Creation of care response model urged for responding to calls for mental health or behavioral health crises

(Plain Press, September 2022)                         Progressive think tanks and mental health advocates have joined in a collaborative effort to spur the City of Cleveland to speed its implementation of a care response model for responding to calls it receives calls for help with a mental health crisis or behavioral health crisis. Mental Health & Addiction Advocacy Coalition, the Center for Community Solutions and Policy Matters Ohio released a report on August 17^th 2022, titled, “Creating a care response model in Cleveland for those in crisis.”

     The report notes a national trend that involves many communities reducing their reliance on police to respond to mental and behavioral health emergencies and instead implementing a “health first approach or care response.” The report says, “many policymakers and community members see these alternatives as the best way to assist people who need compassion and support, rather than an armed response.”

     The report cited an article by the Vera Institute of Justice titled “Civilian Crisis Response: A Toolkit for Equitable Alternatives to Police” which says, “Civilian responders are often mental health workers, peers with lived experience similar to those of the people needing help, and other specially trained individuals.”

     In advocating for a change in policy, the report cites a Washington Post analysis that says African Americans and Hispanics are killed by police in a number disproportionate to their percentage of the population. The report also cites a 2015 report from The Treatment Advocacy Center titled “Overlooked in the Undercounted: The Role of Mental Illness in Fatal Law Enforcement Encounters” which provides evidence that “at least one of every four police killings ends the life of a person with severe mental illness.”

Current efforts in Cleveland

     The report offers some local context to the need for a care response. This includes the call made to Cleveland Police by the family of Tanisha Anderson for assistance in a mental health crisis. This call resulted in Anderson’s death in the hands of the police officers that responded to the 911 call.  The report also notes some of the crisis response policies and programs already being used in Cleveland. These include specially trained Crisis Intervention Team (CIT) police officers, and a pilot program that pairs mental health workers or social workers with police on patrol.

Examples from other cities

     Researchers advocating for a care response program in Cleveland looked at a number of care response programs around the country. Of the programs described in their report, the Care Assistance Helping Out On The Streets (CAHOOTS) program, which has been operating in the Eugene-Springfield Metropolitan area in Oregon since 1989,  researchers said that this was perhaps the best known program.  The report says CAHOOTS teams are dispatched through the police-fire-ambulance communication center and through a non-emergency number. Each CAHOOTS team consists of a worker with experience in the mental health field and either a nurse or an emergency medical technician. The dispatchers in Eugene are trained to determine which calls are appropriate for CAHOOTS and which calls require a response from an armed patrol officer.

     The researchers cited crime analysis from the Eugene Police Department  that said, “CAHOOTS diverted between 3% to 8% of calls coming to the Eugene Police Department in 2021, with backup from patrol officers required 301 times. The top categories CAHOOTS responded to were non-emergency public assistance calls, welfare checks, and transportation of individuals who were often unhoused or dealing with mental health issues.” The report estimates that the savings generated by the CAHOOTS program were about four times the annual budget of the program.

Recommendations

     In making recommendations that Cleveland change the way it responds to crisis calls, the report says, “For too long, our local governments have relied primarily on law enforcement and the criminal legal system to address community behavioral health challenges. Rather than center the needs of individuals in crisis and connect them to supports built around recovery and stabilization, elected and institutional leaders have designed and perpetuated our system around a punitive model that sees crime, addiction, and mental health as inextricably linked. But as we now well know, the outcomes of this system have deepened inequality, consumed too many of our limited resources, and caused unnecessary harm.”

     The organizations making the report outline several options for funding a care response program and urge the City of Cleveland to “immediately begin to scale up a mobile crisis response pilot based on the care response model.”