Description of original award (Fiscal Year 2022, $144,000)
Clearwater Police Department (CPD) officers are often the first point of contact for individuals struggling with diagnosed and un-diagnosed mental health conditions in the City of Clearwater. In many instances, officers encounter the same individuals time and time again. These encounters can become volatile at times, with the threat of harm to both the officer and the person in crisis. Many controversial incidents involving police started as an incident involving a person with mental illness.
Officers often find themselves being criticized for handling such incidents as a criminal matter when the contact should be handled as a mental health call. However, officers are not provided resources or immediate access to resources to handle a mental health call beyond initiating an emergency hospitalization for a mental health evaluation under a Baker Act. This can leave a person suffering from mental illness disrupting a community or create pressure for an officer to “solve the problem.”
Officers unfortunately, by no fault of their own, will often solve the problem by initiating a Baker Act of a person who arguably does not qualify for a Baker Act or by making an arrest of a person when they would not otherwise because of the minor nature of the offense. Even when an officer initiates a Baker Act, a person suffering chronic mental illness is often released after a short period of time and directed to obtain follow-up treatment, that may not be available for up to one to two months. The follow-up treatment often does not occur as the patient may not have the capacity to make sure they schedule the follow-up, or even believe they need treatment in the first place due to their state of mind. This does not provide the best service to the citizen experiencing mental illness and allows the issue to persist without proper attention.
CPD has always been in the forefront of proactive community policing and is committed to addressing the challenges faced by the mentally ill in Clearwater. Currently over 75% of all sworn CPD officers have undergone Crisis Intervention Training (CIT), the Clearwater Police Communication Center personnel have received Crisis Intervention Training for Communications Workers, and the sworn personnel that have not received CIT have all received Mental Health First Aid training. This training has been helpful, but additional approaches to addressing calls involving mental illness is necessary.
In an effort to provide a more appropriate response, the Clearwater Police Department proposes the introduction of a pilot program co-responder model that will pair a police officer up with a mental health professional to respond to calls with persons in crisis and conduct follow-up with persons experiencing challenges around mental health to make every effort to connect the person to the appropriate services.
According to the National Alliance on Mental Illness (NAMI), one in five Americans is affected by mental illness in a given year. An individual who is in the midst of a mental health crisis will no doubt find the first responder to calls for assistance is a police officer. These encounters with law enforcement unfortunately sometimes end with the individual being arrested and jailed. The Stepping Up Initiative, whose mission is to reduce the number of people with mental illnesses in jail, estimates that two million people with serious mental illness are admitted to jails across the country each year. These individuals are much more likely to stay in jail longer and have a higher rate of being incarcerated again in the future than those not affected by mental illness.
According to Miami-Dade County Judge Steve Leifman, one of the nation’s foremost authorities on the criminalization of mental illness, people with mental illnesses in this country will be jailed four to eight times longer than someone without a mental illness. According to the World Health Organization, jails are hardly the ideal environment for anyone suffering from a mental illness. The very nature of a jail is certain to have a negative impact on anyone’s mental health, but particularly on one who is already struggling with mental illness. Some of the challenges for the mentally ill in jail include overcrowding, violence, noise, enforced solitude, lack of privacy, lack of meaningful activity, isolation from social networks, and inadequate health services, especially mental health services.
To address the call categories involving mental illness more efficiently, the Clearwater Police Department partnered with Directions For Living in 2018 to conduct the pilot program, “Mental Health Check Team.” The program was initially structured to focus on a sub-group of “high utilizers” or persons that were the subject of frequent calls associated with mental illness. The team was tasked with making regular, reoccurring contact with this sub-group when the person was not in crisis to make sure treatment was on-going, develop a rapport with the individual, and seek to intervene when necessary prior to a person experiencing a full-blown crisis.
The Clearwater Police Department initially struggled to identify and locate high utilizers, the historical time frame of the data was too long resulting in difficulty locating clients. The team quickly adapted and learned the data needed to be analyzed with a shorter time interval, and be less historical. Directions For Living was a viable partner and exceeded expectations. However, Directions For Living was able to address client needs more efficiently when the client was a patient of Directions For Living. They were able to assist with navigation when the client was not a patient of Directions For Living, but with less efficiency by no fault of the provider. Once the grant funding for the pilot was exhausted, the pilot did not continue due to above listed issues.
