Removing Cops From Behavioral Crisis Calls
October 21, 2020 3:02 AM Subscribe
"It's glaringly obvious we need to change the model" In what will be among the largest and boldest urban police reform experiment in decades San Francisco is creating and preparing to deploy teams of professionals from the fire and health departments — not police — to respond to most calls for people in a psychiatric, behavioral or substance abuse crisis.
Instead of police, these types of crisis calls will mostly be handled by new unarmed mobile teams comprised of paramedics, mental health professionals and peer support counselors starting next month.
San Francisco's new, unarmed, non-police teams are scheduled, at first, to take over the police calls for code 800 – a broad, catch-all category the police describe as a "report of a mentally disturbed person."
Instead of police, these types of crisis calls will mostly be handled by new unarmed mobile teams comprised of paramedics, mental health professionals and peer support counselors starting next month.
San Francisco's new, unarmed, non-police teams are scheduled, at first, to take over the police calls for code 800 – a broad, catch-all category the police describe as a "report of a mentally disturbed person."
This is the heroism some of us once associated with police. This will be a dangerous job. While most mentally disturbed people are not dangerous, many randomly dangerous people are mentally disturbed. The people who take this job are true public servants who will put the public well being ahead of their personal safety. If enforcing control with violence is not an option, you find another way.
posted by InkaLomax at 4:54 AM on October 21, 2020 [14 favorites]
posted by InkaLomax at 4:54 AM on October 21, 2020 [14 favorites]
It is miles better than a police officer initiating contact , but a crisis team that is unable to connect someone to other services isn't very useful in the long run.
From looking at the various proposals here, the main advantage (which is huge and important!) seems to be to deescalate and remove violence from those crisis-response interactions. The level of need for services is so high and even in a "defund the police, spend the money on services" scenario the possible resources fall so far short of the need.
posted by Dip Flash at 5:51 AM on October 21, 2020 [7 favorites]
From looking at the various proposals here, the main advantage (which is huge and important!) seems to be to deescalate and remove violence from those crisis-response interactions. The level of need for services is so high and even in a "defund the police, spend the money on services" scenario the possible resources fall so far short of the need.
posted by Dip Flash at 5:51 AM on October 21, 2020 [7 favorites]
As a counterpoint that surprised me in a conversation with a mother with girls living in a reputedly dangerous public housing development, did not want social services to be the responder as they would "take her children away".
posted by sammyo at 5:58 AM on October 21, 2020 [2 favorites]
posted by sammyo at 5:58 AM on October 21, 2020 [2 favorites]
So rarely is "send an armed person, in constant fear of their personal safety, to bellow orders and accept nothing but submission and full compliance from all involved" what is needed when people need help. I hope this is just the start of a massive shift in how we deal with "people in an emergency" that takes police out of the equation.
Just a sudden thought, but for possibly violent and criminal situations, even then maybe we do not need police. If we sent drones / robots, then the whole "I feared for my safety" would be off the menu and we could avoid a lot of violence. Like in THX 1138, the worst that can happen is you destroy the drone and that goes onto your list of charges.
posted by Meatbomb at 6:18 AM on October 21, 2020 [13 favorites]
Just a sudden thought, but for possibly violent and criminal situations, even then maybe we do not need police. If we sent drones / robots, then the whole "I feared for my safety" would be off the menu and we could avoid a lot of violence. Like in THX 1138, the worst that can happen is you destroy the drone and that goes onto your list of charges.
posted by Meatbomb at 6:18 AM on October 21, 2020 [13 favorites]
Albuquerque's mayor announced something like this back in the middle of June.
But: The"Community Safety Department" would respond to calls "with or without other first responders from the police and fire departments; " the city's survey of residents about the department asked whether responders should have pepper spray, batons, bola wraps, zip ties, or tasers; its first year was budgeted for 40 security officers but few mental health workers; and I think it is taking a year or so to get fully stood up.
posted by NotLost at 6:24 AM on October 21, 2020
But: The"Community Safety Department" would respond to calls "with or without other first responders from the police and fire departments; " the city's survey of residents about the department asked whether responders should have pepper spray, batons, bola wraps, zip ties, or tasers; its first year was budgeted for 40 security officers but few mental health workers; and I think it is taking a year or so to get fully stood up.
posted by NotLost at 6:24 AM on October 21, 2020
If you google "Toronto balcony" most of the top results are about people who "fell" from one after police arrived at their apartment.
