Santa Barbara County Achieves Success with Joint Mental Health Response Teams | Mental health care in crisis

Lenny Marcus came home from work one night about six years ago to find his grown son unconscious, sitting on the floor of his Goleta home, surrounded by his own vomit.

Marcus recalled how his son, then 24, could barely speak; he knew they would have to go to the hospital to pump out his son’s stomach.

Sometime before the drive to the hospital, law enforcement arrived and insisted that deputies drive him to the hospital instead of his family picking him up.

“My son was drunk, crazy, saying inappropriate things and the police got mad at him,” Marcus recalled of that night.

Law enforcement eventually agreed to follow the family to the hospital, he said.

“They followed us to the hospital and the officer was very inappropriate,” Marcus said. “Eventually the hospital staff told the attendant he had to wait outside because he was causing trouble between my son and the staff.”

Marcus said deputies responded to his house in Winchester Canyon multiple times, seeing a problem in his mentally ill son’s behavior when he himself didn’t realize he had a problem.

“My wife was scared to death to call the police because she was afraid they were going to come and shoot my son,” he said. “You read about it all the time in the papers, where people get shot by the police because they don’t realize they’re mentally ill.

“Something that a mentally ill person thinks isn’t a problem, the police think it is.”

This case was before Marcus took a National Alliance on Mental Illness (NAMI) course and learned about Santa Barbara County’s Joint Response Teams, which pair a Behavioral Health Clinician with a specially trained law enforcement deputy to respond to mental health crisis-related 9-1-1 calls.

“The collaborative response is the best thing the county has ever done in my opinion,” Marcus said. “I strongly believe in that. In my opinion, this is the only thing the county has gotten right when it comes to mental illness.

The Collaborative Response Team began as a pilot program in 2018 and was so successful that when grant funding for the pilot program expired in October, the county decided not only to continue funding it permanently, but to increase staffing to three teams.

In the collaborative response model, the deputy responder and clinician work together for a 10-hour shift and respond to crisis calls with the goal of preventing unnecessary hospitalizations or arrests for mentally ill people during a crisis.

“If a call comes in that sounds like it’s mental health and not a crime, the team starts to engage with the individual to find out what’s going on,” said Tony Navarro, director of the Division of Behavioral Health.

“They work with the individual to get them into a shelter, get them home and make sure these people don’t go to jail.”

Crews have responded to 1,707 calls since the start of 2020. Only 3 percent have resulted in arrests, according to data obtained by Noozhawk.

Of the calls teams responded to, 28% were cases where the person had committed an arrestable offence. Of all the calls the teams responded to, 96% were diverted from an arrest.

“Our goal here is to help them,” Navarro said. “For 40 years without this cooperation, people with co-occurring disorders or mental illnesses have been thrown into prison too many times.”

Joint response teams have responded to the Marcus household several times since the family learned about the program. On one occasion, Marcus’ son had a “real meltdown” in his room, throwing a bat at the walls and screaming at the top of his lungs.

“So I called 9-1-1 and asked for a joint response team,” he said. “They came with three police cars, talked to (my wife and I) in the dining room and talked to my son outside.

“They basically just talked him out of it. They knew how to reason with him and how to help him.”

The program aims not only to divert people from prison when possible, but also to divert them from the criminal justice system as a whole and redirect them to the appropriate resources.

Just over 35% of collaborative response team meetings were proactive engagement and follow-up with people who have a history of mental illness.

“We could have a 15-year-old kid threatening to shoot up a school, and what we can do is have a team come out two days a week and play basketball with him,” said Dr. Cherilyn Lee, manager of Sheriff’s Conduct Division Science Division.

“We developed this amazing, evidence-based, common sense program and took it to our community to make it work. Our mission is not to punish people for being mentally ill, our mission is to provide support so they can live their lives outside of the mental health system.

Although joint response teams have been a proven success in Santa Barbara County, Behavioral Wellness and the Sheriff’s Department had to learn to bridge the two different cultures to build this working relationship.

“Law enforcement and behavioral health departments have different cultures, so we really had to learn how to work with someone from a different culture,” said John Winkler, chief of crisis services at the Department of Behavioral Health.

“Because the relationships are built, we on the mental health side are really learning how to communicate better with law enforcement so that we don’t just feel like we’re riding in someone’s car — we’re in the car together.”

The mission of law enforcement is public safety, and the mission of behavioral health is personal safety, Lee explained, adding that sometimes those things conflict.

“Behavioral health tends to focus on the person, law enforcement focuses on the situation and the world around them,” she said. “There will be some clashes, but now we can agree to disagree, whereas before we would have just disagreed.”

“There is constant back and forth, learning and growing between the teams, but we really need each other to be effective. It’s really encouraging because you have psychologists talking and cops and we’re starting to use the same languages. We are light years ahead of most agencies, counties and communities.”

Because there aren’t enough joint response teams for 24/7 coverage, the Department of Behavioral Health is looking at ways to expand the program and hopes to add a fourth team in the near future, said Suzanne Grimesi, a department spokeswoman.

In some California jurisdictions, the joint response team also includes firefighters and paramedics, which is something the Department of Behavioral Health is exploring for Santa Barbara County, said John Doyle, the department’s assistant director.

Some communities have cut law enforcement out of the collaborative response model entirely, but that’s not something the Department of Behavioral Health sees happening here.

“I wouldn’t take law enforcement out of the collaborative response model,” Navarro said. “In Santa Barbara, that’s not going to happen because I really see the safety value of having law enforcement.

“Law enforcement gets a lot of training on the signs and symptoms and how to divert people.”

Lee agrees.

“I don’t think the partnership will ever be perfect, and I don’t think it should be,” she said. “But the fact that we’re doing it together is embedded in the community, in the stories and the letters and the thank-you notes.”

— Jade Martinez-Pogue is the author of Noozhawk. You can reach Se at .(JavaScript must be enabled to view this email address).

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