In Clearwater, the mentally ill continue to present a real challenge for the CPD and its officers. Mental illness does not discriminate – the people that CPD officers deal with are individuals from a variety of economic, educational, racial, and social backgrounds. Sadly, Clearwater police officers regularly deal with a tremendous number of calls for service involving people with mental health issues. In fiscal year 2020, the Clearwater Police Department responded to “at least” 1,399 calls for service that were mental health related. An analysis of the 2020 call data reveals the most calls related to mental health are received Monday through Friday, between the hours of 8am and 7pm. However, the ability to analyze the data is limited.
The “at least” reference to the data is necessary because many calls involving people with mental illness are classified as petty crimes or other titles that are not easily mined without having an analyst read every police call for service. For example, a call may be classified as a disturbance, suspicious person, trespassing, or a variety of other minor titles. In many of these titles, a person involved may not be suicidal or dangerous, but the person’s behavior may be related to a mental health condition. Officers need an available resource to call to a scene when there may be an underlying mental health condition.
Police contacts with persons suffering from mental illness have the potential to become volatile, as the person may become agitated and resist any attempts of assistance. This can result in officers needing to resort to use of force or in extreme circumstances, SWAT team call-out, to safely secure the individual to submit to an involuntary mental health examination (Baker Act). Neither of these options is in the best interests of police or the individual in crisis, with a tremendous risk of injury to everyone involved. Research has shown approximately 20% of police shootings involve a person who has mental health problems. While trying to reduce the impact on police resources is a benefit this program seeks, the primary goal is to achieve better outcomes and to provide proper treatment to individuals to avoid a tragedy when a person is in crisis.
The Clearwater Police Department seeks to initiate a pilot program that pairs a police officer with a mental health professional that is contracted through Pinellas County and working in collaboration with the Pinellas County Sheriff’s Office Mental Health Unit. The construct of this program that is unique is the mental health professional will be a Pinellas County employee and not affiliated with an individual local provider. This will allow for an agnostic approach to the mental health services, allowing the professional to connect a client to a provider that meets the specific and unique needs of the client. Furthermore,
this program collaboration with the Pinellas County Sheriff’s Office will functionally consolidate this service to avoid creating additional complexity to a provider system that is already underfunded and struggles to meet community demand.
Additionally, due to the unique responsibility of operating a jail that provides medical services, the Sheriff’s Office has multiple partnerships the Clearwater Police Department can leverage through this program, such as the Pinellas Integrated Care (PIC) team which addresses treatment barriers and gaps.
The department proposes assigning two existing officer positions and contracting through the Pinellas County Sheriff’s Office for two mental health professionals. Each officer will be paired with a mental health professional. The City of Clearwater will be assigned to these two teams with the areas of responsibility for one team being Clearwater Police Department Districts I & II, and the other team being assigned Clearwater Police Department District III. The hours of the co-responder teams will be set from an analysis of call data based on when in-progress calls associated with mental illness are most frequent. When not responding to in-progress calls, the co-responder teams will assist and coordinate follow-up with persons suffering from mental illness.
As part of this pilot, the Clearwater Police Department would enact enhancements to the Records Management System (ACISS) and train personnel to capture calls involving mental illness by adding a new data field. This will allow for calls to be reviewed and triaged by the co-responder team. This will guide follow-up contacts for the team to conduct when not responding to in progress calls or calls from officers to respond. Additionally, officers will be able to call the co-responder team to any call involving an underlying mental health issue or utilize the report writing system to make referrals to the co-responder team.
The pilot is proposed to run through the 2021 calendar year at which time the success of the program will be evaluated for permanent implementation. The program seeks to produce better outcomes that reduce the need for repeat calls for service and reduce the number of times standard patrol resources are used for mental health calls. The pilot also seeks to reduce the number of persons entering the criminal justice system for reasons related to mental illness, but statistically will be difficult to track.