posted by The Card Cheat at 6:34 AM on October 21, 2020 [2 favorites]
posted by The Card Cheat at 6:34 AM on October 21, 2020 [2 favorites]
related:
President Trump has signed into law a bipartisan bill to create a three-digit number for mental health emergencies. The Federal Communications Commission had already picked 988 as the number for this hotline and aims to have it up and running by July 2022.
posted by Clowder of bats at 6:52 AM on October 21, 2020 [4 favorites]
President Trump has signed into law a bipartisan bill to create a three-digit number for mental health emergencies. The Federal Communications Commission had already picked 988 as the number for this hotline and aims to have it up and running by July 2022.
posted by Clowder of bats at 6:52 AM on October 21, 2020 [4 favorites]
Fear of child protective social services especially in minority communities is really really real. While low sicioecomic status is NEVER a reason for a referral to child protective services, there's just so many things that kids face so many investigations and the hurdles are just huge even for a case that goes no where, where dcfs doesn't create safety plans or remove children or anything of a serious nature. DCFS requiring a medical exam, or urine tox, or psychological assessment, or even manditory interviews or meetings can really hard a family where a caregiver has a precarious job with haphazard childcare and barely enough to get by. So being afriad of social services is a response to that and a perfectly valid one. I have a young kid and am terrified of DCFS.
It's a beaucratic nightmare.
It's part of the reason why community social services need to be community driven, by people who understand who they are serving, the resources available and how to talk to people.
When I did field work, it took a ton of time (upwards of a year, while litterallty providing housing support) to establish any sense of trust, and even then sometimes it didn't happen. I needed to rely on community partners, time and patience for people to even talk about the things that were going on to be able to address them. This is where these crisis intervention models really fail, because trust and understanding takes so much time.
I've done fieldwork with chronically homeless adults. I've walked into some intense situations. Neither I nor my coworkers were injured in the time I did that work and it's bullshit that police needed to be responding to these things armed ever. I've worked with people with significant criminal histories (up and including murder and sex offenses) alone. The safety issues is simultaneously overblown and minimized . I needed way more training in health issues like when to involve medical personnel and when to leave things be. I had someone have a stroke in front of me, and later someone else had a heart attack, walked in on a couple of overdoses where narcan would have been useful but that really wasn't as much of a thing 10 years ago. Thankfully everybody lived and it's just sheer luck that I didn't find somebody dead. I was paid poorly, my supervisors weren't trained in all that we needed to know, there were tons of issues that now that I've been in the field longer I have much better understanding of how inadaquate what we were doing was, but also at the same time how beneficial it was.
This is a needed service for the problem of over policing but doesn't actually change the structural problems that need to be addressed.
That response was a little long and not quite on topic, so I apologize.
posted by AlexiaSky at 7:07 AM on October 21, 2020 [44 favorites]
It's a beaucratic nightmare.
It's part of the reason why community social services need to be community driven, by people who understand who they are serving, the resources available and how to talk to people.
When I did field work, it took a ton of time (upwards of a year, while litterallty providing housing support) to establish any sense of trust, and even then sometimes it didn't happen. I needed to rely on community partners, time and patience for people to even talk about the things that were going on to be able to address them. This is where these crisis intervention models really fail, because trust and understanding takes so much time.
I've done fieldwork with chronically homeless adults. I've walked into some intense situations. Neither I nor my coworkers were injured in the time I did that work and it's bullshit that police needed to be responding to these things armed ever. I've worked with people with significant criminal histories (up and including murder and sex offenses) alone. The safety issues is simultaneously overblown and minimized . I needed way more training in health issues like when to involve medical personnel and when to leave things be. I had someone have a stroke in front of me, and later someone else had a heart attack, walked in on a couple of overdoses where narcan would have been useful but that really wasn't as much of a thing 10 years ago. Thankfully everybody lived and it's just sheer luck that I didn't find somebody dead. I was paid poorly, my supervisors weren't trained in all that we needed to know, there were tons of issues that now that I've been in the field longer I have much better understanding of how inadaquate what we were doing was, but also at the same time how beneficial it was.
This is a needed service for the problem of over policing but doesn't actually change the structural problems that need to be addressed.
That response was a little long and not quite on topic, so I apologize.
posted by AlexiaSky at 7:07 AM on October 21, 2020 [44 favorites]
The concept of "specialist teams responding to certain circumstances" shouldn't feel radical. It's not like we call up the cops to shoot fires out. Fingers crossed for this.
posted by showbiz_liz at 7:08 AM on October 21, 2020 [16 favorites]
posted by showbiz_liz at 7:08 AM on October 21, 2020 [16 favorites]
Fear of child protective social services especially in minority communities is really really real.
