Using Information-Sharing Protocols During Crisis Situations
With interagency information-sharing protocols in place, officers are better positioned to effectively respond in a crisis situation when quick decision making is crucial. These protocols help ensure officers know what information they can and should be collecting on scene, when and how this information can be shared with their PMHC partners, and how to access behavioral health information from their partners in crisis situations. Further, the materials and training provided to officers before they encounter a situation better position them to request a person’s consent to access their personal health information on the scene and to assist in connections to treatment and follow-up care.
Keeping Reference Materials On Hand
Law enforcement officers and behavioral health personnel may find it useful to carry brief reference materials with them to answer questions as they arise about when it is appropriate and legal to share information about a person or encounter. These materials can include decision trees, brief guidelines, or summaries of the agency’s established policies and procedures that are designed for quick reference and ease of use under the variety of circumstances staff are likely to face in the field.
The following reference materials have been created or used by jurisdictions across the country to support their officers on scene. These resources can be used as templates for any community seeking to begin or strengthen their efforts.
- International Association of Chiefs of Police’s Fact Sheet on Training Officers to Effectively Assess and Respond to Persons Experiencing a Mental Health Crisis
- San Antonio Police Department’s Manual on What Officers May Encounter and Should Look for When Arriving at the Scene for Someone who is Exhibiting Symptoms of Mental Illness
- Seattle Police Department’s Manual on Responding to People Who are in Behavioral Health Crisis
- The U.S. Department of Health and Human Services’ Pocket Guide for First Responders and Law Enforcement on the Family Educational Rights and Privacy Act (FERPA)
- The U.S. Department of Health and Human Services’ Pocket Guide for Law Enforcement on the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule
Collecting Information On Scene with Standardized Forms
When law enforcement officers are able to capture important information about a person experiencing a mental health crisis on scene, it better positions them to engage their PMHC partners and facilitate any needed follow-up care. Standardized reporting forms can enable officers in collecting critical information during an encounter such as demographics, observations, and responses to screening questions. These forms help ensure that each person’s on-scene information is accurately collected, which can then be logged into the appropriate record-keeping system and used to facilitate follow-up care. Standardized materials may also guide decision making by law enforcement and behavioral health staff as they determine how to appropriately handle a situation.
The following forms have been created or used by jurisdictions across the country to help officers record information on scene. These resources can be used as templates for any community seeking to begin or strengthen their efforts. Note: While most mental health information collected by a law enforcement officer does not meet the criteria for protected health information, jurisdictions should work with their local counsel to ensure that any information they collect is handled in compliance with relevant laws.
- Charlotte, North Carolina’s CIT Report Form
- Chicago, Illinois Police Department’s Mental Health-CIT Report Form
- Jones County, Mississippi’s CIT Contact Form
- Los Angeles, California Police Department’s Field Checklist, Referrals, and Relevant Information for Incidents Involving Persons Suspected of Suffering from Mental Illness
- Rockingham County, Virginia’s Transfer of Custody Form
Using Consent/Authorization Forms On Scene
Rarely, it may be necessary for an officer to obtain written consent in the field, such as in a rural jurisdiction. In these cases, while on scene, an officer can request, and a person can grant, written permission to release their personal health information by signing a consent form. When these instances occur, extra care should be taken to ensure an individual understands the consent is being provided. To do this, some law enforcement agencies train officers to recognize scenarios when requesting consent may be appropriate and provide them with strategies for introducing these forms while on the scene. Once authorization is given, behavioral health partners and officers can share relevant health information about the person to facilitate connections to services and follow-up care.
The following forms have been created or used by jurisdictions across the country to help officers obtain consent to release or share personal health information on scene. Note that 42 C.F.R. Part 2, which governs privacy for substance use disorder patients, has specific requirements for authorizations to share patient information. These resources can be used as templates for any community seeking to begin or strengthen their efforts.
- Douglas County, Kansas’ Multi-Agency Consent Form for the Release of Confidential Information
- Los Angeles Police Department’s Authorization for Medical Release
- Portland, Maine’s Community Provider Network Authorization for Release of Information
- Salt Lake City, Utah Police Department and Community Connection Center’s Informed Consent Release Form
Contacting a Designated Mental Health Professional
In some jurisdictions, officers seeking guidance on managing an encounter with a person who appears to have a mental illness or who may be experiencing a mental health crisis may contact a designated mental health professional. These mental health professionals have access to a mental health provider’s database where they are able to view information about the person’s mental health history.
One way that officers may contact a designated mental health professional is through existing community resources, such as a crisis line. Within Harris County, TX, officers from the Harris County Sheriff’s Office and Houston Police Department may contact the crisis line operated by The Harris Center for Mental Health and IDD to request guidance from crisis counselors who can access their agency’s database to view information about a person’s mental health history.
Another approach, triage desks, are an emerging trend in this area set up specifically to guide officers during these encounters. The Los Angeles Police Department’s (LAPD) triage desk, or mental health information desk, is staffed by an officer and a mental health nurse. When a responding officer contacts the triage desk, the assigned triage officer consults the department’s database to determine if the person has any history of police contacts in Los Angeles. The designated mental health nurse can access the Los Angeles County Department of Mental Health database to also identify if the person has a case manager, psychiatrist, or if they have frequented any treatment centers in the county.
Equipped with this information, designated mental health professionals can then determine what information to share with the responding officer to support them in appropriately managing the encounter while abiding by established policies and privacy regulations.
The following websites provide more information about these efforts.
- Comprehensive Psychiatric Emergency Program, The Harris Center for Mental Health and IDD
- Houston Police Department’s Mental Health Division and contact information can be found on the Houston Police Department Law Enforcement-Mental Health Learning Site webpage.
- LAPD’s triage desk and contact information for their Mental Evaluation Unit can be found on the Los Angeles Police Department Law Enforcement-Mental Health Learning Site webpage.