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As movement grows to reduce police involvement in mental health crisis calls, Virginia legislators try to figure out a statewide model

As movement grows to reduce police involvement in mental health crisis calls, Virginia legislators try to figure out a statewide model

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Marcus-David Peters had just left his job teaching high school biology and arrived at his second job at a hotel, where he worked as a security guard, when he apparently began to experience a mental health episode.

The 24-year-old Black man left the hotel naked, got into his car, and then crashed it off the side of a highway in Richmond in 2018. A police officer who witnessed the crash saw Peters climb out of the car window. The officer fired his Taser at Peters. When Peters, who was unarmed, advanced, the officer fired two gunshots into his stomach, killing him.

“My brother Marcus-David Peters absolutely deserved help, not death,” said his sister, Princess Blanding.

Peters’ killing highlights the dangers of sending armed officers to mental health calls. His death, along with those of others across the country who were shot by police, have renewed calls for reform about how to respond to people who are experiencing a mental health crisis.

Among the more promising alternatives that cities across the country, including in Virginia, have adopted or are experimenting with is sending mental health professionals instead of police officers to certain 911 calls. The Virginia General Assembly is working on legislation that would create a statewide mechanism mandating localities to implement what is being called a Marcus Alert system. Named after Peters, the new protocol would dispatch counselors to 911 calls when a person has a mental illness, developmental disorder or substance abuse issue.

“Hopefully the law will help ensure that people who have mental health crises are met with the appropriate resources and support and aren’t just locked up or put in jail or the back of a cruiser,” said Del. Jeff Bourne, D-Richmond, the patron of one of the bills.

Medical event not crime

Since protests occurred in May across the country following the police-custody killing of George Floyd in Minneapolis, numerous cities have announced plans to develop programs to have counselors take the lead on certain 911 calls. Advocates of using civilian responders say they can keep interactions from escalating into violence and divert people from jail and toward social services. Additionally, police would be freed up to focus on other crimes.

Mental health-related 911 calls comprise a very small percentage of police calls for service. However, those calls can absorb a disproportionate amount of officers’ time. They may spend several hours helping just one person, especially if that person requires hospitalization because of threats of self-harm or harm to others.

These calls can also be intense and deadly. A Washington Post analysis found that about 1 in 4 fatal police shootings involved someone with a mental illness. These killings leave people asking if the person would be alive today if police weren’t involved.

But that is the current system in most cities in the United States today. If a loved one is having a mental health crisis, a family member dials 911 and the police respond.

“The situation shouldn’t be the family is afraid to call for help, and that’s too often the case when we have set up a law enforcement response, and the responder has to be law enforcement,” said Lisa Dailey, director of advocacy at Arlington-based Treatment Advocacy Center. “There are going to be families that are afraid to call 911 and call in an emergency, and that’s really a failure of the system when there’s not anyone you can call without being afraid it could lead to the death of the individual.”

Many of these existing alternative programs still incorporate law enforcement. Some agencies have units entirely composed of officers who are highly trained to handle mental health calls. Other cities pair police with social workers. Some models don’t have police respond at all unless requested. Advocates of these alternative programs say that police — no matter how well trained or if they have a social worker at their side — can still escalate a situation or result in someone put in jail.

Dailey said there is limited data from the different models to draw conclusions about what works best.

“The appropriate response to a mental health crisis should be medical and not law enforcement,” Dailey said. “There are circumstances where law enforcement would be necessary to have as backup or if it’s a particularly dangerous situation. We certainly agree that the response should be tailored to the idea that what is happening is a medical event and not a crime.”

Different models

Prince William County is preparing to launch a co-response program next month that pairs clinicians with police officers.

“We wanted to find something to help deter people from having to go to hospitals, to help people in the community without going to an in-patient facility if we could,” said Heather Baxter, emergency services program coordinator for the county’s Community Services Board. “Getting emergency services clinicians on the ground at the scene would help the most. For police officers, the longer they have someone in custody, the more likely an incident will occur.”

The results were encouraging from a pilot effort by the Prince William Community Services Board and the police department. So the county provided $900,000 in funding to support continuing the program, which will include three clinicians and three officers who are trained and more skilled in handling mental health-related situations.

