…pairing patrol officers with mental health workers…

“It’s like a bad joke,” says Social Worker Carleigh Sailon, “the social worker and the cop go into a bar…” But it’s not a joke, and both social workers and Denver Police officers have come to think it’s a good idea:  Pairing patrol officers with mental health workers to respond to emergency calls in the community.

Denver Police officers have been trained to respond to calls involving people with mental illness for several years.  Crisis Intervention Team (CIT) training began in Memphis, Tennessee in 1988.  It was started by two women in the National Alliance on Mental Illness to help police recognize and de-escalate people in mental health crises.

Family members of people with mental illness can call for help from police and mention… they want a clinician or co-responder…

Now, with a national focus on reforming police responses, CIT training is an asset from the world of mental health.  Family members of people with mental illness can call for help from police and mention they want a patrol team with a clinician, or co-responder, like Carleigh Sailon.  On Denver Police patrol teams, clinicians find themselves on calls involving criminal activity, and police officers find themselves on mental health calls.

Denver Police Sergeant Steven Gonzales says at first it was like having a stranger in the car, then social workers became indispensable.  “There’s no clinician today,” is a lament he hears when a social worker isn’t present. “We realized there’s a mental health feature in everything we do,” says Gonzales, “there’s so much trust now between the clinician and the officer.”

Clincians rotate through the entire police department and become sought after by officers, according to both Sergeant Gonzales and Clinician Sailon.  They also ride with detectives, Special Victims workers (employees of programs that support victims of crime), and Denver Sheriff’s officers.

In the co-responder model, mental health techniques are used on police calls, and police become involved on calls that involve mental health issues.

In the co-responder model, mental health techniques are used on police calls, and police become involved on calls that involve mental health issues.  Clinicians go on evictions calls when there is a mental health component, and they work to de-escalate the encounter for those being evicted.

Sailon says clinicians work to connect folks with mental illness to services that might prevent negative outcomes.  She says they try to be proactive. “We know that typically mental health and drug abuse go together.  People with mental health issues will self-medicate.  We also know that this is a very difficult population to engage, to make an appointment, get to that appointment, follow through with treatment.  …Maybe you lack things like a cell phone or a car.  We have placed two clinicians… to complete the clinical intakes for MHCD.”  They can help people with arranging for therapy and medications.

Sailon says a clinician was placed at a Denver center called The Gathering Place for women experiencing homelessness.  “People expecting homelessness in Denver had a lot of calls to DPD,” she says, “so we put somebody there to try to head off those calls to see if we can deal with this without calling the police.”  The St. Francis Center, which houses homeless adults in Denver, set up an outreach court so that warrants and tickets could be cleared out on scene.  And clinicians also work with a hoarding task force to provide additional resources.

…clinicians also go to jails to talk with the many inmates with mental health conditions.

Sailon and other clinicians also go to jails to talk with the many inmates with mental health conditions.  She thinks of the small army of clinicians as the “second line of defense” after police presence.  “Sometimes, despite our best efforts a crime has been committed and [a mentally ill person] winds up at the city jail.  I would go in,” says Sailon, “I would speak with them.  I would also conduct the clinical intakes inside the jail.”  She also works to provide some services upon the release of inmates with mental health concerns.

Working with mentally ill people to try to guide them through outpatient community services has a flip side for family members of people who are severely mentally ill.  One of the most challenging circumstances they experience is their effort to have police respond to their loved one by putting the ill person on a 72-hour mental health hold because they believe their loved one is a danger to themselves or others.

‘There’s nothing more frustrating than stand-in in front of a parent who knows their child is struggling and I cannot do what the parent wants me to do.’

Sergeant Gonzales says he has some flexibility in these cases, referencing psychiatric nurses in emergency rooms.  Sailon says one of the realities for clinicians is that they are bound by laws that require them to see dangerous behavior before they can put a person on a mental health hold.  “There’s nothing more frustrating,” she says, “than standing in front of a parent who knows their child is struggling and I cannot do what the parent wants me to do.  There is no worse feeling… because [the parent clearly knows their] child.  [The parent] know[s] they’re not well. But they have to reach a certain level of risk in order for me to be in my legal rights to essentially take their rights away, and send them to the hospital against their will.  That is not easy.”  One legislative effort to address issues related to grave mental illness and mental health holds is legislation from Senate Bill 19-222, “Concerning the improvement of access to behavioral health services for individuals at risk of institutionalization.” The new law has a has a multi-year time line to be rolled out. It calls for more services across the board for people with severe mental illness.  For some families this new legislation is enormously important in trying to prevent their gravely ill loved ones from disastrous inattention.

Sailon says a five-year study is underway to measure the effects of clinical intervention in the lives of people with mental illness who find themselves in the criminal justice system.  Overall, she says, the results look promising.  Sailon hopes more funding becomes available for programs that are targeted at working with mentally ill people before they become involved in police responses.