My dad worked for CPS (behind a desk) and he said he felt like at least half the kids he saw removed would have been better off with their parents.
posted by showbiz_liz at 7:09 AM on October 21, 2020 [6 favorites]
My dad worked for CPS (behind a desk) and he said he felt like at least half the kids he saw removed would have been better off with their parents.
posted by showbiz_liz at 7:09 AM on October 21, 2020 [6 favorites]
From June, a long New Yorker article on homelessness in SF: "A Window Onto an American Nightmare: As the homelessness crisis and the coronavirus crisis converge, what can we learn from one city’s struggles?"
posted by Mr.Know-it-some at 7:18 AM on October 21, 2020
posted by Mr.Know-it-some at 7:18 AM on October 21, 2020
YAYYYYY! <--This is what it's like to live in a place you feel actually cares about the people that live there!
For all the flack I catch when traveling & talking to family & strangers in nearly-everywhere-is-"redder than here"-places across the US about the anachronisitically authoritarian-socialist paradise meets hotbed of civil liberities protest and expresssion we have here in SF & East Bay, I say the same about the Bay Area early lockdown and continued COVID response. Both responses could be better, but at this point in the game we're measuring relative rather than absolute best practice. Hopefully it provides a good model to move forward.
posted by rubatan at 7:21 AM on October 21, 2020 [2 favorites]
For all the flack I catch when traveling & talking to family & strangers in nearly-everywhere-is-"redder than here"-places across the US about the anachronisitically authoritarian-socialist paradise meets hotbed of civil liberities protest and expresssion we have here in SF & East Bay, I say the same about the Bay Area early lockdown and continued COVID response. Both responses could be better, but at this point in the game we're measuring relative rather than absolute best practice. Hopefully it provides a good model to move forward.
posted by rubatan at 7:21 AM on October 21, 2020 [2 favorites]
It is 100% true that for this to really work and thrive we will have to completely re-work every one of our mediocre-to-actually-evil social service programs, revamp a lot of extremely racist and philosophically decrepit Social Work/Psychology/Nursing & Medical educational programs, start involving existing expertise in community organization. But one of the very first steps toward all of that is de-normalizing sending police to kill and maim people for being sick, hurt, or just poor. It's a start.
posted by Lyn Never at 7:47 AM on October 21, 2020 [10 favorites]
posted by Lyn Never at 7:47 AM on October 21, 2020 [10 favorites]
This is part of the “Crisis Now” model. The full model is mobile teams; then 23 hour centers; then 3-5 day centers; and only then what we think of as hospitalization. It’s been shown to be effective and is actually cheaper than using police alone. It’s also at least possible to bill Medicaid for some of the services, if the program is set up carefully. I think (hope) the model will spread.
posted by kerf at 8:00 AM on October 21, 2020 [7 favorites]
posted by kerf at 8:00 AM on October 21, 2020 [7 favorites]
This is 100% what people are talking about when they suggest reorganizing local police departments (the poorly named "defund the police" movement). Local police officers have no need (and sometimes, little training) to be dealing with mental health concerns.
The second -- important! -- step of this process is to increase funding to local social service support programs. These are always the first things cut in a recession and are the last thing to ever get any attention, funding-wise. This, despite studies showing that every dollar spent on some of these programs can result in a decrease in incarceration rates (which are always the most expensive thing a govt can do to "help" someone with these kinds of problems and get into trouble with the law).
Every community should contract out behavioral crisis and mental health calls to a third-party trained in these kinds of interventions. Likely to have longer-term, better outcomes and allow the police to focus on real crime and public safety issues. (And at least among those I've talked, many police officers would seem to agree.)
posted by docjohn at 8:37 AM on October 21, 2020 [2 favorites]
The second -- important! -- step of this process is to increase funding to local social service support programs. These are always the first things cut in a recession and are the last thing to ever get any attention, funding-wise. This, despite studies showing that every dollar spent on some of these programs can result in a decrease in incarceration rates (which are always the most expensive thing a govt can do to "help" someone with these kinds of problems and get into trouble with the law).