The mission of this project is as follows:
Provide an enhanced response to calls for service involving mental illness and more efficiently connect persons needing assistance to available programs.
The strategies of this program are as follows:
Provide an on-duty, co-responder team (police officer and mental health professional) during periods of time when mental illness related calls are more prevalent.
Assist persons suffering from mental illness to get the right level of care on a timetable that meets the individual situation of the client.
The objectives/outcome measures of this program are as follows:
Objective: When available, the co-responder unit will respond at the request of on-scene personnel or to in-progress calls associated with mental illness to facilitate and coordinate client access to services.
Measure: The co-responder teams will seek to handle a minimum of 33% of the calls for service associated with mental illness.
Measure: Review 100% of the recent Clearwater Police contacts with persons suffering from mental illness entered in the Records Management System (ACISS) and evaluate the need to conduct additional follow-up contacts.
Measure: The co-responder team will successfully connect clients to needed services as identified by the mental health professional 100% of the time.
The department would use existing department personnel to staff the two officer positions necessary. The department would negotiate a Memorandum of Understanding with the Pinellas County Sheriff’s Office to pay for the mental health professionals that would serve alongside the officers for the co-responder team. The costs associated with funding two mental health professionals is $144,000 ($72,000 each). The duties and responsibilities and qualifications of the mental health professional is attached to this proposal as an addendum (A).
Should the City Manager or Council wish to proceed, the police department would defer to the Finance Department – Office of Management and Budget for
the recommended funding source. The 2019/2020 contract with the Pinellas County Sheriff’s Office for ancillary police services was underbudget by $161,623, and the City of Clearwater recently had the unencumbered funds associated with this contract returned to the City of Clearwater. The police department request could be satisfied utilizing these funds.
In today’s world, law enforcement having regular contacts with persons who are suffering from mental illness is a given. It is necessary we provide officers with the resources to give proper attention to mental health matters beyond training. Helping those suffering from mental illness get connected to the appropriate services will provide better outcomes for all involved. Institutionalizing a co-responder response for mental health related calls is an emerging best practice. Partnering with the county for this initiative will provide for the best integration with the mental health service community by not creating multiple, overlapping initiatives that add more complexity for the service providers to manage.
Should the City Manager and Council approve moving forward with this pilot, the Clearwater Police Department would negotiate the necessary MOU with the Pinellas County Sheriff’s Office and conduct a selection process to identify and train the personnel to fill the officer positions. The anticipated start date for the Clearwater pilot will be in January 2021.
CRISIS RESPONSE SPECIALIST
Qualifications for the mental health professional are as follows:
• Graduation from an accredited college or university, recognized by the U.S. Department of Education, with a bachelor’s degree in social work, psychology, counseling, or related field
• Graduation from an accredited college or university, recognized by the U.S. Department of Education, with a master’s degree in social work, psychology, counseling, or related field, preferred
• Two (2) years experience in case management, social work, or substance abuse treatment
The functions and responsibilities of the mental health professional are as follows:
• Works in collaboration with law enforcement officers and deputies following their guidance and direction in respect to on-scene safety and protocol; • Responds to in-progress calls with law enforcement officers and deputies in order to determine level of care required for individuals in crisis; • Assists law enforcement when responding to potential individuals in crisis by conducting an assessment, offering effective and efficient interventions, and coordinating care; • Prevents unnecessary hospitalization or arrest of individuals with mental illness; • Assesses individual treatment needs related to psychiatric, medical, social, and emotional care and follow-up after Baker Act/Ex-parte to ensure engagement and access to services; • Coordinates medical response with law enforcement when medical safety is an issue; • Assesses an individual’s risk for danger to self or others and intervenes accordingly; • Exercises sound clinical judgment in determining an individual’s ability to remain safely in the community; • Develops a clinically sound safety plan in the least restrictive setting, only utilizing the Baker Act when all other options have been exhausted; • Develops collaborative crisis treatment and discharge plans that meet the needs of the individual in crisis and law enforcement; • Documents all encounters proficiently by end of shift; • Completes accurate and precise supporting clinical documentation including treatment plans for all crisis individuals responded to; • Staffs cases with supervisors as needed;