New St. Louis program to divert mental health calls away from 911

An accompanying co-responder program will partner behavioral health professionals with officers

By Robert Patrick
St. Louis Post-Dispatch

ST. LOUIS — If all goes according to plan, thousands of 911 calls beginning next month will not reach St. Louis police or fire personnel.

Calls involving people with mental health issues, or in a mental crisis, may instead be diverted to specially trained behavioral health professionals.

Tiffany Lacy Clark, COO of the contractor involved in the program, Behavioral Health Response, said the broader goals of the program are to relieve police and EMS workers from responding to many mental health crises, to prevent people undergoing a crisis from going to jail or the hospital, and to help people obtain behavioral health services when needed.

Lacy Clark called the program "cutting edge" and a "tremendous positive collaboration" among the city, police, mental health providers and others.

St. Louis will be the first city in the U.S. to divert such calls outside the 911 system, officials said.

"We're very excited about it," St. Louis Mayor Lyda Krewson said this month.

The new initiative will have two parts: 911 diversion and a co-responder program.

911 diversion

911 calls involving a mental health concern typically end up with a response by police or an ambulance, and often "neither is really the appropriate place," said Lacy Clark.

In the 911 diversion program, dispatchers will be trained to send calls that don't involve imminent health or safety concerns to Behavioral Health, which already offers telephone counseling and mobile outreach services.

Wilford Pinkney Jr., Krewson's director of Children, Youth and Families, said as many as 5,000 calls could be diverted this way a year.

Krewson said the city handles roughly 700,000 calls to 911 per year, although only about a third result in someone being dispatched, due to the number of duplicate calls that are received for some incidents, and other factors.

The program could save money but Krewson said that is not the primary aim. "The goal is to have a better, more appropriate person responding," she said, and allow emergency responders to do "what they're most trained for."

Both Krewson and Lacy Clark said police were looking forward to the program. Calls involving mental health problems are difficult, take considerable time and place officers in situations they're not trained for, they said.

Pinkney, a former New York City police officer, said officers are generally young and "don't have the life experience to deal with many of these issues." Calls for a mental disorder or breakdown can be traumatic for officers and victims as well, he said.

Lacy Clark said those with mental health issues sometimes don't respond well to authority figures or people in uniforms. Often they are contending with paranoia or have had trauma in the past that they associate with police, she said. People who are having those kinds of episodes have typically fallen away from available social services or have stopped taking their medication, she said.

"We have essentially made the criminal justice system and law enforcement officers mental health providers without the training and resources to do that successfully," Lacy Clark said.

Krewson said not every call with a mental health concern will be diverted, and authorities may not know what is needed until they arrive at the scene. If there is a safety or public health issue, police and EMS would respond, perhaps with a co-responder showing up with them, or later.


The rollout of the co-responder program follows years of work.

Lacy Clark said she and others, including a staffer from the mayor's office, began working in 2017 on ways to better provide mental health services and keep those suffering a mental crisis out of the criminal justice system. Pinkney, she said, "was the catalyst we really needed" to pull all the people together, and his police background allowed him to "speak the same language" as officers.

Pinkney said they looked at other programs around the country including in Houston, Phoenix and Charleston, South Carolina. There have also been two pilot programs run in the police department's Sixth District in north St. Louis. The pilots, originally called "cops and clinicians," paired police with volunteer mental health workers, substance abuse counselors and others who helped connect victims of crime with social services.

Krewson said that after the trials, officials decided, "We really need to make this a part of the system ... to fund it."

At Krewson's request in June, the Board of Estimate and Apportionment shifted $860,000 to the program from the budget for the St. Louis Medium Security Institution, also known as the workhouse, amid a decline in the jail population.

In October, the board approved a contract with Behavioral Health Response.

Co-responders will be trained behavioral health professionals who will work in partnership with officers, Lacy Clark said, and will cover the entire city. Their primary focus is behavioral health support and referral, but they will also respond to domestic violence calls and other traumatic situations to "make sure the people on the scene are OK and connected to additional support."

Krewson said that when someone is in a mental health crisis, it means "all the social systems have failed. That ends up in a 911 call."

She said the city needs more money for mental health services, crisis services and substance abuse treatment.

"When you're in the middle of so much trauma ... and a pandemic and so many people out of work," Krewson said, "there's a lot of stress out there and we're seeing this come out in so many ways."

In 2019, a mentally ill man had an encounter with police and EMS at a St. Louis bus stop that led to his hospitalization and, later, his death. He was a former client of Lacy Clark's when she worked for Places for People, a provider of mental health services.

The Post-Dispatch examined the man's medical and treatment records after his death, with the permission of his father, and wrote about Julius Graves last September.

"The situation with Julius was exactly why we wanted to do this," Lacy Clark said, so that police dispatchers can recognize a situation and officials can respond differently, "to save someone in that circumstance so they don't get tased or arrested and (instead) end up in clinical services where they're supposed to be."

NEXT: Lessons learned from implementing a co-response police-mental health team

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