Every community should contract out behavioral crisis and mental health calls to a third-party trained in these kinds of interventions. Likely to have longer-term, better outcomes and allow the police to focus on real crime and public safety issues. (And at least among those I've talked, many police officers would seem to agree.)
posted by docjohn at 8:37 AM on October 21, 2020 [2 favorites]
I read that police officers typically spend only about 5 percent of their time responding to calls of violent crime.
posted by NotLost at 8:49 AM on October 21, 2020
posted by NotLost at 8:49 AM on October 21, 2020
Good point about budget cuts -- these services should be as difficult to defund (once proven to work) as police departments are. Otherwise every recession will default us back to a police state.
posted by benzenedream at 8:50 AM on October 21, 2020 [4 favorites]
posted by benzenedream at 8:50 AM on October 21, 2020 [4 favorites]
~Fear of child protective social services especially in minority communities is really really real.
~My dad worked for CPS (behind a desk) and he said he felt like at least half the kids he saw removed would have been better off with their parents.
CPS is such a damned-if-you-do-damned-if-you-don't job. There's always this dark spectre of "the one kid you didn't remove from the home ends up dead/molested/beaten/etc." hanging over everything you do. Combine that with understaffing, huge caseloads, and, of course, low pay, and it's amazing anyone goes into the job.
posted by Thorzdad at 9:01 AM on October 21, 2020 [10 favorites]
~My dad worked for CPS (behind a desk) and he said he felt like at least half the kids he saw removed would have been better off with their parents.
CPS is such a damned-if-you-do-damned-if-you-don't job. There's always this dark spectre of "the one kid you didn't remove from the home ends up dead/molested/beaten/etc." hanging over everything you do. Combine that with understaffing, huge caseloads, and, of course, low pay, and it's amazing anyone goes into the job.
posted by Thorzdad at 9:01 AM on October 21, 2020 [10 favorites]
I read that police officers typically spend only about 5 percent of their time responding to calls of violent crime.
I think the more telling metric is that police only close about 2% of the cases that are reported. Management 101 would say "Fire the bottom 10 or 15% and make the standard clearing rate 10% to see immediate gains in productivity"...
posted by mikelieman at 10:19 AM on October 21, 2020
I think the more telling metric is that police only close about 2% of the cases that are reported. Management 101 would say "Fire the bottom 10 or 15% and make the standard clearing rate 10% to see immediate gains in productivity"...
posted by mikelieman at 10:19 AM on October 21, 2020
This model seems to remove police from the default response. One of the benefits of police and crisis teams is having dedicated officers who develop some skills and expertise interacting with people who might need mental health or other medical assessment. Presumably police would be involved on an as-needed basis, based on either the initial call or assessment by the response team on site.
Having seen police and crisis teams work well makes me a little biased against this model, but I'm in a jurisdiction with much less militarization of police, and I appreciate that police involvement probably increases the risk of some terrible outcomes, and provides opportunity for discretionary (i.e., discriminatory) enforcement. Some of the calls they attend would not work without police presence, sometimes because of agitation, and sometimes because of the various legal routes to involuntary assessment in the emergency department combined with the individual refusing to go. (The latter varies among jurisdictions and is a big contentious topic in itself.)
The biggest ongoing gap we have is providing enough support (housing, food, medication, addictions supports, money) after discharge from the emergency department for people with substance use disorders and concurrent psychiatric illness. All that said, the model seems like a very reasonable thing to try, and I'm interested to see how it goes.
posted by sillyman at 11:19 AM on October 21, 2020
Having seen police and crisis teams work well makes me a little biased against this model, but I'm in a jurisdiction with much less militarization of police, and I appreciate that police involvement probably increases the risk of some terrible outcomes, and provides opportunity for discretionary (i.e., discriminatory) enforcement. Some of the calls they attend would not work without police presence, sometimes because of agitation, and sometimes because of the various legal routes to involuntary assessment in the emergency department combined with the individual refusing to go. (The latter varies among jurisdictions and is a big contentious topic in itself.)
The biggest ongoing gap we have is providing enough support (housing, food, medication, addictions supports, money) after discharge from the emergency department for people with substance use disorders and concurrent psychiatric illness. All that said, the model seems like a very reasonable thing to try, and I'm interested to see how it goes.
posted by sillyman at 11:19 AM on October 21, 2020
half the kids he saw removed would have been better off with their parents
Having actually been removed for a period of about 6-months, I could not agree more.
The three places they put my sisters and I were significantly worse - one had feces and urine in the beds. Another basically fed us gruel. We learned very quickly that many people are only involved in fostering for the small sum that they must have gotten for our care.
