Gresham PD: Averting mental health crises
A specialized team within the Gresham Police Department helped de-escalate a mental health crisis earlier this year that otherwise might have spiraled into a dangerous situation for officers and a community member in need of a little extra help.
Gresham officers had responded to calls about a family dispute involving weapons. The focus of the 911 call was Jack — his name was changed by the department to maintain privacy. Jack lives with his mother, who told police that her son frequently suffers from persecutory delusions, which cause him to rarely leave his room.
Officers turned to the Gresham Service Coordination Team to take the helm. The team, which was formed two years ago, calmed the situation and got Jack to agree to attend an emergency session with his regular therapist, scheduling an appointment for him.
But they didn't leave it there. Unlike their colleagues on patrol, the Service Coordination Team is able to continue checking in with clients like Jack. They learned he had two additional run-ins with police the following week, resulting in non-voluntary hospitalization.
More assistance was needed. So team members used their contacts to set up a schedule of phone meetings with a mental health provider for Jack. They also located an intensive case management provider for him and his mother so wraparound care could be provided.
Rather than allow Jack to fall through the cracks, and potentially end up in the prison system, the Gresham Service Coordination Team dedicated the time needed to make a difference.
"Oregon doesn't have a spectacular mental health system — its sub-par frankly," said Gresham Officer Ralph Godfrey. "We are up against a wall, but we keep working every day to improve things in our community."
The team was formed in 2017 through a partnership between the Gresham Police Department and Cascadia Behavioral Healthcare. It is a joint police and clinician response team that answers 911 calls related to mental health crises in the city of Gresham.
The idea was sparked when Godfrey started advocating to different people about a need for more mental health support. While serving on patrol, he kept running into situations where someone was in crisis. But because of the constraints of his job, he couldn't dedicate the hours needed to adequately help them.
"Mental health work is time intensive," he explained. "Sometimes it takes hours to help somebody."
While leadership in the department and City Hall were receptive to his ideas, the funds weren't there to move forward with a specialized team. But a Bureau of Justice Assistance grant bridged the gap and allowed Gresham to move forward with the Service Coordination Team.
"As a team, we will follow up and make sure we can coordinate services if a crisis persists," said Sgt. Tommy Walker. "We can decide if they need to go to the hospital or if they need access to better resources."
The team consists of Walker, Officers Godfrey and Chris Anderson, and Madison Zimmerman, a certified mental health clinician who works full time out of the department. They work with clients referred to them by officers who flag any interactions or cases that involve mental health.
"We know we can't arrest our way out of mental health issues," Walker said. "We need to meet the community where they are at with the necessary resources."
Peter was referred to the Gresham Service Coordination Team because he had begun to call 911 repeatedly for non-emergencies and there were signs he might overdose on his prescription medication.
The officers and clinician reached out for a wellness check, and learned Peter was missing meetings with his regular therapist and was struggling financially in a barren apartment. The team coordinated his case by reconnecting him to mental health services; signing him up for veteran's benefits; and finding him housing security support.
"What we do is even more critical during COVID-19," Zimmerman said. "We get a lot of calls from health providers because they won't go out to visit their clients, and they don't know what the living conditions are like."
There has also been an uptick in mental health crises this year as some struggle with the new normal brought on by the pandemic — therapy and counseling sessions are done over the phone or online. The team offers an in-person connection, and Officer Anderson said he has been texting to check in on a few clients so they still feel tied to the community.
The entire Gresham Police Department has been more focused on mental health in the past few years. All officers receive 24 hours of training, with 20-30% of the patrol force trained to a higher 40-hour course. That allows those on patrol to better identify and respond to community members in need and avoid situations that nationally have led to deadly outcomes.
"Our approach is every officer should be able to recognize a mental health crisis for what it is — that is what citizens expect and deserve," Godfrey said. "This team has the follow up aspect and we can take more time with people."
Any 911 calls with a mental health concern is flagged for the team. Officers complete a mental health nexus after responding to calls that also direct clients to further support. The crises range from delusions, hearing things, veterans struggling with PTSD, substance abuse and suicidal thoughts. They work with the chronically mentally ill, and those with emerging mental illness.
"We are dealing with situations where clinicians often will not respond to on their own," Walker said. "This team is able to help everyone in our community regardless of their needs."
Over a nine-month period, from June 2019 to March 2020, Gresham police responded to 1,890 calls for service involving a mental health concern — or 3% of all 911 calls.
With the team in place, positive outcomes have begun to occur, including diverting the mentally ill from jail. Of the 1,890 calls with a mental health component, only 6% of incidents resulted in an arrest. Instead, citizens with mental health issues were four times more likely to go to the hospital.
Following a mental health 911 call, the team coordinated follow-up services for 180 clients in that nine-month window. The youngest client was 8 years old, while the oldest was 79 — the average age was 40 years old.
"There are cases where a crisis happens and leads to 20 emergency calls in one night," Godfrey said. "We can follow up the next morning, connect them with services and stop tying up the 911 system."
Despite the success of the program, there was some concern it would be shuttered due to funding concerns. The grant ran out earlier this year and with the city's massive budget deficit and looming cuts, it appeared the Service Coordination Team wouldn't see the end of the year.
But the group was able to get another 3-year grant, which will allow them to bring on a second clinician to improve coverage.
"With more people on this team we can help even more," Zimmerman said. "Right now things can still fall through the cracks, so having more support will be nice."
The ultimate goal would be to identify a steady source of funding for the team so they won't be left with white knuckles every time the grants run out. Walker mentioned making the clinicians fulltime city employees and expanding the hours of operation. He also would love to see enough officers assigned to the team to allow for different shifts.
"Theoretically, in three years we may have to say goodbye to this program," Godfrey said. "Our work is important, and we want to see it continue long into the future."
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