If someone dials 911 or a non-emergency number, the dispatchers ask questions to identify the situation . If it’s a mental health call, the mental health unit will respond . Upon arrival, the officer will make sure the environment is safe, and then the clinician will go in to help the person. The mental health unit follows up to help connect those involved with resources and direction toward getting needed care .

Lt. Mike Day, who oversees the Prince William County police department’s involvement in the co-responder program, has noticed a difference in interactions with people when the mental health unit handles the calls.

“We’re trying to make the person we’re dealing with feel comfortable, encourage them to talk to us and put them in an environment where they feel safe, and that’s often where they live,” Day said. “By not removing them from their home or taking them somewhere they don’t want to be, which can strip them of their dignity and reinforce a stigma, we can really meet them where they want to be. We’re getting back into that mindset of what’s in the best interest of the person we’re dealing with.”

The Roanoke County Police Department had a pilot program from 2016 to 2019 that was similar to the model used in Prince William County. Police would go to mental health-related calls, and then officers would make a determination whether to summon a clinician to the scene. Clinicians would then follow up with the person to provide information about available resources.

The Center for Evidence-Based Crime Policy at George Mason University studied Roanoke County’s pilot program.

Clinicians served about 100 people through the pilot, but most of them did not follow through with using any of the resources available to them. The ones who did seek treatment, however, had fewer subsequent police interactions.

“So there seems to be an indication that it’s not just about getting a medical professional at the scene of a crisis,” Roanoke County Chief of Police Howard Hall said. “It’s about finding ways to keep the patient or the victim engaged in some type of mental health service, to mitigate whatever the illness may be.”

Other programs across the country have far less police involvement on some calls, or none at all. Eugene, Oregon, is thought to have started the first such program in 1989. CAHOOTS — which stands for Crisis Assistance Helping Out On The Streets — handles about 20% of the 911 calls and has saved the city, home to the University of Oregon and about 170,000 residents , millions of dollars in police and emergency room resources, according to the program.

Under this model, when calls such as welfare checks, public intoxication and mental health episodes come in, a nurse or emergency medical technician along with an experienced mental health worker head to the scene. The team called for backup for 150 of the 24,000 calls it handled in 2019 — less than 1%.

The Eugene program has received national attention in recent years, with cities working to establish the same model.

Bills under consideration

The state House of Delegates and Senate are still working out the terms of creating a statewide mandate to overhaul how law enforcement agencies respond to mental health crisis emergencies.

SB 5038, sponsored by Sen. Jeremy McPike, D-Prince William, provides more flexibility to localities for how they set up their programs and how police interact with the situation. Bourne is the patron of the House bill, HB 5043, which limits police involvement and has more criteria for officers to follow if they do have to respond to a situation.

“Too often when someone is in a mental health crisis or has an intellectual or developmental disabilities and police are the first ones on scene, particularly if that individual is from a marginalized community, just that officer’s very presence can be escalating in that crisis,” said Sen. Jennifer McClellan, D-Richmond, who sponsored a version similar to Bourne’s that lacked support from other senators. “If we don’t begin to move toward a model where a trained mental health professional whose sole job is to de-escalate that crisis and deal with that crisis, and we leave it just to law enforcement, more and more people will be harmed or killed.”

McPike’s bill would require localities to have a Marcus Alert response system in place by 2022. Bourne’s proposal phases the programs in gradually, with all of the localities having them by 2026.

The state’s Department of Behavioral Health and Developmental Services and the Department of Criminal Justice Services will both be involved in establishing protocols for these programs.

McPike’s bill more closely aligns with the behavioral health department’s STEP-Virginia plan to provide essential mental health services uniformly across the state.

Part of that plan includes setting up a 24/7 crisis call center and framework for teams to handle mental, behavioral, substance abuse and brain injury emergency calls.

“Those that are suffering from different mental health, development disabilities or crises need to have the resources to get the help they need before they come into contact with the criminal justice system,” McPike said.

Bruce Cruser, executive director of Mental Health America of Virginia, has praised the legislation for its goals to help get people the care they need.

“This is an incredible, significant step forward in addressing the mental health needs of our communities,” he said.

The two chambers are likely to vote on a final version this week.

“The Marcus Alert system will never bring my brother Marcus-David Peters back,” Blanding said. “However, it will ensure that people who are experiencing a mental health crisis or suspected mental health crisis as evident by atypical behavior receive help, not incarceration, that they receive help, not death.”

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