Around the country, calls for police funding to be redirected to social services have escalated in recent months.
So have questions about whether it’s more beneficial to have trained crisis workers instead of police officers deal with incidents related to mental health.
But experts overseeing mobile crisis intervention units in the Philadelphia area said that “working in conjunction” with police departments is optimal. These partnerships can provide an additional layer of support for both law enforcement and crisis workers, they said.
The work often begins with educating police departments about what people with mental-health issues face, said Shamit Chaki, director of the Crisis Response Center at Einstein Medical Center, which partners with a mobile unit at John F. Kennedy Behavioral Health Center.
“There is no linear direction in how to manage a crisis,” said Chaki, who has helped train the Philadelphia Police Department. “We give police officers tools and a repository of information they can draw from. We want them to be aware that recovery is possible for people in these crises.”
Incidents related to mental health account for 10% of all police calls in the United States, according to a 2015 report by the Treatment Advocacy Center, a national nonprofit focused on making treatment for severe mental illness possible. The same report found that adults with untreated severe mental illness accounted for one in every four fatal police encounters, and were 16 times more likely to be stopped by the police than other people.
America’s first mobile crisis unit was created in Eugene, Ore., more than three decades ago. Since then, the unit’s success has inspired many others across the country, including in Philadelphia, Montgomery and Chester Counties.
The mobile crisis team that Philadelphia’s Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) oversees has had a “strong reciprocal partnership” with the city’s Police Department for decades, said David T. Jones, commissioner of DBHIDS. The team responds to approximately 3,700 crises annually, Jones said, which can come directly to the city’s mental health line or be forward by 911 dispatchers.
In 2018, the department added three mobile units focused on responding to children and adolescents.
“If a caller indicates that they’re calling because they’re feeling lonely and isolated, then our delegates ... make them aware of services that are available,” Jones said. “If the individual is expressing ideas of harming themselves or others, the delegate would keep them engaged and dispatch the mobile team. If they have a firearm and express they’re having thoughts of shooting themselves, the work would also engage the police.”
Jones said it’s not unusual for the caller to ask for a clinician or a trained crisis worker to be on scene.
The mobile team often “act as first responders,” he said. Or, “if the police respond to a situation where they determine that the individual needs behavioral intervention, they call us.”
As researchers warn of a looming mental-health crisis due to COVID-19 — a recent report by the Centers for Disease Control and Prevention found that 11% of adults reported seriously considering suicide in late June — the city’s mobile crisis unit has pivoted to connecting with people in new ways over FaceTime or Zoom, Jones said.
Chester County’s mobile crisis unit, overseen by Holcomb-Chimes Behavioral Health Systems since 2009, receives more than 2,500 calls a month, both directly and through 911 dispatchers, said Sonja Kenney, clinical manager of the unit.
“We’re built to manage most situations without police,” she said. “Contacting law enforcement would be a last resort, like if there needs to be an involuntary hospitalization or there could be violence or danger.”
In Montgomery County, the goal of the crisis worker is to make the caller “feel comfortable and get a sense of what may have prompted them to call,” said Jess Fenchel, vice president of behavioral health at Access Services, which runs a mobile crisis center that serves Montgomery County and surrounding areas.
“It takes a certain amount of bravery to call,” Fenchel said. “We assess their level of safety and ensure some stability. We want to hurry up, and then slow down. We need to get quickly to people, but then slow down a scenario and help them be calm, so they can make the best decisions.”
Montgomery County created the mobile crisis unit in 2013 and has since formed partnerships with “almost all 50” of the county’s police departments.
Vera Zanders, deputy administrator in the county’s Office of Mental Health, Developmental Disabilities and Early intervention, said mobile crisis intervention is one of the most important parts of a robust community mental-health system.
“It’s an essential way to invest funds if we truly want to help individuals be able to recover,” Zanders said. “We want to take the strain off of the police.”
Many emergency response systems across the country aren’t properly trained to respond to behavioral health crises, so overreliance on first responders can put them in scenarios they’re not comfortable with, Fenchel said.
Even when officers do receive mental-health training, they’re “not living ... in that space on how to connect with a person on the hardest day of their life,” said Anna Trout, crisis and diversion director of Montgomery County’s Office of Mental Health.
“That’s an impossible ask of police, but not an impossible ask of the mobile crisis team,” Trout said. “It’s just not their role, and when it’s not someone’s role when the crisis is potentially life-or-death, why would we continue to keep putting them in that situation when we have other options?”