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Official Journal of Northwestern Center for Public Safety

The Key

Improving Interactions with the Mentally Ill, Part 1

Successful Social Worker Partnerships

By Caroline Paulison Andrew  // Sept. 5, 2018//

 As one of the few public entities open 24/7, people call their local police for a myriad of reasons, including domestic violence, child abuse, juvenile justice issues, dog fights, and drug abuse. As a result, officers often are asked to efficiently and adeptly perform many roles, from marriage counselor and auto mechanic to welfare worker and friend. But the most difficult involves mental health–related crises. (Lamin)

Ten percent of 911 law enforcement calls involve mental health–related issues. For the families and loved ones of the 10 million US adults living with one or more serious mental health illnesses — schizophrenia and other psychotic disorders, bipolar disorder, and psychopathic personality disorders —sometimes the only solution to a crisis is to call 911. While only 3% of Americans suffer from one of these severe illnesses, they make up more than 25% of all fatal law enforcement interactions. (Maciag)

Even for the most experienced police officers, mental health crises can be some of the hardest calls to handle. “Surveys of officers suggest that they do not feel adequately trained to effectively respond to mental health crises, that mental health calls are very time-consuming . . . and that mental health providers are not very responsive. Officers perceive mental health–related calls as very unpredictable and dangerous, which without adequate training in de-escalation, could inadvertently cause them to approach in a manner which escalates the situation.” (Watson)

In addition to crisis intervention response teams (CIRTs), agencies are seeking better tools and strategies for handling their communities’ mental-health calls to ensure the safety of officers and civilians, to reduce strains on police resources, and to help divert the mentally ill away from the criminal justice system and, instead, toward medical resources. The ideal tools would place the mentally ill back into the hands of the medical profession — and those are the tools that are being developed or tested in agencies today. (Gray)

Partnering with Mental Health Professionals

Police agency collaboration with other community professionals, especially community-based mental health workers, offers several potential tools for increasing safety, reducing strain on police resources, and positively impacting de-escalation. Additionally, partnerships with community social workers can help divert the mentally ill from incarceration.

Even when a city or state requires continued education in mental health — and many do not — it is with extraordinarily rose-colored vision that officials consider eight hours of continuing education every three years, as now required in Illinois, as sufficient training for learning about the types of illnesses that may be encountered, and handling potential interactions. (Bjorhus, LeForge)

In their paper “Police Social Work and Community Policing” published in Cogent Social Sciences, researchers Sylvester Amara Lamin, Consoler Teboh, and John Martyn Chamberlain reported that most officers are not trained for managing situations that involve the mentally ill. Most experience the critical dilemma of “anticipating the potential for an escalation or not, within a constrained window of time.” (Lamin). Agency collaboration with social workers provides the critical, clinical knowledge needed in these situations. As the Lamin study predicts, “collaboration between law enforcement and social workers during police interventions will reduce the amount of avoidable casualties as well as build, or increase, police-community trust.”

“The importance of police collaboration with social workers employed by nonprofit organizations, or within their own departments, cannot be overstated. On a daily basis, social workers and police officers primarily work with individuals from the same populations, facing the same kinds of problems and challenges. . . . Collaboration is of primordial importance as agencies . . . can join together in creating ways to tackle issues that lie beyond the scope of any single organization.” (Lamin)

Police Social Workers
Social workers who work within police precincts practice what is defined as police social work. (Patterson) They attend agency staff meetings, where they can offer professional recommendations on mental health cases and case management strategies. Police social workers possess the critical, clinical experience and expertise for providing on-going, mental health–related training for officers, intervention and de-escalation strategies and techniques, and stress management skills. They can also improve strained officer resources by spearheading case management, identifying types of required intervention or medical care, and locating community mental health resources, including in-patient admissions. (Patterson)

Police Social Workers at Dispatch

Selected by the US Department of Justice (DOJ) and the Council of State Governments Justice Center (CSG JC) as one of ten Law Enforcement–Mental Health (LE–MH) Learning Sites, the Houston (TX) Police Department’s Mental Health Division helps other jurisdictions improve responses to situations involving the mentally ill, from co-response and crisis intervention teams (CITs) to general police-mental health collaborations. (CSG JC)

The Houston pilot program also features a 911 Crisis Call Diversion (CCD) program, which staffs police social workers at the department’s dispatch center. When dispatchers receive calls involving mental health, they quickly connect callers to the center’s social worker, instead of dispatching a squad car. If police services are indeed needed, the social worker knows that the dispatcher can immediately send a police unit or other emergency responder to the scene. In 2017, Houston CCD social workers took more than 59,000 mental health–related calls. For 20,000 of the calls, no police or fire/EMS unit was needed. (Baham)

Houston Police Mental Health Division Capt. William Staney told the CSG JC that he initially thought that the CCD program would divert calls from police and fire, improving financial and human resources. However, he also discovered that “the crisis callers are actually providing better services to the community by making better, more appropriate referrals and getting people better guided help than, perhaps, an officer or a trip to the emergency room [can do].” (Baham)

Even when officers do need to be dispatched, Houston CCD Program Manager Karen Slaton notes, “We’re [also] helping in other ways. We’re getting additional information so the dispatchers and police have a better idea of what’s happening. We’re de-escalating people in crisis so that it’s a stable situation.” (Baham)

Co-Response Programs: Social Workers in Cars

Houston’s Mental Health Division now employs 30 police social workers. In addition to launching a crisis intervention team in 2011, the sheriff’s office of Harris County, in which Houston is located, collaborates with the Mental Health and Mental Retardation Authority of Harris County. As a co-response program, the partnership places social workers with CIRT teams for dispatch to mental health–related calls.

Ann Macleod, LCSW, is the mental health authority program director for the Harris County Sheriff’s Office CIRT teams. “When an officer and a clinician arrive at someone’s home,” noted Macleod to CBS News, “they are very empathetic. They are not charging in. It’s not uncommon for an officer and clinician to sit at a dining room table to talk [a distressed person] through it for an hour and a half. No one needed an arrest warrant. They needed someone to listen.” In Harris County, dispatching social workers with CIRT teams has helped divert nearly 13% of 7,700 emergency calls to treatment rather than to the criminal justice system. (Gray).

Whether a police social worker is embedded in an agency or the police department partners with a community mental health organization in an emergency co-response program, social workers dispatched with officers have been of significant help de-escalating situations and avoiding fatalities or serious injuries by offering on-the-spot insight to officers.

In addition to valuable social-emotional skills, social workers are able to access medical records that are unavailable to officers, an asset that can be of utmost value on the way to a potentially dangerous situation. (Kanno-Youngs) For instance, in one situation in Houston, as related to the Wall Street Journal, the police social worker was able to access a delusional man’s records via her laptop while on route to the scene. She learned that the man suffered from schizophrenia, bipolar disorder, and a history of drug use. This advance knowledge allowed the officer to effectively communicate with the man and ask if he was taking his medication. After the officer ensured he was not armed, the social worker was able to have a conversation with the man, who agreed to go to a hospital.

Houston’s senior training officer in its mental-health division, Rebecca Skillern, told the Wall Street Journal that she has observed that one difference in officers and social workers is that “clinicians will look people in the eye more, where officers are going to be watching their hands. Eyes can’t hurt us but their hands can.” (Kanno-Youngs) §

Part 2, Diversion Strategies & Co-Reponse Program Technology will appear in Issue 8, Nov./Dec. 2018.

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