Law enforcement | Mental Health

From “What If” to Real Results

U.S. Police Departments Explore Innovative, Collaborative Ways to Address Growing Mental Health Crisis

By CSG Justice Center Staff

March 29, 2018

“What if when somebody calls 911 and says, ‘I want to kill myself,’ we had somebody who was a suicide counselor and we could transfer that call to them,” asked Lieutenant Brian Bixler of the Los Angeles Police Department (LAPD).

These questions arose after visiting the Houston Police Department (HPD)’s Mental Health Division—1 of 10 Law Enforcement-Mental Health (LE-MH) Learning Sites selected by the U.S. Department of Justice and The Council of State Governments Justice Center—and witnessing the department’s 911 Crisis Call Diversion (CCD) program in action. The program places mental health professionals in the 911 dispatch center, giving operators the chance to quickly connect callers who have mental health-related issues to counselors instead of or in addition to dispatching a police or fire/EMS unit.

“What if somebody called 911,” Bixler continued, “and we had [the person speak to someone] who could de-escalate [the situation] or talk to them in an appropriate way to get them the help they needed, instead of sending a police car?”

These “what-ifs” led Lt. Bixler, Officer in Charge of the LAPD Crisis Response Support Section—which is also a LE-MH Learning Site—to gauge whether something like the HPD model, but focused mostly on suicide prevention instead of all mental health-related calls, could be implemented in Los Angeles. Within months, he was talking to the County of Los Angeles’ mental health provider/subcontractor, Didi Hirsch Mental Health Services, to determine what it would take to create a program within LAPD’s 911 system that embedded a suicide prevention counselor in the call center.

“If you’re a 911 operator, you [can] have comfort with that [counselor] sitting next to you,” he said. “And if they need police service, and we need to dispatch a unit, [the dispatcher is] right there. . . and we can get police resources or emergency resources out to that person as needed.”

By the end of 2017, Lt. Bixler was talking to the LAPD communications division to develop protocols and seek funding for the program. But he was also working to change the thinking of some of his fellow officers who might be worried about the perception that officers were “walking away” from an emergency by diverting the calls to mental health professionals.

“It’s not traditional,” he said. “It’s not what [officers] like to do, but most of the time when we see people who call [about hurting themselves], they are reaching out for help. They want help. And the people that are really good at talking them down are trained suicide prevention counselors.”

For inspiration, Lt. Bixler once again turned to Houston’s program to find out what did and didn’t work when it came to integrating counselors into their 911 communications system.

It’s not traditional. It’s not what [officers] like to do, but most of the time when we see people who call [about hurting themselves], they are reaching out for help. They want help. And the people that are really good at talking them down are trained suicide prevention counselors.

Lieutenant Brian Bixler

of the Los Angeles Police Department

A Model for Success

The HPD began implementing its CCD program in March 2015 after having its own “what if” conversations with its longtime partner and local mental health provider, the Harris Center for Mental Health and Intellectual and Developmental Disabilities (IDD). The program, which now embeds six mental health phone counselors in the Houston Emergency Center, was a natural outgrowth of the police department’s successful partnership with the center.

“When we looked at the types of calls that were coming into the police department . . . they were very similar to the calls that we would receive on the crisis line at the Harris Center,” said Harris Center program director Jennifer Battle. “So one day, we said, ‘well, you know, it seems like an unfortunate utilization of resources to have officers go out to these calls that the crisis line is [fielding] all day long, every day, using mental health and counseling skills as opposed to law enforcement.’”

After being awarded the Justice and Mental Health Collaboration grant from the Bureau of Justice Assistance and securing additional private funding, HPD’s CCD officially launched in March 2016. The program features counselors who are available seven days a week, from 7 a.m. to 2 a.m. to work with people who call 911 for a mental health-related issue to possibly de-escalate the situation, connect callers to services, and otherwise help them find a solution that may not involve a police response.

In 2017, CCD phone counselors responded to more than 59,000 mental health-related calls; for approximately 20,000 of those calls, dispatchers did not have to send fire/EMS or a police unit out to the scene. In addition to those calls, another 24,000 calls resulted in a police response, but with the counselor still providing assistance—an unexpected benefit from the program initially implemented to provide more alternatives to police response.

“The program is called diversion, but it’s not all about diversion,” said Karen Slaton, the CCD Program Manager. “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.”

And when in these crises, officers have benefitted from having the phone counselors involved—it’s clear no one is “walking away” from an emergency. Officer Jason Garcia, part of HPD’s Mental Health Division, recalled a time when he was grateful a CCD counselor was there to help de-escalate a potentially dangerous situation.

“There was a man supposedly calling in to purposely get killed by a police officer. He had a machete in his hand and kept saying that he wanted to die, and he wanted the police to shoot him,” Lt. Garcia said. “The CCD counselor was able to talk him into putting the machete down and to just walking out of the home [calmly] and [being] placed into custody without any struggle. And [the officers] were able to get him to the hospital, get him the help he [needed], and avoided a situation of having to draw down on him just because he has a weapon in his hands.”

The CCD counselor was able to talk him into putting the machete down and to just walking out of the home [calmly] and [being] placed into custody without any struggle. And [the officers] were able to get him to the hospital, get him the help he [needed], and avoided a situation of having to draw down on him just because he has a weapon in his hands.

Lieutenant Jason Garcia

of Houston Police Department’s Mental Health Division

After Overcoming Initial Challenges, Unforeseen Benefits

The LE-MH Learning Sites programs have successfully hosted law enforcement agencies from around the country that are interested in learning more about successful police-mental health collaborations focused on improving responses to mental health-related calls for service. Prior to the CCD’s implementation, the HPD regularly hosted site visits from agencies interested in creating or expanding their own police-mental health collaborations. Now, the CCD program is included in those visits along with HPD’s other mental health collaboration programs, and organizations such as the LAPD are benefitting as a result.

The development of the CCD program hasn’t been without its growing pains—such as initial difficulty creating the logic tree that determined if a call was eligible for diversion—but the gains have been a net positive overall, and the lessons they have learned since launching the program have been invaluable, said HPD Captain William Staney.

“We thought that we’d divert calls from the police department and the fire department and that would save a lot of money and free up a lot more time,” said Capt. Staney of HPD’s Mental Health Division. “But [an additional value] we found [was] 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].”

Slaton agreed that the increased services are a good thing for everyone involved.

“Most of the calls we get are from people who are concerned about someone they care about. They just know that their loved one needs help, so they want someone to get there as quickly as possible,” Slaton said. Adding mental health counselors to dispatch centers is important for the sake of these loved ones, she said. “Just because someone calls 911 doesn’t necessarily mean that [a police response is] the most appropriate option for them.”