcement and mental health providers can effectively address alone. To truly bring mental healthcare to our communities, the root causes and treatments need to be examined. Absent such examination, law enforcement is called to respond to the same location over and over and the mental health provider will treat the same individual within their scope, only to have them return a short time later. Establishing flexible but binding partnerships with service providers is essential to developing long-term solutions to mental health inequities in our communities.
A law enforcement agency looking to partner with a mental health intervention program needs to create a strategic plan that is more holistic than simply partnering with the mental health provider. Other service providers that hold pieces to the larger pipeline of effective mental health management are critical to sustainable treatment. Veteran’s Affairs, Department of Motor Vehicles, peer counselors, courts and the Social Security office are only a few of the entities that can provide resources aiding in the disruption of the cycle of a mental health crisis. When a communal response is developed from the inception, the subject experiencing a mental health crisis has a higher likelihood of success as a broader network provides for a variety of needs.
Establishing a network of communal services properly addresses the subject’s needs, relieving the 911 system as the primary portal to access to mental health treatment. The by-product of routing a subject experiencing a mental health crisis to such a network is the reduction in police and ambulances responding to 911 calls generated for a mental health crisis, which better serves the community.
— Lieutenant II Kelly Muniz, Officer In Charge, Crisis Response Support Section, Los Angeles Police Department
A team approach guarantees success
Law enforcement agencies across the nation are a key element of the success of a mental health intervention program. Officers are typically the first line of contact during a mental health episode. Crisis Intervention Training for all officers is paramount. Law enforcement must also collaborate with behavioral health agencies, EMS and fire personnel, schools, universities, the court system, mental health courts, probation and parole, mental health counselors, hospitals and crisis centers.
A team should be developed for early intervention during a crisis episode for individuals in crisis to provide help as quickly as possible. The longer the crises are allowed to continue without proper medication and therapy, the more likely episodes may become a critical situation for all involved. The team should be in constant contact with each other so the appropriate agency is called upon to handle the situation. Not all crisis situations need police response. The relationship between crisis centers and police departments needs to be fostered and maintained.
The relationships of all agencies working together have to be developed through trust, good communication and a common goal for the community you serve. Each agency involved also needs to express its capabilities regarding financial resources and personnel availability.
Agencies have commonly worked as separate entities and have not used a team approach. The efforts to bring a unified team of professionals together to handle each situation will provide a better service to those experiencing a crisis and, hopefully, a better outcome. This model can be used in small or large departments. In larger communities, the team may meet weekly and in smaller communities, where there is not as large of a need, they may choose to meet bi-weekly or monthly.
— James D. Fry, Chief of Police, Moscow Police Department, Idaho
We want to hear from you
If your agency has a mental health intervention team, what have been your successes and challenges? What advice would you have for other agencies? If you are considering starting a team, what questions do you have for our experts? Email firstname.lastname@example.org.
The Council of State Governments (CSG) Justice Center released a framework to help law enforcement agencies across the country better respond to the growing number of calls for service they receive involving this population. Read the document below.