So - when I had kids - I was terrified of "CPS" ever getting involved.
posted by rozcakj at 3:52 PM on October 21, 2020 [4 favorites]
Having actually been removed for a period of about 6-months, I could not agree more.
The three places they put my sisters and I were significantly worse - one had feces and urine in the beds. Another basically fed us gruel. We learned very quickly that many people are only involved in fostering for the small sum that they must have gotten for our care.
So - when I had kids - I was terrified of "CPS" ever getting involved.
posted by rozcakj at 3:52 PM on October 21, 2020 [4 favorites]
Vancouver has kind of a hybrid model of this (called Car 87) where you can phone a specific number for mental health emergencies and a nurse shows up with a police officer, but even that has one armed person too many in the initial contact. I am fairly newly back to Vancouver, so I'm not sure how well it works or how often it is used.
A few months back a woman was screaming in our alley, which isn't too out of the ordinary for my neighbourhood, so we checked on her from our windows to see if she needed help when it continued (past the usual random yells as someone is passing by) and someone was trying to help her with what was going on, but couldn't really solve her problem (trying to carry a car battery on her bike's back rack with no bungees/tie downs while also very drunk). Anyway, someone in the area eventually called the police and a car showed up and two officers actually dealt with her quite nicely (at this point we started filming just in case) and I think offered to give her a ride home, but wouldn't take her bike or battery with them so she lost it. They called for backup and another car came and it continued, so more backup was called yadda, yadda yadda, and by the end there were NINE police officers in four cars who had shown up to address (and eventually arrest) a woman who clearly (at that time) just needed empathy and a ride to somewhere safe (or further resources to help her) with her bike and her battery. This all took like an hour and a half. I will never be convinced that police are the best or most cost effective way of addressing this kind of issue in our communities - and this was arguably one of the better case scenarios because it never became violent. Glad to see SFO doing this and hope other cities follow suit because wow. It's time.
posted by urbanlenny at 5:40 PM on October 21, 2020 [4 favorites]
A few months back a woman was screaming in our alley, which isn't too out of the ordinary for my neighbourhood, so we checked on her from our windows to see if she needed help when it continued (past the usual random yells as someone is passing by) and someone was trying to help her with what was going on, but couldn't really solve her problem (trying to carry a car battery on her bike's back rack with no bungees/tie downs while also very drunk). Anyway, someone in the area eventually called the police and a car showed up and two officers actually dealt with her quite nicely (at this point we started filming just in case) and I think offered to give her a ride home, but wouldn't take her bike or battery with them so she lost it. They called for backup and another car came and it continued, so more backup was called yadda, yadda yadda, and by the end there were NINE police officers in four cars who had shown up to address (and eventually arrest) a woman who clearly (at that time) just needed empathy and a ride to somewhere safe (or further resources to help her) with her bike and her battery. This all took like an hour and a half. I will never be convinced that police are the best or most cost effective way of addressing this kind of issue in our communities - and this was arguably one of the better case scenarios because it never became violent. Glad to see SFO doing this and hope other cities follow suit because wow. It's time.
posted by urbanlenny at 5:40 PM on October 21, 2020 [4 favorites]
tl;dr but Eugene, Oregon has been doing this for over 30 years (NPR)
posted by neuron at 8:37 PM on October 21, 2020 [1 favorite]
posted by neuron at 8:37 PM on October 21, 2020 [1 favorite]
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I'm in Chicago which is currently facing a real lack of services for homeless due to current events, and rising homelessness, with no answers or city guidance or overflow spaces regards to what to do when people are actually seeking services, much less what to do when people are in desperate need of someone to follow them and connect them with ongoing supports. I can't find a reliable way to communicate, when shelter beds are rare, phones unavailable, mailing addresses non existent or so out of the way that the people who need to use them don't, lack of computer access or education to use computers. Sometimes the only social service contact they have is in the context of crisis and if entrance to supports services can't happen then and there, they go about things just as they were prior to the crisis and will likely reenter crisis.
I hope the outcomes are really good for this. I also hope that they are paying their staff well and providing them resources to make a difference, instead to de-escalation/metabilzation return to streets which seems to be the model that we are using for lots of people. It is miles better than a police officer initiating contact , but a crisis team that is unable to connect someone to other services isn't very useful in the long run.
Its a step in the right direction but there are so so many to go.
posted by AlexiaSky at 4:52 AM on October 21, 2020 [13 favorites]